I want to thank you for your April 7, 2014 article bringing attention to the problem of violence in the ER, the fear of nurses working there, the lack of training, and the tendency not to report assaults. What nurse have to realize is that violence isn’t just “part of the job” and that crossing the threshold of the ER door (or any hospital door for that matter) does not strip us of our civil rights. Most training provided teaches “de-escalation” which is simply verbal skills to try to defuse the angry party. Training usually neglects to teach us what to do when the situation turns violent, leaving staff to react however they will, and leaving the nurse in danger of injury and the facility at risk for litigation. OSHA mandates employers train for known hazards, and yet facilities continue to stick their heads in the sand on this issue, when this type of training is more likely to be needed than our annual fire extinguisher check offs. I am proud to say that my facility has started using a program called “Escaping Violent Encounters for Healthcare” that was developed by a company called DT4EMS. We teach our staff how to recognize a potentially dangerous situation, avoid it, and then should the worst happen, how to escape the violent encounter. The program teaches that there is a difference between a patient and an attacker, and empowers nurses to remove themselves from danger, allow security and law enforcement to do their job, so we can safely focus on ours. The class stresses the importance of reporting, and we teach our employees to use the hospital address to keep their homes safe. The class is causing an amazing culture change, and people who were looking for new jobs say they now feel safe to stay. It’s wonderful to see. Nurses can take the class on their own if their facility won’t offer it, and I think it is one of the most valuable classes an ER nurse can take.
