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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: lgrubbs@nursing.fiu.edu 181641127188

doi: 10.1067/men.2002.127188

August 2002 28:4 JOURNAL OF EMERGENCY NURSING 279