Thursday, April 12, 2007

Psychiatric nurses react differently to attacks on staff vs patients on inpatient units

"Psychiatric nurses have a one in ten chance of being physically injured by an aggressive patient over the course of a year and many more suffer emotional distress because of the verbal abuse they receive while working in these difficult and challenging environments."

Didn't realize my odds were that bad. When I was working in the psychiatric emergency room, we would regularly have people who came in totally out of control. However, part of the job is always being on your toes, and having security guards around to help out when we needed the extra muscle really helped too. The verbal abuse was totally unavoidable, and I just chalked that up to a job hazard. Luckily, in the 3 years that I worked there, I don't recall any physical injuries from attacks on my unit, though we definitely had patient assaults and crazy incidences in that time.

Sometimes I think that my risk is actually higher these days, since I'm in an outpatient clinic where security and other staff are not as readily available, and I'm behind a closed door alone with patients all day long. It's easier to get lulled into a sense of security when you don't have the constant adrenalin of emergencies wandering thru the door all the time. I have a panic button, but that's just not the same as having someone within line of sight. At least we still have annual safety trainings, and we get a couple days where we practice verbal de-escalation, and practice at physically getting out of holds and chokes.

More data from the study:

"Researchers from The City University, London, recorded 254 aggressive incidents on five acute inpatient psychiatric wards over a ten-month period. " "57 per cent of the aggressive incidents that took place at the inner city hospital were aimed at staff, 19 per cent involved other patients and 12 per cent resulted in self harm. Seclusion was used to resolve more than a quarter of all incidents, with a further 23 per cent resulting in the patient being held by force."

All this means is that nurses put patients in full seclusion and restratint more often when another staff member was attacked than when another patient was attacked. I guess this makes since, since

I guess this makes sense. People have a tendency to retaliate more when they perceive they are personally at risk.

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