Nursing Notes

November 18, 2010

Increasingly, nurses facing violence on the job

Here is another article that lies out the problem with violence that nurses and nursing staff are dealing with.  This is a good, but long, article and I hope you will click over to read the entire thing.  Nurses should not have to wonder if going to work will mean a loss of livelihood or worse, a loss of life.

This article is from The Philadelphia Inquirer.  Please do go to the site and read the next page.


By Jane M. Von Bergen

Inquirer Staff Writer


Amber Knierim, 20, wanted to be a nurse when she grew up, her MySpace profile says.

Instead, she’s in jail for beating one up – a Temple University Hospital emergency-room nurse who was attacked when she tried to keep Knierim from grabbing needles from an empty examination room on June 21.

“She picked the wrong person to mess with,” said Joan Meissler, 53, of Northeast Philadelphia, now working on light duty until she heals from the beating that wrecked her finances and left her in permanent pain, angry, and disheartened.

On Wednesday, 180 nurses and other health-care workers will convene in a ballroom at the Philadelphia Airport Hilton for a booked-to-capacity session on workplace violence for health-care workers, sponsored by the Pennsylvania Association of Staff Nurses and Allied Professionals, a union.

“It’s a national problem,” said union president Patricia Eakin, adding that she did not want to single out Temple. Eakin, a nurse, an emergency room colleague of Meissler’s, was on duty the day Meissler was attacked.

Meissler wants Temple to erect a billboard in the neighborhood with two pictures on it – hers and Knierim’s. “Temple needs to send a message to the community,” said Meissler: ” ‘Lay a hand on one of our staff members and you’ll spend the next five years in jail.’ ”

The U.S. Department of Labor Tuesday released 2009 statistics that ranked paramedics and nursing aides as being the workers most likely to miss work because of injuries. While most of the injuries come from overexertion caused by lifting, there are 38 incidents of violent assaults per 10,000 nurses aides.

The only occupations that face a greater likelihood for assault on the job are police and correctional officers.

Between 8 percent and 13 percent of emergency-room nurses are victims of physical violence every week, according to a survey released in September by the Emergency Nurses Association, a professional group in Illinois.

Why is the work so dangerous? Nurses and experts point to a number of factors.

First is proximity. “We as nurses are hands on – to touch and be touched,” said nurse Christine Pontus, occupational health and safety director for the Massachusetts Nurses Association and one of the national leaders addressing the issue. “The boundaries are not as clear.”

Pressed to reduce expenses, hospitals have been cutting back on nursing and security staff at a time when the number of uninsured using emergency rooms is growing. Those same budget constraints are limiting options for treatment and care of the mentally ill and addicted.

Unemployment and the economy has exacerbated stress among the general population, with that tension manifesting itself in hospitals, where frustrated patients and their families waiting longer for treatment tend to lash out at staff members.

Most of the violence is by patients or their families against nurses and other staff, according to the Emergency Nurses’ survey.

Many hospitals don’t have complete safety plans that include adequate staffing, consistent and frequent use of security wands and metal detectors, training in violence de-escalation, safety committees with worker representation, emergency-drill sessions, and analysis of unsafe conditions.

Meanwhile, there is some sense that nurses and others should accept violence as part of the job, Pontus said. She is the lead speaker at Wednesday’s event. District attorneys from Philadelphia and Delaware County are scheduled to attend.

“A lot of times the victims are traumatized and afraid to speak,” especially if the organizational culture doesn’t support them, Pontus said.

“There is a stigma of victimization, embarrassment, fear of being blamed for provoking the assault, fear of job loss,” she said. “The patients abuse us and we abuse each other. We’re all post-traumatic out there.”

Two weeks ago, a California nurse working in the intake area of the Contra Costa County jail died when a new inmate faked a seizure. When the nurse bent over him to help, he grabbed a lamp and smashed her over the head. She died on Oct. 28, three days later.

A psychiatric technician at Napa State Hospital in California was strangled on Oct. 23 by a patient, one of a majority committed there for crimes related to their mental illnesses. Local news reports described a chaotic facility where security had become lax.

Those are the headline cases, but the reality is more like what emergency room nurse Sean Poole, 33, experienced at Crozer-Chester Medical Center on Friday night.

Poole and a fellow nurse were trying to get blood work from an intoxicated and delusional patient when the patient bit his coworker, drawing blood. “It was pretty bad,” said Poole, who lives in the tiny borough of Parkside in Delaware County.

Poole has been punched and bitten, but has never pressed charges. “It’s hard to get anything to stick,” he said. “If they are intoxicated, it won’t hold up because they were intoxicated. If they are mentally ill, it won’t hold up because they aren’t in their right mind.”

In the spring of 2009, Crozer-Chester nurse Aimuel Elder walked into a patient’s room to find family members fighting and using pepper spray. He got sprayed as well.

“I tried to settle things down,” he said. “The police were called and so were our own security. The police arrived before our security.”  …[Read more]

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  1. Work place violence is one of the reasons why I left emergency nursing, which is still my passion. I now work in a private doctors office. Boring, but safe. Most importantly, I can come home every night to see my kids and husband. I miss the A&E, but felt that I could no longer run the risk for my kids sake. Great post. Keep speading the word.

    Comment by Heddwch — November 18, 2010 @ 8:19 pm | Reply

    • Thanks for the comment. As a psychiatric nurse, I also have to weigh the pros and cons of staying in this line of work. But the bottom line is that I love working with this population and I believe that I actually get to do nursing in this field. I spend time talking with my patients which is something I have come to look forward to.
      I do understand your worries about safety and your family, but since my family is grown, I no longer have that to worry about. I do wonder at times if going to work will cause me to be injured, maimed, or even killed and I think that should not be a part of being a nurse.

      Comment by Shirley — November 18, 2010 @ 8:36 pm | Reply

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