Step Away From That Nurse! Violence in Healthcare Continues Unabated

Laura A. Stokowski, RN, MS

Disclosures

November 19, 2014

In This Article

Editor's Note: It was only earlier this month that another attack on nurses was reported, this time at a hospital in Minnesota, when it appears that a patient suddenly became violent and attacked nurses with a metal bar taken from his hospital bed. The frightening video shows how the nurses were attacked as they sat in the nurses' station in the middle of the night.

Brutal Attacks on Nurses

A nurse approached a patient's bedside to remove an intravenous (IV) catheter in preparation for discharge from the hospital.[1] He lunged at her, hitting her with an IV pole and knocking her to the ground, stomping on her head, and beating her repeatedly until she became unconscious. The nurse suffered head trauma and multiple fractures to her face. She survived the attack but required neurosurgery and was in critical condition for some time. The patient, who was not known to be dangerous, apparently became angry when told he was being discharged from the hospital.

Fortunately, such extreme incidents of violence are not everyday occurrences in healthcare. Still, they do happen, as illustrated by the following headline-making incidents:

At a psychiatric hospital in Maine, a patient attacked a nurse with a chair, injuring her face and head. In an earlier incident in the same unit, another angry patient beat a nurse in the head and stabbed her with a pen.[2]

A corrections facility nurse in Michigan was checking on an inmate whom she thought was having a seizure, when he jumped up and attacked her.[3]

At an ambulatory surgery center in Texas, a patient's son accused staff of trying to kill his mother, and he fatally stabbed a nurse who tried to protect other patients from harm.[4]

At a rehabilitation facility in Oklahoma, a man became angry when nurses removed his father's urinary catheter, attacking a nurse with a wrench, pulling out some of her hair, and forcing her into a medication room.[5]

In California, two incidents took place on the same day in different nearby hospitals. A visitor bypassed a weapons screening station and purportedly stabbed a nurse 22 times. In the second incident, a visitor grabbed a nurse and stabbed her in the ear with a pencil.[6]

These events show that attacks on nurses can be sudden, serious, and life-threatening. They take place in a broad range of settings and involve patients, family members, and visitors who become angry for seemingly minor reasons or for no apparent reason at all. Violence against nurses is more frequent in, but not limited to, the emergency department (ED) or psychiatric units. It can happen in any healthcare setting, at any time. The unpredictable nature of workplace violence in healthcare is what makes it so difficult to prevent.

And the violence is not just physical. Emotional, sexual, and verbal abuse are not only more common, but are much more likely to be unreported. Nurses who are threatened with physical violence, but unharmed, do not always report the incident to their supervisors. Thus, firm figures on the frequency of workplace violence in healthcare are elusive.

Reading about these incidents of violence is a little scary. After all, no nurse goes to work expecting to be physically assaulted. Fortunately, the problem of workplace violence has not gone unnoticed by healthcare researchers, and new data are expanding our understanding of the threat to nurses.

A disheartening trend evident in the healthcare literature is that violence against nurses appears to be a growing problem globally.In the past 2 years alone, articles have been published in the professional literature on violence against nurses in the United Kingdom,[7] Ireland,[8] Australia,[9] New Zealand,[10] Switzerland,[11] Sweden,[12] Slovenia,[13] Greece,[14] Turkey,[15] Cyprus,[16] Pakistan,[17] Iran,[18] Jordan,[19] Egypt,[20] Nigeria,[21] sub-Saharan Africa,[22] Japan,[23] and China.[24]

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