How to handle workplace violence as an emergency nurse

The job of an emergency nurse can be incredibly rewarding, often giving you the opportunity to provide first-hand assistance with saving the lives of those in need of medical help. However, while taking steps to ensure safety is important for nurses in all types of care settings, it's particularly essential in emergency departments. In fact, the Journal of Emergency Nursing found that in 2013, more than 70 percent of emergency nurses reported experiencing verbal or physical assault by patients or visitors. 

Although the potential for these incidents shouldn't take away from the benefits of being an emergency nurse, they do emphasize the importance of being properly prepared to handle a violent situation if one were to occur. Use this guide to help you handle workplace violence you may encounter as an emergency nurse. 

1. Look out for possible warning signs
There are certain physical states or injuries that can increase the risk of violent behavior. If a patient is under the influence of drugs or alcohol, for example, chances are low that they will be able to fully control their emotions or behavior, increasing the risk of violent incidents. Head injuries can also result in unpredictable behavior and violent impulses. 

If the day has been particularly busy and patients or visitors have had to experience long waiting times, the combination of impatience and anxiety can result in anger and frustration. The same emotions may be evoked when a visitor has been informed that a loved one is in critical condition or has passed away. In these situations, it's always best to be on guard and ready for any type of behavior.

Just as there are certain conditions that could lead to violent behavior, there are also more subtle signs of impeding violence. For example, profanity, loud speech, darting eye movements, rapid pacing and clenched fists may be red flags. Take extra precautions if these occur. 

If a patient appears to be upset or disgruntled, take extra precaution.If patients appear to be upset or disgruntled, take extra precaution when treating them.

2. Ask for guidance or training
Several states have implemented laws that say it's a felony to assault a health care professional. However, only a few have required or provided violence-prevention training and incident reporting. Without the need to provide these statistics, it's near impossible to know how many hospitals across the country have sufficient safety protocols and training for nurses. However, according to Scientific American, the Emergency Nurses Association has conducted surveys that suggest this number is very low

If the hospital you work at has not provided you with the adequate resources to prepare you for an incident of violence, bring this to the attention of your managers. They may be able to get a training session in the works, or at least provide you with advice and guidance on what to do so you're not caught off guard if you come across a violent patient. 

"Try to avoid giving orders."

3. Keep calm and alert
When patients get angry, maintaining a calm attitude and acknowledging their feelings will show them that you just want to provide them with the proper care. Try to avoid giving orders, getting too close, touching them or speaking too loudly, as these actions can be interpreted as aggressive. 

Taking a few seconds to evaluate each new situation for potential violence every time you take on a new patient will keep you on your toes. If you think that the patient could be potentially violent, never approach this person alone, especially in an isolated area. Make sure that you always have easy access to the exit – never let the patient stand in between you and the door.

4. Never be afraid to reach out
If you're in a situation where you feel unsafe, call for your manager or security. Report any violent incidents you may have encountered to management. This may push your hospital to offer better training and work harder to ensure employee preparedness.

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