National Nurses United

to deal with problems; family dysfunction; poor emotional attachment to parents or caregivers; lack of supervision G ��� Gang affiliation or preoccupation with street gangs; admits to being in gang (potential for drive-by, retaliatory, felony-related shootings); wears ���colors��� (black or blue typical of Crip-related gangs, red typical of Blood-related gangs) or logos (BK-Blood killers, CK-Crip killers); graffiti/tattoos on books/body; use of hand signals E ��� Exposure to and/or history of violence: exposure to domestic violence, child abuse, community violence; history of violence against animals, humans (especially intimate partner), or property R ��� Rebellion and poor socialization skills: intimidating and bullying behaviors; uncontrolled anger; narcissistic, antisocial, paranoid, and/or schizoid personality traits; terroristic threats O ��� Obsession with violence: preoccupation with music, movies, Safety Tips for Nurses Ideally your facility should be providing comprehensive training for all staff in violence prevention. The basic safety tips listed below are not a substitute for such training but can help you build an awareness of and simple measures to take to mitigate violence in your workplace! WATCH FOR SIGNALS THAT MAY BE ASSOCIATED WITH IMPENDING VIOLENCE: Verbally expressed anger and frustration Body language such as threatening gestures Signs of drug or alcohol use Presence of a weapon video games, writing and/or art with violent themes; violence-related apparel; weapons collection; frequents a firing range or owns firearm; stockpiling ammunition; committing acts of violence; ���warrior (pseudo-commando) mentality��� U ��� Underachievement and other school/work problems: low interest in school/work, poor academic/work performance; history of discipline problems; truancy; job-related difficulties S ��� Substance abuse: alcohol, marijuana, abusing heroin, cocaine, amphetamine, LSD, PCP, or inhalants RN Template for Problem Solving cna/nnoc/nnu contracts have created new standards for RNs and patient protection. A crucial part of quality patient care is ensuring adequate hospital staffing to avoid putting patients at risk and driving nurses out of the profession. CNA/NNOC/NNU representation provides RNs with the tools to have a real voice in patient care decisions, which we use to create safer healthcare facilities to protect our patients, our licenses, and ourselves. The Professional Practice/Performance Committee (PPC) is a staff RN-controlled committee with the authority to research, analyze, and document unsafe practice issues. The PPC has the authority to recommend specific actions to management to resolve problems and power to make real changes. The PPC is an elected, staff RN committee with representatives from every major nursing unit that meets in the facility on paid time and tracks conditions of concern to RNs through an independent documentation system called the Assignment Despite Objection (ADO). The PPC is a forum through which nurses and nursing concerns can be translated into effective action. If your facility does not have a PPC, you should discuss your concerns with your peers and make sure your facility implements an effective violence prevention program. PPC Collective Advocacy in Action MAINTAIN BEHAVIOR THAT HELPS DIFFUSE ANGER: Present calm, caring attitude. Don���t match the threats. Don���t give orders. Acknowledge the person���s feelings (for example, ���I know you are frustrated���). Avoid any behavior that may be interpreted as aggressive (for example, moving rapidly, getting too close, touching, or speaking loudly). BE ALERT: Evaluate each situation for potential violence when you enter a room or begin to relate to a patient or visitor. Be vigilant throughout the encounter. Don���t isolate yourself with a potentially violent person. Always keep an open path for exiting. Don���t let the potentially violent person stand between you and the door. TAKE THESE STEPS IF YOU CAN���T DEFUSE THE SITUATION QUICKLY: Remove yourself from the situation. Call security or the police, as circumstances require, for help. Report any violent incidents to the management and your labor representative 20 N AT I O N A L N U R S E Prepare a violence prevention care plan for staff nurses: Recognize and name the experience of abuse, assault, lateral and/or horizontal violence, bullying, coercion, and moral distress Affirm the personal and professional obligation to act and commit to addressing the experience. Actively participate in professional activities to expand knowledge and understanding of the impact of assault and workplace violence. Develop skill, through the use of mentoring and resources, to decrease the risk that you and your colleagues will experience assault, workplace abuse, and violence. Implement strategies to accomplish desired changes in the work environment while preserving the personal integrity, and credibility from which nurses derive their authentic power. Become familiar with and use your professional, institutional, and union���s resources to address, mitigate, and prevent workplace violence. PPC Documentation: Educate and Mobilize RNs must educate and advocate for their profession and their patients by reporting to their PPC, through use of the Assignment Despite Objection form (ADO), all acts of violence, whether intimidation, verbal threats, or actual physical attack. Also RNs must notify their employer using issue reports, incident reports, and other verbal and/or written reporting to put management on notice and give them the opportunity to correct the unsafe situation. Be sure to keep a copy for your own records. Notify the police, and enlist the support of your labor representative to alert the appropriate regulatory, licensing, and accreditation agencies as circumstances require. Documentation establishes a database and W W W. N A T I O N A L N U R S E S U N I T E D . O R G MARCH 2012

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