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ED Violence Racks Up Huge Costs

Alexandra Wilson Pecci, for HealthLeaders Media, February 11, 2014

"There is a barrier when hospital administration and hospital leadership don't support nurse reporting," Brecher says, adding that although nurses' direct managers might support them, that support might disappear higher up the chain of command.

The new study illustrates these kinds of barriers. Some leaders, for instance, might be afraid of bad publicity for the hospital. One nurse who experienced violence said, "[The Chief Nursing Officer] seemed to be more concerned that I was filing a police report than over the fact that I was assaulted." Another nurse said that the hospital wanted to appear "friendly" so it didn't secure the doors or install weapon detectors: "Administration will only take action when some lethal event happens."

Brecher says despite barriers like these, she believes that hospitals can change the culture of complacency and acceptance around violence in the ED. In fact, she's seen it happen.

"The ones that were successful had a multidisciplinary team who were not afraid to look back…and assess the culture of their organization," she says. They define violence clearly (for instance, is spitting violence?) and educate staff about what it is.

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1 comments on "ED Violence Racks Up Huge Costs"


Marilyn Kirchner (2/18/2014 at 10:43 AM)
Reading your article regarding violence in the ER struck home. I was assaulted by a patient, knocked unconscious and the same culture of "part of the job" prevailed. My interaction with this patient was only seconds, he looked passive and there had been no mention of potential violence. I over heard the administrator asking "what I did to rile him", I felt assaulted all over again. I am retired now, miss nursing greatly, but our society has fostered this violent culture many patients are literally given a "free pass" since they hide behind their persona of a patient. There is no impulse control due to much lack of parenting, but the nurse should not be the punching bag. I applaud and strongly urge any legislation which would protect ALL medical personnel, and I agree it MUST start at the top with demonstrated "zero tolerance" not just lip-service.