[medi]

I was reading through my older site mail and pulled this from the archives because I thought it made interesting reading & a good conversation piece in the case of this topic.. and I think it will give us all food for thought about the state of affairs of healthcare facilities - short staffing etc- we all face. Read this and please share with us all whether you could imagine this happening in the place where you work-- and if so-- what could help prevent it ok?

From a nurse who was working for a VA Hospital at the time:

"I began my nursing career at a local VA Hospital in 1993. While providing medical care to a fully competent veteran patient he assaulted me by grabbing my thumb and pulling it up behind my back. He held me in this hold for quite
sometime, I called for assistance at the same time struggling to get away. I was able to finally break free but as I did he grabbed my wrist and also bent it back. At this time, nurses began to arrive in the room and break the hold that he had on me. I was then sent to the Emergency Room where X-rays were taken of my thumb, wrist and hand. The Orthopedic, MD, that that I had torn ligaments and tendons and he placed me in a splint and was told to return in one week. During that week I had severe burning and swelling in my hand and wrist. When I returned in one week he then placed me in a spica cast and sent me on my way. Within two days I returned to his office with burning pain,
swelling and numbness in my fingers. He was not happy with me, he stated tome, " do you know how much these casts cost?" Personally I could have cared less, this was my hand. By the way, this Orthopedic doc only seen patients
for hips and knees!! Well.... he split the cast, moved it around and taped it closed and I wore it like this for another 6 weeks. When he removed it 6 weeks later, my thumb was considerably shorter than the other and it had a
large knot on the joint which he had no explanation for. As my condition was no better, they decided to send me to a hand specialist. ( I should note that I was never advised that I had a choice of physicians from the very beginning). Well, this new physician was no better. He ordered 6 months of physical therapy and after this failed he decided to do surgery. Following this I had extensive scar tissue and severe nerve damage.

I returned to light duty work duty work in an office setting as a program assistant. I did this for three years as best I could coping with the pain. Then my boss in her infinite wisdom decided I could do Home Health work. She
stated that the only patients I would see would be medically stable. Wrong...they sent me to the home of a patient that had just been released from the hospital, and he was completely unstable. During my visit the patient stated to me that he needed to use the bathroom. As he stood up he began to fall forward, I grabbed him with my already weak extremity and pulled him back to a sitting position. In doing so I immediately knew that I had injured my shoulder. Upon returning to the office I advised my supervisor of the incident and was advised to go to employee health. They stated to me that they would try to get me in to an Orthopedic doctor as soon as possible.
That was 10 days later. It would have been even longer if I had not finally got upset and demanded that they do something. It ended up that I had a torn rotator cuff. Well, to make a long story short I had two shoulder surgeries. After the last surgery I developed severe pain and a burning sensation like I had never known. The surgeon then sent me to a Pain Management Specialist who stated that he suspected that I had RSD. When I went back to the surgeon he stated that there was nothing else he could do for me and stated that I should continue to see the Pain doctor which I have been doing and continue to do. The RSD has now spread to my other upper extremity and my right lower extremity. The prognosis is poor. I am now permanently disabled all from this traumatic injury that could have prevented had my employer taken proper action. They had allowed this behavior among patients. They never supported their staff. During my time as a nurse there I had seen many nurses injured as a result of patients with this type of behavior. I hold my employer to blame for my injury, as a matter of fact, I was told to keep my mouth shut and talk to no one regarding this issue. When this incident occurred it should have immediately been turned over to security, which it wasn't. This patient was never held accountable for his actions, nor any of the others that injured any of my coworkers. This is not acceptable. I am sure that until things are corrected it will continue to happen. Workers are afraid to challenge the system in fear that they will lose their jobs."

What are your thoughts after reading that?

Have you ever experienced or known a nurse who received an on the job related injury that was due to patient injuring the staff?

Are staffing conditions giving rise to increased risk to your safety on the job?

What could change things for the better?

[medi]

Remember that psych nurse who got hurt by a patient that I mentioned? I found a story about her that everybody should read...

"The war against nurses"
http://dir.salon.com/news/feature/20...ses/index.html

This is a sickening excerpt from the piece..
"In the state of Massachusetts, it's a felony to attack an E.R. doctor," workplace violence expert Marilyn Lanza points out, "but only a misdemeanor to assault a nurse."

Wonderful eh?

[FluffyBear]

I've done some searching on sites to see if there is any information on this sort of thing. I found an article at the international nursing site that is a Framework for addressing health sector violence. I feel it is a great starting point for finding better ways of dealing with the many potential violent situations, but that it isn't very realistic in its need for resources that are not available in today's Canadian health care systems. I could not even begin to comment about other countries health care systems.
If anyone is interested in this .pdf file, you can find it at http://www.icn.ch/proof3b.screen.pdf . I would be curious as to what others think of this framework.
One of the points that were made to stop workplace violence was to create a job design that would decrease the potential. A few of the ways this could be acheived are (and I am quoting directly here):
• job planning is improved
• work overload should be avoided
• pace of work is not excessive
Having only gotten to the point where I am now doing my clinical practice on a surgical floor, and seeing the low morale of the nurses there, I wonder how much would have to be done to make it an environment that worked for the nurses, the patients, and all the other members of the health care team.

[nursinghumor]

Hi Everyone,

Found this article on the Nursing Spectrum website. It's one of their Continuing Education modules, free to read:

Surviving and Thriving with Conflict on the Job Valerie Restifo, RN, MA, MS, NursingSpectrum.com:"The goal of this program is to enhance nurses’ abilities to effectively deal with conflict on the job. After you study the information presented here, you will be able to —
Analyze the dynamics of conflict in the workplace.
Identify behavioral responses to conflict and their outcomes.
Apply five conflict resolution strategies to specific situations."
http://nsweb.nursingspectrum.com/ce/ce112.htm

Sheds a lot of light on the topic.

Andrew Lopez, RN
http://www.4nursing.com

[1mg.epi]

Where I work we have had increased staff on staff attacks during stressful times. Most recent was a doctor who grabbed a (smart-but)male nurse by the throat and choked him fro 3-4 sec. He still works here and the prosecuting attorney will not touch the case. If we do not hold people responsible for their actions, can this happen again?

[JeannieTaylor]

I guess the state of Arizona is good for something. In our E.R. there is a huge sign that states, 'it is a felony to harm any health care personnel.' I take that to mean ANYONE working for the Hospital gets the same protection by the law.

[1mg.epi]

We have that law also. I was assulted when I worked ER. Got the person 90 Days when I pressed charges. Mind you, the hospital does not like us pressing charges.

[HemoStat]

When I was a young new grad, a physician threw a bottle of IV fluid at me because, according to him, it didn't matter what he asked for, I should have known what he meant.

He missed hitting me with the bottle, but it scattered and cracked a glass window next to me and I got wet and there was glass in my hair.

I didn't prosecute, but the hospital banned him from admitting patients to the ICU and reassigned his existing patients to other physicians for a month or until I accepted his apology, which ever came first.

A month later he regained his priviledges and to my knowledge didn't try that commando tactic again........

We put up with enough verbal crap from the Doc's without having to be physically acousted....Don't they realize we are on the same team?

HemoStat

[Pony Girl]

This story sounds like its fit to print. Unbelivable. Did someone turn in a formal complaint about this MD's conduct to the board of medical quality assurance?

[LauraRNwv]

What about the elderly or confused patients who beat the crap out of you when you are trying to help them up out of the floor/off the bedside commode/into their beds/out of the hallway/off the elevator/out of other patient's beds? Do nurses have any recourse when they are injured by these folks? I have been a nurse for 12 years, but have always been told that there is nothing that can be done if the patient didn't know what they were doing/had altered mental status.