ER nurses facing increased assaults due to program cuts
Emergency room nurses face an increased fear and risk of being assaulted due to program cuts. According to a USA Today article, in a survey conducted by the Emergency Nurses Association, more than half of ER nurses surveyed indicated they have been assaulted by patients. It isn't uncommon for emergency room nurses to have been assaulted more than once. Strategies for dealing with such assaults vary from state to state; however, the problem has become so serious that efforts have been undertaken by the federal government to deal with the problem so that ER nurses are better protected.
The assaults
In Cleveland, Ohio, ER Nurse Erin Riley suffered multiple injuries, including a chipped tooth and several bruises and cuts when she tried to come to the aid of an ER physician being assaulted by a psychotic ER patient. In another case, a patient under the influence of alcohol groped her, according to an Associated Press article published on Breitbart. An ER nurse in New York had her jaw dislocated when she was assaulted by a teenage patient weighing 250 pounds.
It isn't just female ER nurses who have been attacked. Nurse Jeaux Rhinehart thought he had mastered techniques to get out of the way quickly enough to miss the kicks, punches, spitting and other types of ER assaults committed by patients. Then one day, he did not move quickly enough. An addict seeking drugs smashed him in the face with a billy club and broke several bones in his face. For several weeks while he recovered, his diet consisted of liquids he could drink through a straw. Another patient attacked him and threatened to come back and kill him. He says the assaults that have been committed against him by patients are always on his mind. Emergency Nurses Association President Bill Briggs, a nurse for 30 years, said in the USA Today article that he has suffered bruises and bumps and says that the assaults have had such an emotional impact on him that he wonders why he stays.
The effects of program cuts on ER nurse assaults
According to the AP article, increases in violent assaults against ER nurses have been increasing nationwide as more drug addicts, mental health patients and alcoholics seek services through emergency rooms. In fact, according to the Substance Abuse and Mental Health Services Administration, statistics do indeed support claims that violent assaults in the ER are increasing. From 2006-2008, the number of reported assaults in the ER rose from 16,277 to 21,406. It isn't only mental health and substance abuse services organizations, but also nurses who blame the downturn in the economy for the situation getting worse. States and communities have made significant cuts to programs and services, including cutting and eliminating substance abuse and mental health programs, closing state hospitals and trimming jobs in agencies that serve addicted and mentally ill populations.
The executive director of the National Association of State Mental Health Program Directors stated that with a downturn in the economy, this is the worst time to make cuts in programs that provide mental health services. Robert Glover says that in times of economic hardship, people have more anxiety about things such as job loss, and there are often more family problems and substance abuse during times of economic hardship. According to comments in an article published by Channel 22, WWLP, Glover also stated that when these people get to the point of being in crisis, due to program cuts, most of them will end up presenting to the ER. A Vermont nurse says that these patients expect fast-food type service and that they often lash out when they don’t get what they want, when they want.
Finding solutions to assaults on ER nurses
Rita Anderson, the New York nurse who was attacked by the 250-pound teenager, said "It doesn’t matter if you’re drunk, or you’re on drugs, or you’re in pain; that doesn’t give you the right to hit another person.” Nurses are beginning to stand up for themselves and push for measures to protect themselves, including safety measures in hospitals and stricter penalties for assaulting nurses, as well as filing charges against patients. These measures haven't come about easily. In fact, some government officials, courts and even nurses resist measures to prosecute patients who assault nurses in the ER.
Recommendations from the International Association for Healthcare Security and Safety include having a teamwork plan to recognize and de-escalate violence. An anonymous survey, in which over half of the more than 3,000 ER nurses surveyed revealed they have been assaulted while working in the ER, has led to efforts for stiffer punishment for patients committing ER assaults. Bill Briggs says that “every emergency department should have its own plan in place,” and he suggests that such a plan should include hospitals assessing and creating a safe environment in the ER, panic alarm buttons being made accessible and more security being made available.
It will, however, require that there not be as much resistance to stiffer penalties. Although 26 states have supported efforts for more severe penalties for ER assaults, some states have demonstrated resistance to such measures. Some states have no laws at all, and recently, North Carolina and Vermont rejected efforts that would have made it a felony to assault ER nurses. The Emergency Nurses Association plans to work with the Occupational Safety and Health Administration (OSHA) to ensure safety precautions are required in all states. Certainly, it should be a part of every ER nursing program to educate nurses about ER violence and measures nurses can take to protect themselves. Nurses would do well to keep themselves informed of the procedures to be followed regarding ER assaults, of efforts by nursing agencies and organizations and of state laws regarding assaults on ER nurses, and to realize the importance that they report any assault committed against them by an ER patient.
