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L E T T E R S
News,
Unsolicited Letters With
Notes, and Comments From Our
Readers Always Welcomed
All letters must be typed double-spaced and should be sent on disk to Karen Halm, PO Box 489, Downers Grove, IL 60515 or via E-mail to: [email protected].
More on Nurse Assaults
J Emerg Nurs 2002;28:278-9. Copyright © 2002 by the Emergency Nurses Association. 0099-176712002 $35.00 + 0
More on nurse assaults
Dear Editor:
I was aghast as I read the statistics in the research arti-
cle titled, "The Extent, Nature, and Precipitating Factors of
Nurse Assault Among Three Groups of Registered Nurses
in a Regional Medical Center. ''1 This was a well-written
research article that addressed the issues head-on.
My concern is this: Would any other profession allow
88% of its workers to be physically assaulted, as was the
case in the ED group responding to this survey?
We hear the worn-out mantra "patient care comes
first" so often that we are dulled to the reality that nurse
safety comes first. This tends to make us martyrs. Only
29% of nurses even report incidences of abuse, but the fact
that nurses wrote in the margins of this survey speaks vol-
umes. Nurses do not have time to report, much less fill out
a survey while on duty.
It would be interesting to know if the physical assault
experienced in the emergency department at the hands of
one patient/family continued into the ICU and the floor by
the same patient/family. This could be tracked via manda-
tory incident reporting. I like the idea of making incident
reporting mandatory regardless of evidence of physical
injury.
As an ED registered nurse, I cared for a 20-year-old
male gunshot wound victim this past weekend [who
was...] protected by our security staff because of fear of
retaliation by the gang with which he exchanged gunfire.
Another 23-year-old man was killed and a third 17-year-
old girl lost a third of her foot during these shootings. We
were afraid we would be caught in the crossfire, but no
security or police were posted to protect us.
:178 JOURNAL OF EMERGENCY NURSING 28:4 August 2002
LETTERS
This same shift, I [. . .took care of] a man [who was
unusually protective of...] his personal clothing in a patient
belongings bag. It bothered me, and I finally had security
search the bag. Several weapons were confiscated. How do
I get my institution to understand the seriousness of work-
place violence?
Measures in our institution are not effective. Our
ambulance bay opens freely, as does our front entrance, for
walk-in [patients.] We can call security if we need them,
but usually the event has already unfolded by the time they
arrive. Which preventative measures were in place at this
specific hospital at the time the nurses were surveyed, and
which ones have been adopted since then? Is there a study
to show the effectiveness of specific interventions?
Only 86 nurses responded to this survey. What about
the nonresponders? What you don't get to hear about is
how many nurses are killed while putting patient care first.
I imagine that statistic is shocking. I think the authors
would have many more data and interesting points to sort
out with a bigger study. I would love to accept your chal-
lenge, as I pursue my master's degree in nursing, [...to con-
duct...] further research... Susan Sanders, RN, Savannah, Ga; E-maiL" sfi564 @hotmaiL com
REFERENCE 1. May D, Grubbs LM. The extent, nature, and precipitating fac-
tors of nurse assault among three groups of registered nurses in a regional medical center. J Emerg Nurs 2002;28:11-7.
18/64/127187 doi: 10.1067/men.2002.127187
Rep ,: There were no preventative measures for security in the
areas that were surveyed other than the usual hospital secu-
rity guards. They are often present in the emergency
department, but most of the time they are guarding "Baker
Act" (the Florida Statute governing voluntary and involun-
tary admittance to a psychiatric center) patients and cannot
leave their post. They must call for backup, which general-
ly takes time. The inside ED door is locked with a code, but
the code is more than 10 years old and everyone knows
what it is, even the "frequent fliers." The only areas of the
hospital that are equipped with extra security are the new-
born nursery and the pediatric floor, which have surveil-
lance cameras and alarms that go off if someone comes in
or out of the stairwell. This extra security was added because
of a previous incident in which a child was abducted from
the nurser~ The hospital has not made any changes in secu-
rity since this research was done, but this was intended to
serve as groundwork for the need for future interventions.
The hospital is building a new emergency department and
plans to put in extra security when that is completed in the
next few years.
When a patient is transferred to a different area, the
chart is not flagged if the patient is violent towards the staff
or has a history of staff abuse from previous admissions.
Word of mouth is the general means of communicating
that information. We are not aware of a study that looks at
the effectiveness of certain interventions. Our list of inter-
ventions was taken from the Occupational Safety and
Health Administration and ENA Web sites.--Laurie M. Grubbs, Phi), ARNP, and Deborah D. May, ARNP, MSN;
E-mail: [email protected] 181641127188
doi: 10.1067/men.2002.127188
August 2002 28:4 JOURNAL OF EMERGENCY NURSING 279