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Drug-affected teen allegedly bit hospital nurse in vicious assault

Gold Coast Bulletin, 29 Dec. 29, 2015. Australia
Patients attack sends two nurses to hospital.
CBC News. Dec. 17, 2015 (Canada)
Hospital patient arrested after assaulting nurses, staff members.
Live 5 News. Sept. 3, 2015. (USA)
Nurses beaten up in ward.
Sowetan Live. August 5, 2015. (South Africa)
These are just a few of the news headlines about violence against nurses from across
the world, and the incidence seems to be increasing. It occurs most commonly in
Emergency Departments and at long-term care facilities, and with patients who are mentally
unstable or under the influence of alcohol or drugs.
The National Institute for Occupational Safety and Health (NIOSH) defines workplace
violence as any physical assault, threatening behavior or verbal abuse occurring in the
workplace. Violence includes open as well as hidden aggression and ranges from verbal
abuse to homicide.
The American Nurses Association is taking a firm stance on violence against nurses and,
in July 2015, issued a policy statement Incivility, Bullying, and Workplace Violence. In it,
the ANA advocates the development of evidence-based strategies to prevent and take
action to lessen the effects of incivility, bullying, and workplace violence to promote the
health, safety, and wellness of registered nurses and other health care workers.
The British Columbia Nurses Union in Canada has launched a hotline for nurses assaulted
on the job. According to the President of the Union, nurses have a higher rate of workrelated assault than police officers. The Emergency Nurses Association recognizes violence
against nurses as a serious occupational risk which requires action by employers, law
enforcement, and the community.

The Emergency Nurses Association recognizes violence against nurses as a serious

occupational risk which requires action by employers, law enforcement, and the community.
With increasing workplace violence, what can need to know and what they can do
during these situations?

1. Never accept violence as part of the job

Studies have shown that many incidents of violence against nurses are not reported. One
of the reasons might be that nurses accept violent behavior as part of the patients problem
He couldnt help it, She was drunk. Another reason might be a real or imagined belief of
indifference on the part of management or fear of being dismissed if they speak up.

Jaime Aragon is a retired community health nurse who was nearly killed in 2008 when a patient
stabbed him multiple times. Image via: pef.org
When a nurse is injured in an assault, the incident should be managed as for any other
work-related injury as required under laws dealing with health and safety in the workplace. It
should be reported and investigated, and the nurse must be provided with the necessary
treatment, including trauma counseling if required.

2. Take action after an assault

If you have been assaulted, remove yourself to a safe area and ask a co-worker to stand in
for you. Call for security back-up or police assistance as necessary. Report the assault to
your supervisor as well as to your union. This can initially be done verbally, but you should
follow up with written reports. Exercise your civil right of reporting the incident to the police.

Ask your supervisor to arrange for medical attention according to institutional policy for
injuries on duty. Also, ask for trauma counseling to prevent Post Traumatic Stress Disorder.

There are several reports of nurses suffering post-traumatic stress syndrome after an attack
and being unable to return to work. One nurse with over 30 years of experience in ER had
suffered many attacks, but after having been strangled with her stethoscope, she felt that to
keep herself safe, her only choice was to end her career. She stated that there had been no
support from co-workers and management. The incident was taken lightly, and no one cared
when she resigned.
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Keep personal copies of all your reports, photographs of your injuries, as well as a diary of
all related events (who, what, when, where, how) before, during and after the incident.
Return to work only once you feel safe and confident.

3. Support co-workers who have been assaulted

A violent assault has a severe impact on the victim which is often not acknowledged or
understood. It leaves the person shaken, confused, fearful and with a loss of selfconfidence. It would be of great help to this person to have someone in their corner to guide
and assist in reporting to management, writing up incident and police reports, and even
accompanying her to the doctor and the court.

Talk to someone about it.

Nurses could advocate for implementation of such a peer-based support system which has
been used very successfully in helping the person feel safe, valued and respected.

4. Advocate for adequate organizational policy

All organizations should have an adequate policy and other measures in place to deal with
acts of violence. Unfortunately, based solely on statistics of incidences rather than the real
and hidden costs, many organizations do not view this as a priority.

Its not part of the job!

Nurses within an organization can advocate for improved policy. This policy would include
preventive measures such as reporting of incidents and follow-up investigation which could
point to possible causes (e.g. understaffing) and ways in which similar incidents can be
avoided. Other techniques include training of staff in techniques for de-escalation of
violence; as well as flagging of patient records where there is a potential for or a history of
violence. The policy should further highlight how incidents of violence should be managed,
including the support which must be given to the staff member involved. Human resources
departments should be responsible for ensuring that the policies as carried out.
Assistance in dealing with the employer can be obtained from the Nurses Union or
Association and the ideal timing for advocacy would be when a recent incident is still
grabbing attention.

5. Join nursing groups advocating for legislation

Because of the wide-spread concern about increasing violence against nurses, nursing
organizations across the world are seeing this as a priority issue and lobbying for stricter
laws and penalties for incidents where nurses are assaulted. Every nurse should support
this actionwithin their own area of influence.