Curbing ED Dangers Requires Strong Leadership

Just because they're in a hospital setting, doesn't mean patients are exempt from prosecution, and nurses leaders should be remind their staff of that, Johnson-Kelley says.

If the nurses endure a particularly violent or disturbing event, Johnson-Kelley says the staff will do a "huddle" afterwards to "talk with everybody about what happened and get everyone's feelings out." Nurse leaders should also follow-up with abused nurses to see how they're coping.

Here are a few other tips from Johnson-Kelley:

• Anticipate the situation. Teach your staff to round with patients and their families.
• Put systems in place to provide safety for the staff, such as emergency panic buttons and security officers that are on-site and visible
• Debrief. "We try to do it right after the incident so we can involve everyone involved. Make use of your organizations Employee Assistance Program (counseling) to ensure your staff receive the support they need," she says. "Make sure your staff feel supported when they report an assault."

Although violent patient behavior may never go away, perhaps especially in the ED, the commenter on last week's column is correct: "Certainly more needs to be done to protect medical staff." Mandatory crisis prevention courses might not be the whole answer, but they are a start. So, too, are leaders who provide support and education to nurses.

"I don't tolerate it," Johnson-Kelley says. "It's not acceptable at any level for anybody to either verbally or physically abuse the staff here."