Issue link: https://nnumagazine.uberflip.com/i/117874
Follow the healthcare provider���s recommendations for treatment and work restrictions. Workplace Violence Legislation: Nursing Considerations and Critical Thinking the bedside rn���s experience, judgment, and authority to control the nursing process in the environment of care should be given great consideration and weight when designing and evaluating systems to minimize or eliminate hazards for the protection of patient and professional interests. Critical incident analysis is required to examine a significant or pivotal occurrence to understand where the system failed. Researcher Phyllis L. Crocker of the Cleveland-Marshall College of Law writes that ���the nexus between poverty, childhood abuse and neglect, social and emotional dysfunction, alcohol and drug abuse, and crime is so tight in the lives of many capital defendants as to form a kind of social historical profile.��� Historically, nurses have recognized the organic connection between the socio-economic determinants of health and behavior. Patients may have a diminished decision-making capacity and moral culpability within the context of a change in their health status, which can trigger emotional volatility and behavioral impulsivity. They may lack the judgment and foresight of consequences due to significant neurological and cognitive deficiencies. While not excusing violent behavior per se, these limitations can set the psychological stage for violence; at the same time they make patients less morally culpable for their actions. The ultimate punishment of charging a patient with a felony (felonious assault) is considered contrary to the idea of fairness in our justice system, which accords the greatest punishments to the most blameworthy. Patients, because of their impairments, by definition may have diminished capacities to understand and process mistakes, to engage in logical reasoning, and to understand the intentions and reactions of others. Improving safety for patients and staff requires a systems approach that includes holding the owners, administrators, and managers accountable for modifying unsafe conditions in institutional settings. The following states have laws in place requiring Violence Prevention Programs: California, Illinois, Maine, Massachusetts, New Jersey, New York, Oregon, and Washington. In addition, the following states have laws that increase penalties for those convicted of violence against healthcare workers: Alabama, Arizona, Colorado, Hawaii, Illinois, Massachusetts, Nevada, New York, North Carolina, New Mexico, and West Virginia. In July 2010, Massachusetts enacted a law that increased penalties for those who assault nurses and other healthcare workers. The bill was filed by the Massachusetts Nurses Association, who conducted a major study of workplace violence in response to the increase in workplace violence in healthcare settings. Existing Massachusetts law treated assaults on emergency medical technicians while they are providing care as a crime with penalties. The new law extended this protection to nurses and other healthcare providers. Thoughtful disagreement and controversy has ensued regarding the ultimate effectiveness of this legislation in preventing assaults in healthcare settings and protecting healthcare workers. The Maine State Nurses Association (MSNA) /National Nurses United RNs were instrumental in securing passage of workplace MARCH 2012 violence prevention legislation in response to the increasing incidence of violence in hospitals. MSNA nurses sponsored and won legislation to address and prevent this growing problem. ���An Act to Enhance Security of Hospital Patients, Visitors, and Employees��� was signed into law summer 2010. The bill requires hospitals to adopt a safety and security plan that includes a process for hospitals to receive and record incidents and threats of violent behavior as well as protections for employees who report them. ���This is a step in the right direction,��� according to Terrylyn Bradbury, an emergency room nurse at Millinocket Regional Hospital. ���Hospitals need to take every measure possible to protect nurses and employees from violence at work. In our Professional Practice Committee (PPC), we are now working on implementing a workplace violence prevention training program.��� At Calais Regional Hospital in northeastern Maine, nurses have been concerned about their safety and the safety of other employees. This is especially true in the special care unit, which is behind closed doors.�� There is potential for a dangerous situation to occur if a nurse is unable to get out of the room to ring the staff assist bell.�� The PPC has won approval to order personal alarms the nurses can carry in their pockets, assuring that timely help is never out of reach. ���I supported this legislation, and campaigned to get it passed, so all Maine nurses would be safer at work,��� said Anne Sluzenski, an RN at Calais Regional Hospital. ���Passing this bill was a good first step, but we must remember there is always room for improvement when it comes to making ourselves and our patients safe.����� National Nurses United staff is working with U.S. Sen. John Kerry of Massachusetts on introducing a federal bill to address violence against healthcare workers. The bill would be similar in intent and language to one introduced this year into the California Legislature by the California Nurses Association titled: The Healthcare Worker Protection and Workplace Violence Prevention Act. Specifically, the bill would: ��� Toughen existing statutes requiring hospitals to have safety and security plans in place by expanding the types of security considerations hospitals must make when developing and updating their plans; requiring better employee training and education on how to prevent and respond to violent acts; and, requiring hospitals to have systems to adequately respond to, investigate, and report acts of violence against employees. ��� Protect employees who have been victims of workplace violence by ensuring they are provided evaluation and treatment, and retain the right to seek assistance and intervention from local law enforcement. ��� Require hospitals to report incidents of workplace violence to the state. ��� Authorize the state to impose administrative penalties against hospitals that fail to comply with workplace violence laws. ��� Require the Correctional Standards Authority to develop standards for safety and security plans designed to protect healthcare personnel in state and local correctional facilities, including correctional treatment centers, from aggression and violence. ��� Prohibit a hospital from prohibiting an employee from, or taking punitive or retaliatory action against an employee for, seeking assistance from local emergency services or law enforcement when a violent incident occurs. 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