Once you graduate from nursing school and start your first job, it doesn’t take long for you to realize that the days of “perfect” SIMS lab patients are gone—and you’re not prepared for it.
Unfortunately, dealing with volatile patients (not to mention families), stressed-out coworkers and hot-headed doctors are things that most nurses are left to confront for the first time all on their own and without much prep. So what can you do to stay safe?
Know Your Environment
Nurses who work in the emergency department and psychiatric units have an increased risk of exposure to violence. Med-surg and outpatient clinic nurses can also experience violence in the workplace. Short staffing and the reduced use of patient restraints in healthcare facilities also put nurses at risk. The potential for violence can occur any time a nurse interacts with a patient or the patient’s family. A nurse can be attacked while caring for a demented patient or one suffering with delirium from medication or recreational drug use, psychiatric disorders or hospital psychosis.
If you’re a new nurse, especially in psych, remember that each patient diagnosis and each medication can have multiple reactions that can cause a patient to lash out at those who are caring for them. Some healthcare facilities offer training courses that teach nurses how to defuse and manage volatile situations and patients. If you work in one of these specialties, then run, don’t walk, if one is offered in your facility.
Exercise Your Rights
Hospitals and healthcare facilities should have policies to protect their staff. Educate yourself on those policies and follow protocols when dealing with any violence. Most nurses have been verbally or physically attacked by a patient at some point in their career. When such an incident escalates to an uncontrollable level, never try to control a patient alone. Hospital security needs to intervene. Security officers are trained professionals and can protect you from any and all abuse. Memorize the codes and phone numbers for security within your facility.
Supervisors should be notified, and be sure to document all patient interactions and reactions in an incident report. In some states, nurses can contact local police, file reports and press charges if involved in a patient attack. Always seek medical care after a patient attack; even the smallest injury can become a future problem.
Use Your Smarts
Hospitals and healthcare facilities are public places. Never enter an unsecured area alone—the potential for an attack is too great. Nurses and healthcare providers need to feel secure and safe in the facilities where they work. Always stay alert and know where phones are located within your facility. If in doubt, buddy up when you leave the building or enter the parking garage.
Never give a patient your personal information. Keep your phone number and email address private. If a patient needs to contact you, use the facility’s phone number and email address. Keep your private life separate from your professional life.
Know the Signs of Horizontal Violence
Horizontal violence, or bullying, can make the working environment unbearable. Nurses may encounter bullying from superiors, coworkers and the patients they care for. How do you keep moving forward in an environment that could be potentially toxic? Document each infraction against you. Confront the perpetrator; sometimes he or she will back down. Stay positive in the midst of your struggle. Show respect if the horizontal violence is coming from a superior, and again—document, document, document! Once you have enough documentation and/or you feel that you need to take further measures, go up the ladder of command and voice your concerns.
Sadly, some nurses leave the profession, vowing never to return, while some manage to endure hating each and every moment of their workday. Nurses work in stressful environments where patients’ lives are their priority; add horizontal violence and you have a recipe for emotional disaster.
No one needs to feel threatened at work, nurses included. If, after an attack, you find yourself having physical or emotional difficulties, seek professional help. Most facilities have outside counseling resources available to employees. Don’t try to go it alone. We all need support from our friends, coworkers and loved ones. If the situation seems impossible and the violence has escalated to a level that causes injury, you have to report it. No one ever should have to feel that their life—emotional or physical—is in danger because of someone else’s actions.