Of course everyone should be safe at work. And everywhere else. There is no question about this.
What concerns me though is the tendency of the nursing field to often approach this in a "respect my authority" manner. Of course, not all nurses, and all that, and I would say (as someone who has children with high support needs, has worked in many emergency and acute psychiatric settings, and frequently expert witnesses on healthcare-related cases) that most nurses have adequate skills in terms of treating people like people and keeping everyone safe and respected. I've generally had a collaborative relationship with most nurses on my teams and those who care for my children.
However, I've also worked with a loud minority of nurses who view themselves as in charge of everyone, experts in everything, and unwilling to listen to anyone else, and these nurses also tend to be the ones who focus on how they got called a mean name, rather than understanding that someone is in a really tough situation. It's well-documented that nursing is unfortunately one of the professions that attracts people who want to abuse power without needing a relatively high amount of schooling (along with police, state agency workers, administrative assistants in certain settings, etc.) The licensing boards and hospital administrations tend to back up these nurses, again, citing the "they have an extremely difficult job" line.
I would be interested to see a study observed coded by a neutral third parties in terms of whether nurses are being assaulted equally across the board or whether it's certain ones repeatedly, whether they were consistently employing active listening and shared decision making before it happened, and whether this is correlated with nurses trash-talking and blaming people for their situations.
From what she tells family, the problem is that psych patients are either sent to medical facilities or jail facilities - and not to secure places built to deal with their specific issues. Then the attitude is "nurses just have to deal with it" rather than "we need to fix this system".
Nurses often don't have time for "active listening" or "shared decisionmaking" with anyone, given high patient to nurse ratios and constant demands to hop from one technical skill procedure to the next (what the hospital considers to be their job as these generate billing codes). Or they are not trained to do so in an effective manner. Or both.
You are veering dangerously close to blaming the victim here, too. It would be interesting to see studies - but understand that time pressures are extreme and COVID has blown them up massively. Also understand that it is the "big nurses" that are sent in to take care of mentally decompensating patients, and this would have to be accounted for in a lot of research.
Folks in an emergency room waiting for either discharge with services in place or transfer to a psych facility are generally assigned a "sitter" who is a CNA or similar. These folks attend to them, set limits, get them anything they need, listen to them, etc. They do not have any training other than on-the-job training in terms of listening to folks and keeping them happy. They are usually quite effective at this.
It isn't blaming the victim to point out that exactly what *is* upsetting folks is people coming at them with the attitude of "I don't have time to listen to you." That's exactly the kind of thing I see getting people upset, when people tell someone they have too much work to do, aren't trained in this, and can't help someone out.
The study you linked showed that simple training in listening and deescalation did significantly decrease assaults. It also stated that 41% of nurses in the study reported horizontal violence (insults, sabotage, etc. coming from other nurses).
I can tell you that when I'm working in acute settings, so little of what I'm using directly with folks is my advanced clinical training. It's not a time or place to be doing therapy. Literally what I'm doing is understanding that they're somewhere they don't want to be, they're scared, they feel like whatever is going on is going to last forever, and they don't have any reason to trust us. Of course the system is broken. The easiest way to help people deal with a broken system is to tell them you realize how very much it sucks, not tell them it isn't your fault and they're inconveniencing you personally. This isn't a difficult skill to teach, but it requires people to buy in, and it requires a culture shift. Telling someone you don't have time for them after they've either taken a huge risk to seek help or have been involuntarily transferred is of course going to escalate them. I'd be pissed off too. Same thing with arguing and rolling your eyes when they (usually correctly) assert that they have the right to certain things.
Comments
If we had socialized medicine
Would that make the nurses federal employees, and would people get into bigger trouble for assaulting them?
When I had my gall bladder
When I had my gall bladder out at Milton Hospital, my roommate attacked the nurse by punching her in face. The police were called, etc.
The gall...
Sorry, it was too easy
Partial story though
Of course everyone should be safe at work. And everywhere else. There is no question about this.
What concerns me though is the tendency of the nursing field to often approach this in a "respect my authority" manner. Of course, not all nurses, and all that, and I would say (as someone who has children with high support needs, has worked in many emergency and acute psychiatric settings, and frequently expert witnesses on healthcare-related cases) that most nurses have adequate skills in terms of treating people like people and keeping everyone safe and respected. I've generally had a collaborative relationship with most nurses on my teams and those who care for my children.
However, I've also worked with a loud minority of nurses who view themselves as in charge of everyone, experts in everything, and unwilling to listen to anyone else, and these nurses also tend to be the ones who focus on how they got called a mean name, rather than understanding that someone is in a really tough situation. It's well-documented that nursing is unfortunately one of the professions that attracts people who want to abuse power without needing a relatively high amount of schooling (along with police, state agency workers, administrative assistants in certain settings, etc.) The licensing boards and hospital administrations tend to back up these nurses, again, citing the "they have an extremely difficult job" line.
I would be interested to see a study observed coded by a neutral third parties in terms of whether nurses are being assaulted equally across the board or whether it's certain ones repeatedly, whether they were consistently employing active listening and shared decision making before it happened, and whether this is correlated with nurses trash-talking and blaming people for their situations.
Yes and no
My niece works ER in the Chicago area.
From what she tells family, the problem is that psych patients are either sent to medical facilities or jail facilities - and not to secure places built to deal with their specific issues. Then the attitude is "nurses just have to deal with it" rather than "we need to fix this system".
Nurses often don't have time for "active listening" or "shared decisionmaking" with anyone, given high patient to nurse ratios and constant demands to hop from one technical skill procedure to the next (what the hospital considers to be their job as these generate billing codes). Or they are not trained to do so in an effective manner. Or both.
You are veering dangerously close to blaming the victim here, too. It would be interesting to see studies - but understand that time pressures are extreme and COVID has blown them up massively. Also understand that it is the "big nurses" that are sent in to take care of mentally decompensating patients, and this would have to be accounted for in a lot of research.
Here's a pre-covid study on the situation: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6025092/
This is the whole problem though
Folks in an emergency room waiting for either discharge with services in place or transfer to a psych facility are generally assigned a "sitter" who is a CNA or similar. These folks attend to them, set limits, get them anything they need, listen to them, etc. They do not have any training other than on-the-job training in terms of listening to folks and keeping them happy. They are usually quite effective at this.
It isn't blaming the victim to point out that exactly what *is* upsetting folks is people coming at them with the attitude of "I don't have time to listen to you." That's exactly the kind of thing I see getting people upset, when people tell someone they have too much work to do, aren't trained in this, and can't help someone out.
The study you linked showed that simple training in listening and deescalation did significantly decrease assaults. It also stated that 41% of nurses in the study reported horizontal violence (insults, sabotage, etc. coming from other nurses).
I can tell you that when I'm working in acute settings, so little of what I'm using directly with folks is my advanced clinical training. It's not a time or place to be doing therapy. Literally what I'm doing is understanding that they're somewhere they don't want to be, they're scared, they feel like whatever is going on is going to last forever, and they don't have any reason to trust us. Of course the system is broken. The easiest way to help people deal with a broken system is to tell them you realize how very much it sucks, not tell them it isn't your fault and they're inconveniencing you personally. This isn't a difficult skill to teach, but it requires people to buy in, and it requires a culture shift. Telling someone you don't have time for them after they've either taken a huge risk to seek help or have been involuntarily transferred is of course going to escalate them. I'd be pissed off too. Same thing with arguing and rolling your eyes when they (usually correctly) assert that they have the right to certain things.
It won't work until you fix the system
It isn't an attitude of "I don't have time" it is a REALITY.
You are putting way too much on the worker, far too little on the job.
Fix the job, not the worker.
Why not...
...fix both?
I'd guess both are in need of it.
This is victim-blaming
This is victim-blaming nonsense.