According to the Health Promoting Hospitals and Health Services International Conference held in Berlin this year, 98 percent of emergency room nurses in the Unites States reported verbal harassment and 67 percent reported physical violence.  While in Canada, 84 percent of the nurses in the emergency department witnessed verbal harassment once in every shift.  While there are 90 percent of them claimed to experience verbal abuse at least once a week.  In Australia, there are 70 percent of nurses who experience violence at least five times a week.

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.