National Nurses United

Violence_FNL with art 12/9/10 11:38 PM Page 14 As any registered nurse can tell you, violence at work can take many different, unexpected forms. It can be the belligerent, drunken 20-something who needs stitches in the ER, or the disoriented, elderly lady in post-op who scr atches and tries to bite you every time you change her dressing. Maybe it's not physical, but a verbal threat to hurt you after work. Sometimes it's not even the patient, but the patient's family members who abuse the medical staff. But workplace violence in medical settings does have one thing in common: it's prevalent, and rising quickly. The Joint Commission, the federal body that accredits hospitals, in June warned that since 2004, the database it keeps of sentinel events on hospital grounds had significant increases in reports of assault, rape, and homicide, with the greatest number of reports from 2007 to 2009. The healthcare industry has the highest rates of workplace violence among all sectors, constituting 45 percent of the two million incidents that occurred annually in the United States between 1993 and 1999, according to the U.S. Bureau of Labor Statistics. And a survey released in July 2009 by the Emergency Nurses Association reported that more than half of all emergency room nurses had been physically assaulted at work, which includes being spit upon, hit, kicked, pushed or shoved, and scratched. Anecdotally, RNs are reporting that conditions have worsened in the past five years because patients are more prone to lose control. Due to the Great Recession and massive layoffs which have resulted in even more patients losing health insurance coverage and mental healthcare, people are stressed out, desperate, and more agitated when they enter the hospital or seek help from the emergency room. Several severe attacks on medical providers have captured headlines recently. In late October, a patient inmate at a jail in Martinez, Calif. faked a seizure and smashed a lamp into the head of responding RN Cynthia Barraca Palomata, killing her. In June, Joan Meissler, an emergency room RN at Temple University Hospital in Philadelphia, was badly beaten by patients. A psychiatric technician at Napa State Hospital in California was strangled by a patient in October. And in September, the son of a patient shot a Johns Hopkins Hospital doctor before turning the gun on his mother and himself. "It's all part of inadequate healthcare for people and especially the lack of mental health," said Patricia Eakin grimly. Eakin is an emergency room registered nurse who works with Meissler at Temple University Hospital and is president of the Pennsylvania Association of Staff Nurses and Allied Professionals. "People don't have a family doctor or social safety net, so they come to the ER, and the wait times are huge." In response to workplace violence, many National Nurses United affiliate groups are working to help prevent the incidents from happening in the first place through better staffing, and to ensure that incidents that do happen are prosecuted or handled seriously. Some RNs who are currently bargaining contracts are seeking to include model workplace violence language into their agreements. Another route for groups is to pursue legislation in their respective states. Following Palomata's death, the California Nurses Association worked with California Assemblymember Mary Hayashi to introduce a bill, AB 30, that would assure RNs have adequate staffing and safety measures at work. Staffing, say RNs, is critical to minimizing violence because not only is the physical presence of more nurses a deterrent to someone who might cause trouble, but more nurses also ensures that patients and their families receive quality care and attention, keeping frustration levels down. In Massachusetts, the law already treats any assault on an emergency medical technician while the technician is providing care as a separate crime with its own set of penalties. The Massachusetts Nurses Association in spring helped pass a law that extends those same protections to nurses. MNA is also still working on additional pieces of workplace violence legislation. Pennsylvania RNs are also considering introducing legislation. Meanwhile, they are tackling the problem through education. Eakin said that RNs at Temple have been complaining to management for years about inadequate security and problem patients, but that the hospital never took their concerns seriously. For example, after one impatient man repeatedly confronted an ER triage nurse about getting examined and then threatened to "blow [her] f****** head off with a shot gun" when she got off work, the security guards simply told the man that he "shouldn't be rude to the nurses. " Eakin ultimately filed a class action grievance against Temple around the time Meissler was attacked. Once she started doing research into workplace violence for nurses, she learned it was a major issue for RNs all over the state. So on Nov. 10, PASNAP decided to hold its first statewide workplace violence conference for unionized as well as nonunion RNs, an event so well attended there was standing room only. The Massachusetts Nurses Association presented its continuing education course on workplace violence, the RNs shared stories, and district "Many nurses and healthcare professionals were led to believe that being attacked at work was 'just part of the job' or that 'the patient didn't know any better.' There was a general misbelief that as caregivers, they had no right to stand up for their own safety." Listen to Nurse Talk radio's segment on workplace violence at www.nursetalksite.com. 14 N AT I O N A L N U R S E 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 NOVEMBER 2010

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