VIOLENCEVIOLENCEIn the WorkPlaceIn the WorkPlace

Objectives: After completion of the presentation, the participant will be able to:

Identify 4 signs of a potentially violent situation.

Identify 3 methods of controlling disruptive behavior.

Describe how to report an incident at GBMC.

Describe 5 security measures you and/ or the facility can take to prevent violence.

Introduction:Violence is a serious problem. It occurs

EVERYWHERE...

.............Even in the WorkPlace! GBMC HealthCare, Inc. has developed this program to address this issue.

This self learning packet will provide you with the knowledge to prevent and de-escalate disruptive and potentially violent situations in the workplace.

Policy # 807 is found in the safety manual. It can also be found on the GBMC Intranet under Employee Health policies. FAMILIARIZE yourself with the policy: ZERO TOLERANCE is the position of our management at GBMC.

HOMICIDE IS THE LEADING CAUSE OF WORKPLACE DEATH

FOR WOMEN AND THE SECOND LEADING

CAUSE OF DEATH FOR ALL WORKERS

(Center for Workplace health and safety, Inc.)

Incidence:

One in 6 violent crimes occur on the job.

Highest incidences occur in places:– where cash is regularly

handled– where employees work alone

(late @ night)– where there is regular contact

with prisoners– AND.......................

Incidence cont.

WHERE THERE MAY BE HIGHLY EMOTIONAL

SITUATIONS, SUCH AS HOSPITALS AND SOCIAL

WORK/ SOCIAL SERVICES ORGANIZATIONS.

Incidence cont.

INTENSIVE CARE UNITS, ORs, MEDICAL-SURGICAL

FLOORS, NURSERIES, NURSING HOMES, AND COMMUNITY HEALTH SETTINGS HAVE ALL

BEEN THE SCENES OF VIOLENT ACTS!

OF 1209 EMERGENCY DEPARTMENT NURSES

RESPONDING TO A RETROSPECTIVE

SURVEY, 97.7% HAD EXPERIENCED SOME

TYPE OF VICTIMIZATION

(Journal of Emergency Nursing, 1991)

Causes of Violence Robbery is the number 1

cause in the workplace. BUT,

Violence occurs from: Coworkers, visitors, outsiders,

and customers under emotional stress

A relative, friend, or acquaintance entering the premise to do harm (Domestic Violence situations)

Individuals under the influence of a substance

Prolonged waiting

PREVENTION:

“UNIVERSAL PRECAUTIONS FOR VIOLENCE”

It should be expected but can be avoided or mitigated through preparation

Security Procedures:Self:

Alert security of unusual behavior

Identify visitors

Wear ID badge

Store briefcase and purse locked and out of site

Do not walk alone at night

Facility: Visitor registration Lighted hallways &

stairwells Lighted garage Cameras Panic buttons

(garage) Safety surveillance

– security; – plant operations; – safety committee; – management

Security Procedures cont.

Facility Layout Unit Layout: location doors,

windows, furniture Identify items that may cause

injury: chairs, small equipment

Identify items that could help protect: mattress, pillows, sheets

RECOGNITION OF POTENTIALLY

VIOLENT VIOLENT SITUATIONS

TAKE THREATS OF INTIMIDATION SERIOUSLY!!

DO NOTNOT IGNORE!

Threats may be:

verbal, written, physical, over the phone, or through e-mail

Signs of Potential ViolenceViolence

Threats Tantrums- may be sign of

more violent behavior Withdrawn Angry Blames others Becomes verbally/ Physically

Abusive Talks about guns

MORE SIGNS! Unreciprocated romantic

obsession Expressions of hopelessness

or heightened anxiety Violence towards inanimate

objects

Levels of Disruptive Behavior

1. Anxiety, discomfort, anger

2. Defensive- Verbally Threatening

3. Physically Acting Out

4. Stimulation/ Stress Reduction

1. Supportive/ Reassurance

2. Directive: Set reasonable, consistent, clear limits

3. Proper physical control

4. Staff establish Rapport

ACTION:

Setting Effective Limits

Explain which behavior is inappropriate

Explain why the behavior is inappropriate (focus on behavior; not person!)

Give the individual reasonable choices

Allow time for the individual to make a choice

Enforce Limits

Setting Effective Limits

Remember: Speak in calm, soft voice Do NOT intervene alone! Adopt a supportive posture (no

arms across chest; no hands in pockets!)

Be aware of personal space: Don’t allow yourself to be backed into a corner!

Do not convey negative feelings Listen, Listen & Listen!

Methods of Controlling Disruptive Behavior

Verbally Chemically (medications) Physical Control Techniques

Disruptive Behavior Causes:

FEAR AND ANGER TO THOSE IN THE ENVIRONMENT

TRAINING:

Will assist staff in:– control of actions and

emotions– Provide framework to develop

emotional support and– provide a team for physical

safety

If you find yourself in an escalating situation:

MAKE NO HEROIC ATTEMPTS TO SUBDUE OR CONTROL PATIENT/ INDIVIDUAL!

INSTITUTE PROCEDURE AND GET HELP!

GBMC Procedure:

POLICY # 807: SAFETY MANUAL

If incident occurs which includes threats:

Report threat or act to supervisor IMMEDIATELY!

Complete Employee Medical Referral Form and seek appropriate medical treatment (ER or EHS based on extent of injury and hours)

Consider use of Employee Assistance Program (410-938-3200 or 1-800-823-1337)

Manager will contact:

Employee Situation– Human

Resources– Security– Employee

health and Safety

– Management

Visitor*/ Patient– Security (may

call BCPD)– EHS if

employee involvement/ injury

– management

*Visitor may be friend or acquaintance of employee

Employee Situations are taken Seriously!

Employee who threatens/ acts violently will:

Be evaluated by EAP to determine if threat to workplace

Remain off work until healthcare provider authorizes release

Need to undergo treatment/ counseling if recommended by Healthcare Professional.

Staff will: Be supportive to each other Be supported by

management Offered EAP services (EAP

will determine if debriefing necessary)

SUMMARY:

WORKPLACE VIOLENCE IS A REALITY!

PROPER TRAINING AND PREPARATION, AS WELL

AS SUPPORTING SYSTEM PROCESSES AND

PROCEDURES CAN MINIMIZE THE THREAT OF

VIOLENCE.

BE PREPARED! DON’T BE A VICTIM!

Resources:

Human Resources x2204

Employee Health x2239

Security x2222