Types of Workplace Violence
Usually, no relation to business or its employees (example - nurse assaulted on the way to parking garage; nurse is robbed while on the way to a home-health visit)
Criminal Intent
A patient lunges at a staff member in the emergency department
Staff Assist
A charge nurse purposefully "dumps" ambulance patients in the same nurse's assignment because they had a disagreement two weeks ago
Covert Bullying
Charge RN/APCM/PCM, MD/APP, SW, RN, EDT, Security, SW gather outside the patient's room to do introductions, describe the purpose of the meeting, address patient/family concerns, develop behavioral plan, understand clinical picture. Decide who will lead the discussion
2. DART Team Huddle
This type of violence is the most common in healthcare settings - most frequently in emergency and psychiatric treatment settings, waiting rooms, and geriatric settings.
Customer/Client
A patient family member continually comes up to the nurse's station and walks into another patient's room looking for their nurse. Returns back to their room when prompted.
DART
A doctor might consistently criticize a nurse's work, but never directly confront them or offer constructive feedback.
Covert Bullying
Notify the Charge Nurse that a DART has been activated. USII will send a Voalte message to the team members with a location and time to meet.
1. Activate DART
This type of WPV includes bullying, and frequently manifests as verbal and emotional abuse that is unfair, offensive, vindictive, and/or humiliating. It is often directed at persons viewed as being "lower on the food chain" such as in a supervisor to subordinate, doctor to nurse, nurse to nursing assistant or other ancillary staff. This could also include peer-to-peer violence.
A patient is yelling, slowly walking towards an ED technician who is cornered in a treatment room
Staff Assist
A nurse might yell at or insult a colleague, making them feel humiliated and disrespected.
Overt Bullying
Enter SAFE event and document disruptive behavior, what action was taken, and the follow up/assessment in a blank note. SW to enter progress notes of meeting outcome and enters flag into patient's chart. Security reports their leadership the DART activation for tracking.
5. Document plan/reevaluation of plan of care as needed
The perpetrator has a relationship to the employee outside of the workplace that spills over into the work environment. For example, the partner of a nurse follows her to work, repeatedly calls the employer creating a disruption in the working environment and threatens them or their colleagues.
Personal Relationship
A patient has a disruptive outburst due to type and route of pain medication ordered by the physician
DART
A supervisor might publicly criticize an employee's performance during a team meeting, embarrassing them in front of their colleagues.
Overt Bullying
Debrief with the team outside of the patient's room. Appoint follow up items to specific team members. Determine 24-hour (or sooner) follow up plan.
4. Debrief with DART team members
Behavioral plan of care discussion with patient and/or visitor.
3. Discussion with patient/visitor