Since AJN is read by a broad spectrum of readers, we aim to have content for every nurse in every issue. That means providing articles on a wide variety of topics; it's the reason we don't do themed issues. But among the varied content in this month's issue are two articles that focus on the same topic—and it's a topic that unites all nurses: the increasing presence of violence in the workplace.
As new nurses, we quickly became aware of the routine hazards of our profession: the back and neck injuries; the physical strain of lifting patients, bending over beds, and pushing and pulling equipment; the emotional stress of a high-pressure job, where mistakes in judgment can cause real harm. But few of us began our careers expecting physical violence to be a common occurrence. In recent years, however, things have changed. Violent behavior seems to be a commonplace and increasingly frequent occurrence in hospitals and nursing care facilities. More and more, such violence is the result of intentional harm.
Researchers from the National Institute for Occupational Safety and Health found that the incidence rate of injuries from workplace violence increased by 23% each year between 2012 and 2015. In 2016, the Bureau of Labor Statistics reported 6,190 cases of nonfatal injuries from violence in hospitals, of which 3,490 were intentionally inflicted by another person. Nursing and residential care facilities reported a total of 8,240 nonfatal injuries, with 5,160 classified as intentional.
An American Nurses Association survey of 3,765 RNs and nursing students conducted in 2014 revealed that 43% of respondents had been verbally and/or physically threatened by a patient or a patient's family member; 24% reported they had been physically assaulted. Clearly, this is a major problem that needs to be addressed.
In their article in this issue, “Workplace Violence Training Using Simulation,” Brown and colleagues describe a program developed at their institution that uses simulation training on a mock unit. The goal is to train staff how best to react when faced with a threatening or overtly violent incident. Through participation in staged scenarios involving an active shooter and debriefings, staff learn what to say and do to increase the odds of surviving an assault and to protect patients. (To see a video clip of a simulation that accompanies the article, go to http://links.lww.com/AJN/A125.)
Another article on this topic, “Workplace Violence,” appears in this month's Legal Clinic column. Nurse and attorney Edie Brous provides an overview of the pervasiveness of workplace violence and discusses the underreporting of it. She also describes what nurses should expect their employers to do to keep them safe at work. She notes that addressing the issue requires a multipronged approach that includes the passage of legislation, the establishment of “zero tolerance” policies and training by employers, and nurses educating themselves on policies and programs that support safety.
Her takeaway message is an important one: “Nurses should never accept workplace violence as just part of the job…. Violence is perpetuated when it is normalized.”
Also in this issue, we're very pleased to publish research by Mason and colleagues that was conducted as an adjunct to their recent replication of the 1997 Woodhull Study on Nursing and the Media (the replication study is being reported elsewhere). In this qualitative study, the researchers examined why reporters don't seek out nurses’ views when reporting on health care—an important issue, because they are perpetuating nursing's invisibility and negating nursing's importance in health care by ignoring nurses’ opinions. The authors also offer recommendations on what to do to increase journalists’ use of nurses as sources.
Then there are our two CE articles: one on a relatively new intervention for hemorrhagic shock—resuscitative endovascular balloon occlusion of the aorta—and the other from the Hospice and Palliative Nurses Association about managing pain in people with opioid use disorder, another issue nurses are increasingly confronting. And of course there's coverage of major health news, commentaries, and more.
All in all, we've got something for every nurse. Read on.