Monday July 28th 2014

ENA study: Culture change needed to reduce violence against emergency nurses

A qualitative study on assaults on emergency nurses sponsored by the Emergency Nurses Association (ENA) found a need to change the culture of acceptance prevalent among hospital administrators and law enforcement, as well as a need to better train nurses on signs of potential trouble.

“Assaults on emergency nurses have lasting impact on the nurses and the ability of emergency care facilities to provide quality care,” said 2014 ENA President Deena Brecher, MSN, RN, APN, ACNS-BC, CEN, CPEN. “More than 70 percent of emergency nurses reported physical or verbal assaults by patients or visitors while they were providing care. As a result, we lose experienced and dedicated nurses to physical or psychological trauma for days or sometimes permanently. Health care organizations have a responsibility to nurses and the public to provide a safe and secure environment.”

According to Bureau of Labor statistics, an assault on a health care worker is the most common source of nonfatal injury or illness requiring days off from work in the health care and social assistance industry.

Despite that alarming statistic, the qualitative research study discovered a culture of acceptance among hospital administrators, prosecutors and judges. One emergency nurse assault victim related being told by a judge: “[W]ell, isn’t that the nature of the beast, being in the emergency room and all?” Another told the researchers, the “administration will only take action when some lethal event happens.”

In addition to, and perhaps in correlation to, the culture of acceptance, the study concluded that emergency nurses and hospital personnel in general are not trained to recognize cues for violent behavior.

“It is imperative that hospitals and emergency care workers address the issue preemptively through adoption of violence prevention education, zero-tolerance policies, safety measures and procedures for reporting and responding to incidents of workplace violence when they do occur,” the researchers noted. “Such actions are necessary to help nurses recognize incipient violence.”

The ENA, an organizational affiliate of the American Nurses Association, has long taken the position that health care organizations must take preventive measures to circumvent workplace violence and ensure the safety of all health care workers, their patients and visitors.

“There will always be the potential for violence against emergency nurses,” Brecher said. “But we must not accept it as the price of helping the sick and injured. With training and a change of culture, we can significantly decrease the occurrence of assaults against emergency nurses.”

The study can be found at www.jenonline.org/article/S0099-1767(13)00561-8/abstract.

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