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Curbing ED Dangers Requires Strong Leadership

Alexandra Wilson Pecci, for HealthLeaders Media, April 24, 2012

For example, "if you have a patient that stands in the door of their room a lot, those are the patients that you want to go and address early before they come out yelling and screaming," she says.

Nurses also learn about using non-confrontational body language. For instance, standing with an "open" body—arms uncrossed, knees apart, etc—is less threatening than standing with a closed body.

Of course, there are times when violent or disruptive behavior can't be prevented—patients under the influence of drugs or alcohol are especially unpredictable. In these cases, learning when to call for backup is critical.

According to Johnson-Kelley, since implementing the training, they've seen an increase in the use of "Code Gray," which she says can be attributed to the staff learning how to use it. The incidents of staff assault have remained the same.

"So, if you note that the number of calls is up and the number of injuries has not increased you can draw the conclusion that the training is helping as the assaults reported has not increased with the number of Code Gray calls," she says.

Nurses at the center of violent situations also need to feel cared for themselves. Johnson-Kelley says if nurses are hurt, they should not only be given medical care in the ED; the hospital should also provide support if the nurse decides to press charges against the assailant.

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