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Emergency department are experiencing violence and it has been escalating year after year.  So how are the hospitals coping and resolving this concern?

To come up with solution regarding this problem, it is important to define emergency room violence and differentiate it from other forms of violence.  Emergency room violence is different since it involves patients, family, relatives and close friends.  These violent acts came from feelings of frustrations, vulnerability and lack of control over health emergencies.

Violence prevention training for hospital staff is one step in reducing the incidence of violence in hospital emergency rooms.  Potentially violence patients and visitors can be recognized by the hospital staff by attending training in violence prevention.

Some preventive measures and procedures are already being undertaken by the healthcare institutions to prevent this escalating violence.  Some security measures include metal detectors at entrances, photo ID cards for staff, badges for visitors, patient processing policies to lessen waiting time, controlled access to hospital buildings, secure telephone communications,  locked doors to emergency rooms, closed circuit TV monitoring and trained security guards.

Nursing Solutions Now (NSN) offer some protection tips to emergency department health care workers.  They have the D.O.G.G.S. or Defusing of Grievance Grants Safety.  To use the D.O.G.G.S. method, it is important to understand the mindset of the potentially violent person and that is by communication with the person.  It is necessary to practice active listening.  Avoiding confrontation is also one step to build trust and therefore provide help. It is important to allow the person to verbally vent out the emotions without comment or judgement.  Getting a suggestion from the aggrieved party is essential and the person’s suggestion might even be reasonable.  To preserve the person’s dignity, move toward a win-win resolution.

To further address these attacks and harassments,  the Nurses Association in the Unites States is promoting a bill  (A6186/S3441) aimed at violence against nurses.  With this bill A6186/S3441, any acts of assault that may cause physical injury to a registered nurse or licensed practical nurse while on duty will face Class C felony charges.  This same provision already exists for assaults made against policemen, firemen, peace officers, and emergency medical technicians.  The bill was passed by the US State Senate  last April 2, 2008 and is currently awaiting the decision of the Assembly.

Meanwhile in Canada, the Canadian Nurses Association (CNA) is exploring the effectiveness of their Criminal Code to address healthcare professionals experiencing violence. CAN promotes that the employers should enforce strategies to prevent, identify and address violent behaviours, examine the root cause of violence and take steps to address them and provide mandatory education and training to management and staff.

Different nursing organization could come up with different ways or tips to avoid and prevent emergency room violence.   But it is also important thing is developing or making sure that there is a backbone or law supporting our emergency nurses against possible violence in their workplace.  But the first step against violence is prevention.

Being a traveling nurse, you are given the opportunity to go wherever you wish to go while still practicing your profession. With this, you can expand your resume and be able to work at some of the country’s top medical facilities. You can freely choose jobs close to your home or anywhere across the country.

Normally, most travel assignments last 13 weeks though some traveling nurses company can customize the length of the assignments according to their needs. There are also other companies that offer short-term ands quick-start travel assignments, usually lasting from 4 to 8 weeks.

A good advantage to this kind of job is that, there are no annual contracts so you can work as many assignments as you like. This also means a stable financial income for you.

So how can you find the best traveling Nurses Company? It is true that one of prime factors that travel nurses look for is the high pay. However, it is not always the chance of getting better wages but it is also the opportunity to choose your benefits. This means that you should look more closely to individual companies and what they can offer you.

So what exactly are the benefits you expect from being a travel nurse? Here are some of the basic options you can find on various traveling nurses company and agencies:

1. Favorable working hours and conditions – Of course it is no doubt that nurses and health care professionals are in demand. Many companies are offering them a time off as a motivation to work for them. Most companies do all the possible ways to keep working hours a reasonable level such as hiring travel nurses who can temporarily work for them. This means that there is less demand for overtime works, allowing nurses to have time for themselves, their personal activities, as well as their families. The aim is two fold – a give and take relationship. With this reward, companies are not only attracting potential nurses and keeping quality employees but also they realize that nurses can usually maximize their nursing tasks when they are handling reasonable hours of work with sufficient staffs to provide backups.
2. The tangibles – As a travel nurse, not only you are offered with top dollars but you are also given the privilege of receiving several benefits which are not given to nurses before. Some rewards may seem small to some people but can become big time issues eventually. One example of this is direct deposit. This may seem just a small detail but as soon as you are getting your paycheck, for instance on a Thursday night but you failed to make the trip to the bank Friday and wind up with a check that hasn’t still been cashed out the following week.
3. Part-time, situational and temporary jobs – If you are a nurse who meets situational criteria, there are companies out there which can offer you great job placement. If you don’t want to have the responsibility of a full-time job but want to work only a few weeks at a time, you are given lots of good options without working full-time. There are companies that provide placements to people like you. But be cautious to choose the reputable traveling nurses company. Be wary of signing a long-term contract that bounds your work with other companies.
4. Education – If you want to be viable in the travel nursing marketplace, you may want to advance your education. You can make the wise move of getting some additional training to advance your career with education.
5. Pay – Of courses nurses choose their field to help other people but it’s no question that money is attractive.

This is very important especially when you have collect evidence from a victim and have to offer this testimony in court. Everything you say should be objective because the evidence presents the facts themselves.

For you to become a forensic nurse, you must have at least be a resident nurse and complete the training regimen. This includes specialized training in the classroom as well as 40 hours of didactics and 40 hours of clinical work.

For those who want to specialize to become a SANE or sexual assault nurse examiner, part of the training focuses on handling and collecting evidence like fibers, hairs and fluids which are collected for DNA testing. You will also need to learn how to use the equipment. It can be very basic like a digital camera to an Omnichrome or a colposcope which can detect bruising underneath the skin’s surface.

When a victim is brought in to the emergency room, you spring into action and then talk to the person. Working with law enforcement officers, you will be able to comfort the victim, get details and then get the person who did it. This normally takes 3 to 4 hours.

Another forensic nursing career could be that of a nursing forensic examiner. This job will also involve collecting evidence but most of those brought in are victims of interpersonal abuse. This includes child or elder abuse, domestic violence, near fatal to fatal traumas, shootings and stabbings.

In cases of stabbing and shootings, the most important thing to get is the bullet and any other items that are left on the victim. They will also remove the clothing so this can be examined by preserving this in a special wrapping before transporting this to the lab.

Should the victim die, then the forensic nurse examiner will work with the medical examiner by answering questions about what he or she saw before this person died.

If you want to go into private practice, one subspecialty is that of forensic psychiatry. Here, you don’t have to collect evidence but you have to evaluate the mental capacity of the person to see if she or she is fit to stand trial in a jury of their peers.

Since you evaluated that person, you may be called in as an expert witness in both criminal and civil proceedings. For this, you need to complete a basic certification course.

Forensic nursing has a lot of potential given that it is something new. Statistics show that there will be a demand for more trained professionals in the next 10 years and with that goes to the wages. This means you are sure to find a job in a community health center, hospital, public health department, law firms and correctional facilities.

But is a forensic nursing career all about money? Certainly not because as a healthcare professional and from a legal perspective, you are able to help not only the victims but also their families coping with what happened especially when what you do helps catch whoever is responsible for it.

With the shortage of nurses across the country, various hospitals and medical centers have introduced this alternative way that will answer the shortage issues. The assignments of traveling nurses are made through agencies that specialize in travel nursing.

The agency normally provides the nurse with top dollar paychecks as well as other very good benefits like housing and travel expenses, licensing assistance, and payroll services. The hospital temporarily fills the position and the traveling nurse gets paid above the market wages.

With this great option for nurses, they are given the opportunity to travel anywhere while still having to accomplish their nursing job.

In order for a travelling nurse to get good compensation, better assignments, and have a stable financial success, it is necessary to join a traveling nurses association. This association is comprised of members of the medical profession.

They will provide and protect the every need of a travel nurse, preventing them from being underpaid and all other unwanted cases. They shall be the one responsible for guaranteeing the welfare of every traveling nurse. Below are the basic roles of travelling nurse associations:

• Provide travel information to nurses.
• Provide information to nurses and health care professionals about their traveling assignments.
• Provide job placement opportunities.
• Offer substantial discounts for members at major hotels, car rental agencies, and resorts.
• Provide members with a complete list of approved travel industry suppliers such as travel agents, airlines, vendors, and cruise ship companies.
• Ensure that all nurses that are members of the association are licensed and registered.

The traveling nurses association generally follows the state’s Federal Regulations that requires hospitals that are certified to participate in Medicare to have sufficient number of licensed registered nurses, licensed practical nurses, and other health personnel that are capable of providing nursing care to all patients whenever needed. This means that staffing of nurses is necessary and must be strictly done to meet the patient’s needs.

If you are a traveling nurse and wanted to get the best job and the location you want, let your traveling nurses association help you out. You can also do the smart move of finding a reputable travel nursing agency that will provide you exactly what you want.

Since it is a fact that travel nursing is a very competitive business and agencies do all the possible ways to make themselves known, it is not impossible to find and be on the job you want.

One way to get your dream travel nursing job is to ask for a recommendation to your colleague who has already worked a travel assignment. With the huge competition, it is an edge to get a good recommendation for an easy travel nursing job hunting.

Being a member of a big traveling nurses association, you will surely get instant access to the most powerful nursing job search database available in the internet. With just a click from your mouse, searching to find the best assignments that match your specialty will be at hand. Not just that, you are also guaranteed to get the advantage of excellent services and benefits that no other careers could offer you.

Emergency room nurses are very much in demand and there are numerous ER nurse jobs available in different settings. It may even allow ER nurses to travel to exciting locations.

Emergency nurses would get an average salary (as of June 2008) according to www.nursezone.com is $59,227. A travelling ER nurse can expect to make at least as much or more every year including housing, insurance and other benefit due to the high need of their expertise and skills and understaffed facilities.

Travel nursing was developed in response to the nursing shortage. With travel nursing, nurses are relocated for short term nursing positions. Travel nurses are offering incentives ranging from relocation assistance and furnished housing to stipends and bonuses to qualified registered nurses and health professionals.

But there are additional costs of being a traveller. Costs would included additional licensing costs and travelling costs. These costs can be reimbursed based on the company, recruiter and of course, your negotiation skills.

Nurses often dream of combining their medical growth and seeing the world. But a nurse should always be prepared. A successful traveller requires good financial planning, a flexible outlook, knowing what companies and recruiters to deal with and how to negotiate.

Of course, salary for travel nurses widely varies. Salary is based on the location, need of the hospital or the nursing unit. Perceived staffing needs by the unit manager and still, on the ability of the traveller to negotiate. Generally, areas in the southern United States pay less than areas in the north or west. Housing costs can also have an impact on the salary as well, since housing can be part of the benefits a travel nurse will receive. In terms of picking out the location an E.R. nurse wants to practice her profession, she would need to consider the process of applying a nursing license in the state to be assigned.

Currently, 17 states belong the Nursing Licensure Compact. With this Compact, a nurse who is under any of these 17 states may practice in other states. They would have to follow the laws and regulations of the state in which they are practicing.

A travelling E.R. nurse is can have a staff position which is frequently in critical care settings. Many jobs or positions available as a travel nurse would be in critical care. It is also essential for a registered nurse who wants to be travel nurse to possess background in critical care. Adaptability, flexibility and capable of easily making friends are also some characteristics present in a travelling E.R. nurse.

Some drawbacks in being a travelling E.R. nurse is that there is often little or no time to get oriented at the new location and moving from place to place every three months (average). Issues in obtaining licensure and paying taxes are also some major drawbacks in this profession.

A travelling E.R. nurse with this kind of profession would have the chance to meet new people. She would even have the chance to grow personally and professionally since exposure to different working conditions is inevitable. This opportunity provides a venue for E.R. nurses to experience different facilities and enhance their medical knowledge at the same travel around the country, even the world! It is the best of both worlds.

Emergency room nurses are used to fast paced environment. Since the emergency department of a hospital, is usually overcrowded emergency room nurses can be seen multitasking to balance and prioritize patients and their time. How dangerous is it to be working in a hospital?

With increasing reports of emergency department violence, emergency nurses are placed among police officers and other peace officers. The Massachusetts Bureau of Labor Statistics reported more than 4.000 health care professionals to experience verbal and physical assault while working in the ER (2005).

Different steps are being undertaken to address the escalating umber of violence experienced by emergency room staff. Legislations in increasing the penalty for perpetrators are awaiting decision from the Assembly. Various programs and trainings to resolve violence are commencing in hospitals and other health care institutions.

So what else is dangerous about being an emergency nurse?

According to the International Hazard Datasheets on Occupation as released by the International Labour Organization, there are seven main dangers emergency nurses can be exposed to.

1. Emergency room nurses, as part of their responsibilities; cleans, disinfects and sterilize medical equipment. They may be exposed to agents that may damage the skin, mucous membranes and respiratory system.
2. Emergency room nurses can also be exposed to anesthetic gases, drugs and radiation.
3. Emergency room nurses may be injured by shard objects like needles, blades and other similar objects.
4. They may contact with hot surfaces, faulty electrical equipment and may cause skin burns.
5. Sick patients in the emergency room present a risk of infection from body fluids.
6. Emergency room nurses may suffer from musculoskeletal problems and back pains due to handling heavy patients. Continuous work while standing and walking may cause fatigue and leg problems.
7. Emergency room nurses also may suffer from stress and burnout caused by shift and night work and by other psychological and organization factors.

The Emergency Nurses Association recognizes the increasing number of emergency nurses experiencing stress. The emergency care environment can be very stressful and physically and emotionally traumatic for the health care workers and nurses.

ENA recognizes the following contributing factors in the increasing stress levels of emergency room nurses.

1. Critical incidents that can cause strong emotion and may interfere with the ability to perform the duties. Incidents like mass casualties, disasters, unexpected death of a child or co-worker can be attributing factors.
2. Long term demands can also be a stressor. Long work hours, job insecurity, poor communication and an increased potential for a workplace violence fall under this factor.

ENA sees that unresolved issue of stress can result into absenteeism, sleep disorders, burn out, emotional difficulties and health problems.

So how can these repercussions be avoided?

International Labor Organization (ILO) provided several pointers to keep the emergency department safe for the emergency room health workers. Nurses should comply with all safety instructions and conduct periodic inspection of electrical medical equipment. Keeping all passages clearly visible and uncluttered is also another tip. Following appropriate procedures in infection control and handling and disposing sharp objects is necessary.

To resolve the stress emergency nurses are experiencing, ENA supports the development and utilization of critical incident stress management. ENA also supports the use of personal stress management strategies like relaxation, meditation, exercise, group therapy, guided imagery, massage or humor therapy.

ENA also recognizes the impact of workplace violence and the need for a program which would include education, prevention, appropriate security measures, identification of incidents, reporting and protocols.

Emergency nurses have a very rewarding job and at the same a dangerous one. These are all the sacrifices they have to put up the serve the people.

There is one official journal of the IAFN, which it calls Journal of Forensic Nursing. This comes out on a quarterly basis and is distributed among the members of the association.

The main goal of this journal is to help in the advancement of the science of forensic nursing by sharing information about so many cases related to forensics that have been handled by experienced forensic professionals. This journal includes manuscripts that serve as a rich source of knowledge for beginners or even those who have already started their careers.

These manuscripts are submitted by the members and extensively reviewed by the board before they get published. This is to make sure that the information will truly benefit the members who will read them and refer to them when they need to. The requirement for a manuscript to see publication is for it to be original and has never been published yet.

There are also certain guidelines to follow for those who wish to have their work included in the journal. All the details including the photographs, tables, and references should strictly conform to the standards set by the Publication Manual of the American Psychological Association.

Forensic nursing, which has gained momentum in 1992, is the practice of applying nursing science to legal proceedings. Forensic nurses provide health care services directly to patients who are victims of violent crimes. They also assist people in treating trauma and in handling death, or abuse of any kind.

Forensic nurses deal with the following cases:

• Domestic violence
• Sexual assault
• Abuse or neglect of child or elderly
• Psychological abuse
• Human trafficking
• Occult- or religious-related violence
• Forensic mental or psychiatric health
• Nursing in correctional establishments
• Legal nurse consultations
• Automobile or pedestrian accidents
• Suicide attempt
• Work-related injuries
• Disasters
• Administration of patient care
• Service accidents/injuries
• Check for environmental hazards
• Detect drug or alcohol abuse
• Check illegal abortion
• Tissue and organ donations or charity
• Homicide cases
• Suicide cases
• Suspicious deaths

IAFN and their plans

Since IAFN is an international organization, members to this association are scattered around the world. The organization doesn’t only include forensic nurses as members, but also other professionals who provide support and complement the work of the forensic nurses.

The organization has initiated the journals to reach its goal of disseminating information about the science and its growing number of practitioners. As the leader in the development of forensic nursing, the IAFN holds the following goals close to their principles:

• Try to prevent violence as much as possible by helping solve crimes faster
• Make improvements on the current standards in terms of evidence collection and forensic nursing practice per se
• Promote sharing of information within the professional circle to help each other grown in the practice
• Establish ethics in the practice of forensic nursing
• Educate the up and coming forensic nurses

These goals are all aligned in the forensic nursing journals that are being published to develop forensic nursing in the United States as well as in other countries around the world.

The role of a Nursing Assistant is a demanding one. One of the biggest complaints from them is that they have too much to do, and not enough time to get it all done. Burnout is dangerous because it affects individuals emotionally, physically, and mentally. It is tough to see bright, compassionate Nursing Assistants leave the medical field because they have come to resent the role they have taken on. It no longer serves a purpose for them. What was once a positive experience has become a nightmare.

The stress of burnout on a Nursing Assistant can lead to problems with their health as well as lead to depression. Often, they either quit their job or they are fired. This leads to financial difficulties and many times issues in their relationships. Nursing Assistants report burnout in their profession is common because they are overworked, unappreciated, confused about work expectations and priorities, worry about job security, they are overwhelmed by the number of responsibilities, and they do not feel their pay is sufficient for the amount of duties that they are required to perform on an ongoing basis.

It is important that Nursing Assistants understand burnout, and the havoc it can reap in their professional and personal life. Understanding what burnout is, why it happens, and the signs of it can help Nursing Assistants deal with the situation before it spirals out of control. The first step in avoiding burnout is to take care of yourself physically and emotionally.

Signs you are experiencing job burnout or soon will be include no longer finding enjoyment in areas of your job you once really liked, becoming cynical or bitter about your job, and you are starting to experience problems in relationships with co-workers, friends or family as a result of the conflicts of your job.

Other important signs to watch for are looking for excuses to not go to work, calling off or asking to go home early on a regular basis, becoming easily annoyed with co-workers, envious of those who do enjoy their work, and not caring if you do a good job or not. It is likely you will start to experience physical and emotional exhaustion.

Being a Nursing Assistant can be stressful. However, stress and burnout are different. They are often confused because they signs and symptoms of the two are very similar. The defining factor is stress comes and goes, so the signs and symptoms do as well. With burnout, the feeling doesn’t go away, so the signs and symptoms linger ongoing.

As a Nursing Assistant, you can’t eliminate stress, but you can help control and reduce the effects of it. It is important to get plenty of rest and take care of yourself. Since most of us stretch ourselves too thin with too many commitments, see if there are areas you can cut back in. If you have solutions to issues at work, write them down. Ask to meet with your supervisor. Explain the problems, then offer solutions. This will show that you are interested in resolving the issues rather than just complaining.

It is very important to take time for yourself. Relax with a warm bath or read a good book. Too often we take care of everyone else’s needs at work and at home, leaving nothing of ourselves for us! Since the healthcare profession is the top contender for employees suffering from burnout, Nursing Assistants need to really take head of this advice and put it to good use early on in their career. This will help ensure they continue to enjoy their work, offering patients the best possible care.

Travel nursing allows you to stay on vacation for two to six months in free lavish accommodations while at the same time earning top dollars in hourly wages. But despite all these advantages, some travel nurses shied away from the traveling profession because of bad experiences to some traveling nurses recruiters like they are being underpaid or they have been deprived from benefits.

Also, many travel nurses have complained because of inadequate housing or recruiters who were not pro employees. This has resulted to nurses jumping from one recruiter or agency to another.

With this issue, it is important to choose the right traveling nurses recruiters that are willing to help nurses find their desired job locations, compensation, and good benefits. So how can you actually find the right travel nurse recruiter? Because recruiters and agencies are the keeper of the keys for travel nurses, they should be able to offer lucrative and exotic travel assignments.

Traveling nurses recruiters have contracted with healthcare facilities across the country to provide qualified and experienced nurses within their medical facilities. This normally lasts for a 13 week assignments. With many travel nurse positions to fill, recruiters are required to attract qualified nurses to fill these needs.

In this situation, since you are in demand, you will be offered with good benefits. With the tight competition among the travel nursing agencies, the perks are always upgraded so as to lure you and encourage you to work stay with them.

But you see, it is not just the benefits that are upgraded but more importantly the service that they are going to offer you. You play a great role for all traveling nurses recruiters. You are their lifeblood since without you, they will not exist.

So what are the vital factors to be considered in choosing traveling nurses recruiters? Well, first, it is important that you “hitch your wagon” to the winner. This is necessary since the travel company you choose will be your employer throughout your assignment.

So what is the edge of a winner? It is basically how they take care of you and assist you to all your needs. Do they listen to your personal ambitions and targets? Do they provide you with good options that you are exactly looking for?

When it comes to assessing traveling nurses recruiters and agencies, it is important to note that the real deal is on how they handle your concerns. Things just happened no matter how well you have planned your travel.

This is where you can measure up the dedication and concern of your recruiter – from handling your concerns to ensuring your welfare. This is the ultimate quality of a “keeper”. Make some background check to know the reputation of your prospect recruiter.

Ask those who have already gone thru this recruiter, ask the company for references from travelers who have already been with them, and ask how was their experience with them. How was the housing, basic expenses, or was the paycheck was timely? If the answers are all positive, then you have just found the traveling nurse recruiter that you need.