Emergency Department Workplace Safety Concerns

As discussed previously, the act of restraining or secluding a patient can present the ED staff with challenges in maintaining a safe work environment. The ED can be a scary and sometimes dangerous environment to work in. Amid the normal chaos of multiple staff and gurneys constantly moving rapidly throughout the hallways and physicians buzzing in and out of various rooms, there may be screams, yelling, or threats of violence that can be heard coming from patients. It is likely that some of these patients may be experiencing a mental health crisis.

In a survey covering a 2-year span from 2009 to 2011, 54.5% of surveyed ED nurses reported experiencing some type of physical violence and verbal abuse during a typical work week. One-quarter of the nurses surveyed stated that they had experienced physical violence 20 or more times over a 3-year period (Walsh et al. 2011). One of the chapter coauthors experienced patient violence when a patient he was assessing became agitated during an assessment and kicked him in his side torso; another patient pulled out a knife and made threats to stab him when he was discussing the patient’s discharge plan.

Given the potential for violence in the ED, it is important that ED staff feel safe and comfortable with the idea of coming to the workplace each and every day. Unfortunately, sometimes the stigma that is inherently attached to patients afflicted with psychiatric disorders can have a direct effect on the ED direct care staff’s comfort level in caring for and treating these patients. If the ED direct care staff do not feel safe and secure in their work environment, they may have difficulty providing a quality level of care to the patient. As Maslow’s hierarchy of needs shows, feeling safe and secure are basic human needs. If these basic needs are not met, the person will be unable to function at their highest potential level and ultimately both the patient and the staff member become victims to the fear that can be present while working with patients suffering from psychiatric disorders. This scenario raises a question: How can we ensure that our staff will feel safe and secure?

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