VIOLENCE

IN
NURSING
WHAT IS VIOLENCE?
What is VIOLENCE?
╚>> any incident where an employee
is abused, threatened or assaulted
in circumstances arising out of,
or in the course of,
their employment.
What is VIOLENCE?
╚>> the intentional use of physical force or
power, threatened or actual, against
oneself, another person or against a group
or community that either results in
or has a high likelihood of resulting
in injury, death, psychological harm, mal
development or deprivation
(WHO, 2000)
What is VIOLENCE?
╚>> “THREAT”
= a statement or behavior
that causes a person to believe
they are in
danger of being
physically attacked
What is VIOLENCE?
╚>> “PHYSICAL ATTACK”
= direct or indirect application
of force by a person to
the body of, or clothing
or equipment worn by,
another person
WHAT ARE THE TYPES OF
VIOLENCE?
TYPES of VIOLENCE
VERBAL
ABUSE PHYSICA
L ABUSE

PSYCHOLOGI
CAL ABUSE
WHAT ARE THE EXAMPLES
OF VIOLENCE?
EXAMPLES of VIOLENCE
PUNCHIN
PUSHING
G

YELLING
BITING

THROWI
SEXUAL
NG
HARRASMEN THREAT OBJECTS
T S
 WHAT ARE THE
CLASSIFICATIONS
OF VIOLENCE?
Classification of violence

A. CLIENT – INITIATED VIOLENCE

= covers situations where a client or

a client’s family member, friend, or
guardian can be the source of the
violence
Classification of violence

B. INTERNAL VIOLENCE

= covers situations where someone

who works under the direction of an
organization is the source of
the behavior
Classification of violence

C. EXTERNAL VIOLENCE

= covers situations where violence is

perpetrated by persons with no
legitimate relationship to the
organization
 WHAT DO YOU NEED TO
ASSESS IN ORDER TO
KNOW IF THE CLIENT
IS PRONE TO VIOLENCE?
 INITIAL ASSESMENT
1. The patient’s mental status

2. The patient’s physical status

3. The patient’s past history of

violent behavior
 INITIAL ASSESMENT
4. Signs and symptoms of current
intoxication or
use of mind altering drugs

5. The patient’s past history of

criminal activity
 INITIAL ASSESMENT
6. The patient’s financial history

7. The patient’s coping

mechanisms for stress
and patterns of
expressing anger
 INITIAL ASSESMENT
8. The patient’s history of family
violence

9. If the client has made

any sexual advances or
communications directed
toward the healthcare worker
 INITIAL ASSESMENT
10. If the patient has access to any
foreign object
that could cause harm
to the caregiver
 WHAT CAN YOU DO TO
DEFUSE A POTENTIALLY
VIOLENT SITUATION?
 10 Do’s and Don’ts

DO:
1. Watch for signs of escalation in the
angry person.

2. Take control of the immediate

environment.
 10 Do’s and Don’ts

3. Project calmness. Speak quietly and

move slowly. If standing, maintain a
relaxed, a non-threatening posture,
at right angles, not directly in front of
the person.

4. Use empathetic listening skills.

 10 Do’s and Don’ts

5. Manage the aftermath of a critical

incident by debriefing with all staff
members who were involved to
discuss the incident, critique the
action taken, and plan for future
occurences.
 10 Do’s and Don’ts

DON’T:
1. Ignore warning signs or your “gut”
feelings.

2. Corner the person or allow

yourself to be cornered.
 10 Do’s and Don’ts

3. Interrupt, argue, or speak

condescendingly.

4. Touch the person or allow them to

touch you.

5. Try to be a hero if the person has a

weapon.
 WHAT ARE THE
EMPLOYERS’
RESPONSIBILITIES TO
PREVENT WORKPLACE
VIOLENCE?
Employers’ Responsibilities
► Before hiring an individual, do
intensive background checks

► Provide training for all employees

► Provide on the job counseling for

employees
Employers’ Responsibilities
► Make the workplace the safest
possible for all employees

► Make sure employees are told about

a no tolerance level for any
potential threatening situations
that may occur in the workplace
 WHAT DO THE
CURRENT SURVEY
RESULTS TELL US
ABOUT WORKPLACE
VIOLENCE?
SURVEY RESULTS
Studies have shown that
35% and 80% of hospital staff
has been physically assaulted
at least once
during their careers.
SURVEY RESULTS
36% of the Registered Nurses
report having experienced
episodes of violence
in their workplace
in the past five years.
SURVEY RESULTS
62% said that they or a
co-worker had been verbally or
physically assaulted at work – but

22% did not

report the assault.
SURVEY RESULTS
Registered Nurses in
Emergency Departments (76%)
and mental health units (67%)
were mostly likely to experience
an episode of
work-related violence.
SURVEY RESULTS
Assaults came from
patients (38%);
visitors (23%);
even coworkers (18%),
physicians (10%)
and management (6%).
SURVEY RESULTS
Almost half (48%)
of all responding RNs
said they had not
received sufficient training
on violence prevention strategies.
SURVEY RESULTS
Almost half of the RNs
also said there was a lack of
adequate numbers of trained
security personnel at their facility.
THANK YOU