Workplace Violence Tier 2 Protecting Your Patient And Yourself Quiz

any physical assault, threatening behavior or verbal abuse occurring in the work setting

1. criminal intent 2. customer/client 3. worker-on-worker 4. personal relationship

In Type 1 violence, the perpetrator has no legitimate relationship to the business or its employees, and is usually committing a crime in conjunction with the violence (robbery, shoplifting, trespassing). For example: a nurse assaulted in the hospital parking garage; a home health care nurse is mugged while conducting a home visit. In health care settings Type I violence occurs less frequently compared to other types of violence.

Type 2 violence is the most common in healthcare settings. This course considers the customer/client relationship to include patients, their family members, and visitors, and will be referred to as CLIENT-ON-WORKER VIOLENCE. Research shows that this type of violence occurs most frequently in emergency and psychiatric treatment settings, waiting rooms, and geriatric settings, but is by no means limited to these. Prevention of Type 2 violence is a primary focus of this course.

Type 3 violence between coworkers is commonly referred to as lateral or horizontal violence. It includes bullying, and frequently manifests as verbal and emotional abuse that is unfair, offensive, vindictive, and/or humiliating though it can range all the way to homicide. Worker-on-worker violence is often directed at persons viewed as being "lower on the food chain" such as in a supervisor to supervisee or doctor to nurse though incidence of peer to peer violence is also common. This course explores the roots of worker-on-worker violence in healthcare settings.

In Type 4 violence, the perpetrator has a relationship to the nurse outside of work that spills over to the work environment. For example, the husband of a nurse follows her to work, orders her home and threatens her, with implications for not only this nurse but also for her coworkers and patients. This course does not specifically address Type 4 violence but many of the concepts, techniques and protocols presented here for violence Types 2 and 3 are applicable.

patient/client/visitor

-violence is accepted as "part of the job" -nurses often fear being blamed for doing something wrong -nurses believe that some patients cannot be held accountable for their actions -there is no discernible benefit to reporting

the different criteria and sampling methodologies used by various reporting agencies

is an acute emotional upset; it is manifested in an inability to cope emotionally, cognitively or behaviorally and to solve problems as usual

rapid heart beat, increased blood pressure hyperventilation, sweating rash or hives stomach pain, nausea, vomiting diarrhea, frequent urination chest pain involuntary shaking release of stress hormones decreased sleep

fear: of injury, loss of life, losing control, or of going crazy high anxiety: about what to do, how to escape, stopping the abuse shock/disbelief guilt, embarrassment, or shame fight-flight impulse toward self-protection post-trauma sequelae: e.g., nightmares, re-play of the frightening incident, crying

inability to focus or concentrate interference in ones usual problem-solving ability

cannot perform usual work demands becoming withdrawn crying easily lack of sleep avoiding usual social interaction losing temper easily - yelling, getting angry at family members, etc. acting impulsively driving hazardously as a result of anxiety and emotional upset

true

-standards of care not met -medical errors -decreased patient satisfaction

-lower productivity -use of sick leave

true

-focus on patient safety & customer service -belief that workplace violence is part of the job -complacency about workplace violence

clinical, environmental, organizational and socio-economic

True

-bullying -verbal abuse -threats

-increased bureaucratic demand -short staffing -feelings of powerlessness

True

-management commitment -worksite analysis -hazard prevention and control -safety and health training -recordkeeping -program evaluation

-removing anything from your person that can be used as a weapon -acknowledging that if a personal history of abuse exists, it may impact your thought process

-check patient records for notes concerning a history a violence -check to see if patient (or family member) is on a sexual predator list -travel with a cell phone

True

False

False

False

stage 1 stage 2 stage 3 stage 4 (crisis) crisis resolution

normal stress & anxiety level the background of crisis development brought about by the minor annoyances and frustrations of everyday life. Individuals at this stage are rational and in control of their emotions and behavior.

Rising anxiety level - a heightened condition typically including rapid heart rate and respiration. The person might appear lost or confused about how to solve a problem. Voice may be pitched higher or quaver with accelerated speech patterns. Small nervous habits such as finger or foot tapping may be manifested.

Severe stress and increasing anxiety - a person's reasoning capacity is seriously diminished, with fixation on the here and now. Behavior typically becomes boisterous or disruptive. Communication may include shouting, swearing, argumentation, and threats. Physical indications include pacing, clenched fists, perspiring, and rapid shallow breathing.

Acute crisis - characterized by unbearable anxiety and loss of cognitive, emotional, and behavioral control, with urgent need to end the emotional pain. A person in crisis is unable to solve problems or process information rationally without help. Behaviors of persons in crisis are erratic and unpredictable to a point that they may pose a danger to themselves and others.

-cognitive -behavioral -emotional

visible and palms open

"I can see your frustration and I really want to help you. Please calm yourself and sit down so I don't have to call security for help."

-provide non-mandatory access to counselors as part of the employer's standard response procedures

-the patient appeared agitation, but did not act out physically or verbally

to identify and correct vulnerabilities in the present violence prevention protocols and procedures