According to National Nurses United 8 in 10 Nurses have experienced some level of workplace violence over the past year. Incase you prefer things in percentages this is 80%. In the US alone 20 nurses per year are considered workplace homicides. Violence on nurses has become so common that it has simply become “part of the job”. Healthcare facilities report they are providing education to staff that includes Gentle approach and encouragement to report. Nurses are reporting, however nothing tangible is ever done.
As a nurse of over 20 years I have reported numerous bites, punches, threats, and being choked on one occasion. In most instances these behaviours are repetitive by a patient until it involves another patient being anssaulted and family members threatening legal action if the situation is not dealt with. The issue in many Long Term Care homes is where do you move them? An unfortunate fact about Long Term Care homes is they are a “catch all” for all types of patients. On many occasions we were receiving patients after being in jail. People that are mentally ill that have been homeless for many years. Recovering addicts. The list goes on as there really isn’t anywhere to put many people that are unable to care for themselves so they fall into Long Term Care. So you have a situation where you have around 4 women typically on a unit to 50-60 patients. This is usually a nurse and 3 PSW’s. When you picture people moving into LTC I’m sure the first image that comes to mind is a sweet little lady in a wheelchair, and while there are a few of them there are also several people coming in as young as 30 years old. Some of these patients are ambulatory, disoriented, violent, and strong! If the patient is deemed an emergency admit the facility has to admit them if they have the space. So we are admitting violent patients in to live among “our sweet little old ladies” and skeleton staff.
When a violent act occurs there is a process to follow. Do you require a hospital visit? Next is the report. The report typically makes you feel worse than the actual incident. The first question being- How did you approach the patient? Followed by what could you have done differently to prevent this event from occurring? And what have you learned from this event? Are you kidding me? So I get to writing the report Mrs Smith was singing along and I greeted her and she smiled at me, I gave her the medication and she bit me. (For example) The report is dropped in the box and nothing is ever done despite multiple reports of different occurrences with the same patients. LTC is very clear that it’s always the workers fault and that you should have done things differently. I was once grabbed from behind and choked by a patient. No blame on them, they had severe dementia. I did not approach this individual nor did I engage them as I didn’t see them coming. This patient was large and another case of better placement such as supportive housing where they are better equipped for a patient of this size and level of behaviour. The beds are just not available and the funding to have adequate staffing is not available so many patients and staff are suffering from this.
Since Workplace Violence is now considered our new norm as Nurses what can be done about this? At this point all we can do is advocate for change. Many nurses simply leave the field, but for those of us who were born to be Nurses this just isn’t an option. Nurses are aware that when you come into the emergency department you are typically feeling your worst, you are in pain, you are scared, and this is the last place you want to be. You are sitting in a room full of people and feel forgotten, but please know that Nurses are just trying to do their best.
A sad but great read.
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