Apr 19 2010

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Emergency room staffs are victims of abuse and violence

By Sherry Casey, The Morning Call

As an emergency room nurse for a local hospital for the past 10 years, I have been an eyewitness to the increasing misuse of the emergency department, causing overcrowded conditions, long wait times and patient frustration. These conditions are major factors contributing to the increasing occurrence of violence aimed at ER nurses.

A recent study from Florida showed that 100 percent of emergency department nurses experienced verbal threats and 82 percent reported being physically assaulted. Consequently, ER nursing is considered among the most hazardous occupations in the United States. Over the course of my career, I have been a victim of both verbal and physical violence on numerous occasions — too numerous too count.

In addition, I have witnessed assaults against my colleagues by patients and their families. According to recent literature, an adverse result of emergency room workplace violence is the exodus of nurses from the emergency room. The bottom line is that ER nurses, fearing for their safety, are relocating to less hazardous environments. Is this not alarming? Is the public aware of what is taking place in emergency rooms? Is this situation detrimental to our health care system? Should nurses have to take this abuse as ”part of the job?”

Patient safety has deeply embedded roots in the profession of nursing, starting with Florence Nightingale. Patient safety has always been and continues to be a nursing priority.

Furthermore, nursing is the pivotal health care profession, highly valued for its specialized knowledge, skill and caring in improving the health of the public and ensuring safe, effective, quality care. Nurses work tirelessly to provide that care, often ignoring our own physical needs and frequently ”skipping” lunch to meet the needs of patients during our 12-hour shifts. So when is the safety of all nurses going to become a priority?

The Emergency Nurses Association says health care organizations have a responsibility to provide a safe environment for their employees and the public and provide safety training programs.

Nurses should be allowed to protect themselves and their patients and have the right and responsibility to report incidents of violence and abuse to their employer, without fear of reprisal, as well as the right to report incidents to local law enforcement authorities and pursue legal action.

Emergency departments should have trained and equipped security personnel and structural/environmental controls to provide adequate and appropriate barriers against acts of violence.

Legislation that mandates and regulates safety standards and controls for workplace violence prevention should be strengthened and supported.

However, violence aimed at nurses does not exist solely in the ER. Studies have shown the violence present in the ER is often transferred to floor nurses when the patient is admitted into the hospital. The violence continues to snowball and has the potential to negatively affect many. Health care organizations need to be aware of this situation and make every effort to stop the initial snowball from forming in the ER.

Recently, the U.S. Department of Health and Human Services posted its Healthy People 2020 objectives. Interestingly enough, two of the stated objectives are to reduce physical assaults and to improve access to trauma care in the United States.

So let me ask the question: Where do people who have sustained injuries seek treatment? You got it, the ER.

If we do not rapidly address the increasing incidence of violence aimed at health care professionals, there may not be ER doctors or ER nurses to take care of the injured and/or ill citizens who go to the emergency room for treatment.

How can we attempt to meet the Healthy People 2020 objective of improving the access to trauma care centers in the United States if nurses or doctors are not willing to put themselves in harm’s way? To maintain the safety of ER staff and meet the Healthy People 2020 objectives, solutions to the crisis occurring behind closed ER doors must be established and implemented.

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