Discussion post 1 & 2, Discussion post reply 1 & 2
DISCUSSION POST 1 Think about your current or former workplace. Are you aware of any specific actions that were taken to protect employees from workplace violence? What more could you suggest? DISCUSSION POST 1-REPLY 1 Discussion 4-1 COLLAPSE Let me start by saying, I work in a busy inner city ER/Trauma center five minutes outside of Washington, DC. We have a high rate of patients with psych disorders who are non compliant with medications and we also have the same psych population who medicate with drugs and we have people who use drugs for recreation. I said all of this to say, workplace violence is a norm where I work, and I have worked there for 13years. When I first started working in this ER, we had a large number of psych patients not taking medications, and they would come in responding to internal stimuli or paranoid and we would have to get them on a stretcher medicate them and restrain them. We did have security, but they were not much help, so it was the nurses and techs fighting these people to get them on the stretcher medicated and restrained, needless to say we fought everyday. The hospital, then decided to incorporate security into medicating and restraining, which was better because there were more people to help hold and help get these patients restrained. Even through that, we still would have the random attacks on employees. No more than 5-6 years ago, along with the regular drugs, PCP and spice became hot items. PCP/spice are powerful hallucinogenics that causes people to become angry, and violent and these people do not follow commands. These guys are worse to gain control of than the regular psych patients, because they do not feel pain so nothing stops them. We usually medicate and restrain these patients as soon as they come in , but we remove restraints when they go to sleep. Sometimes, the patient is able to sober up and sometimes they wake up angry and start all over with the violence. We have had rooms including the ceiling torn down, we have had large tv screen tracking monitors torn off of the wall, and employees attacked. In the last 2 years along with security the hospital has added the county police department with up to three officers on a shift. The officers have also had to resort to using tasers and fighting with violent patients. The last straw was on our psych ward last year a patient made a weapon out of a chair leg and stabbed one security officer in the neck, and another in the face. After that mishap, the hospital hired a new security director who happens to be a retired FBI agent. She in turn fired the last security company who were just bodies, and hired another company who specialize in conflict resolution and martial arts, and they have very large dogs on patrol at the hospital. The dogs are even trained to take violent people down with gentle force, now the dogs are very large and weigh 90lbs-135lbs but as gentle as they can. I don’t think there is much more the hospital can do to curb violence, society has just become more violent and unfortunately the ER takes the brunt of it. I have seen so many staff members jumped on, punched, kicked, and bitten and I wish there were warnings so that the employee can run, but most times there is not. I would like to say metal detectors could help, but we completely unclothe patients upon arrival so no chance of them having a weapon. There is nothing else left to do but pray. DISCUSSION POST 2 How could you use the Nursing Process to address a staff member’s performance shortcomings? DISCUSSION POST 2 REPLY 1 Jennifer Pierson Pierson- Module 4 Discussion 1 POST REPLY Think about your current or former workplace. Are you aware of any specific actions that were taken to protect employees from workplace violence? What more could you suggest? Workplace violence is a serious situation that nobody would like to actually occur. Emotions run high when a person or family member is sick, and anger can escalate to violence pretty quickly. CHKD, where I am employed, has several safe guards in place to protect the employees from violence in the workplace. I have not encountered any employee to employee violence but have seen incidents of family members threatening harm to employees. Recently, we had a mother who was angry that the patient was admitted to the ICU. The patient was in foster care, was suffering from diabetic ketoacidosis, and was admitted for medical management. The biological mother heard about the admission and arrived at the hospital. She was very angry that he was admitted, did not believe that he was sick, and began threatening to sue. She threatened to sue the nurse, the foster mother, the attending physician, the resident, the secretary, basically anyone that walked by the bed space was threatened. The mother then began to state “just wait until his father gets here, he’s going to kill all of you, just wait…” This was very concerning for the staff. A code green was called, which alerts the facility to a violent situation and appropriate staff are dispatched to assist in the situation. A code green team is made up of several security officers, a police officer, a behavioral health technician, and the house supervisor. The mother was escorted from the unit, the situation was discussed with her, and she was banned from visiting the hospital. The police officer then notified the father of the situation and he was told that if any violent behavior was witnessed then he would be banned as well. Other than the code green team, security is very vigilant in making walking rounds throughout the hospital on an hourly basis. They check in with each charge nurse, they check the stairwells, and check empty units. There is also a Norfolk City police officer located in the emergency department at all times. Some staff are required to park in lots that are quite far from the hospital, security provides a shuttle to and from the lots to ensure the safety of the employee. The ICU where I work is a locked unit and visitors cannot enter unless they call in first. However, this is not fool proof. Many times, visitors will wait until another visitor calls in, is granted access to the unit, the door is buzzed open, and then they follow that family member in through the open door. Visitors also hold the door open, so others can be let in. It would help if we had a security member or staff member assigned to sit at the desk by the door to ensure that only the approved visitors were able to enter the unit.