Nursing & Healthcare Directories on: The Nurse Friendly
Direct (Bedside Nursing) Patient Care
Violence & Violent Patients

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Nurses face rising tide of violence; It's now a felony to assault a nurse, Sunday, November 27, 2011, Lauren Auty, RN, BSN, MJ:" "Call Security!" is a phrase that is too often yelled across a busy Emergency Room. It's a disruptive moment for any staff nurse, patient or family member who is involved. Violence in Emergency Departments is a hot topic due to the rising frequency of occurrences nationally. Everyone knows that you don't touch a cop or any 'man in uniform.' Even mouthing off to a cop will get you in trouble. That should never change. As a new mother, I am a believer in instilling a little fear along with manners. I don't want to have a "punk" for a child. Some people just missed these lessons growing up and everyone from the McDonalds server to nurses are paying for it. As an ER nurse for most of my career, I have become almost desensitized to the reality that violence in our workplace is becoming more frequent and just as common in the suburban hospitals as those in major cities. The explicatives mother f****w**** or bitch, or f-this and f-that are common language in an Emergency Room. As the nurse this language is directed at, you learn to walk away and control the patient with methods supported by your hospital."
http://www.philly.com/philly/blogs/phillyrn/134572643.html

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Suicidal and Violent Patients, Purpose:"Patients with alcohol and other drug problems may have suicidal or violent tendencies. Being familiar with the risk factors and warning signs for these tendencies can help C/MHC staff make appropriate referrals. This module also presents guidelines for dealing with suicidal and violent patients in order to help staff manage situations needing immediate attention."
http://p2001.health.org/CMHC01/MOD15TR.htm

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Psychopathy and violent behavior among patients with schizophrenia or schizoaffective disorder, Hare Lab.:"Objective: Although a strong association between violence and psychopathy has been demonstrated in nonpsychotic forensic populations, the relationship between psychopathy and violence among patients with schizophrenia has not been thoroughly explored. Patients with and without a history of persistent violent behavior were compared for comorbidity of psychopathy and schizophrenia or schizoaffective disorder."
http://www.hare.org/abstracts/nolan1.html

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Violent Ideation in Medical Patients in Four Insurance Systems, healthpsych.com:"Most of the literature on violent patients has focused on patients in psychiatric facilities. Little is known about violent patients in the general medical setting, although it would seem that violent and dysfunctional behavior may predispose patients towards injury. These effects were explored using community and physical rehabilitation patient samples which were obtained from over 90 sites in 36 US states, and which approximated the U.S. Census for race, education, age, and gender. Background information and BHI profiles were also obtained. The results found that the patient group reported significantly more violent ideation (VI) than did the community group. VI was also significantly associated with involvement in worker's compensation or personal injury insurance systems, work conditioning programs, the BHI Hostility scale scores, and a number of other psychosocial factors."
http://www.healthpsych.com/violence.html

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Violent Patients, FERNE:"Emergency physicians encounter violent patients as predictably as they encounter airways. Fundamentally, the approach to violence in the ED is analogous to the approach to the airway. There are many routes to airways compromise, yet regardless of the cause, the physician must control the airway before subsequent treatment. Similarly, violent behavior is an endpoint for many different medical and psychiatric pathologies; the emergency physician must control the behavior, to prevent escalation and injury, before moving on to further evaluation. At the same time, it is imperative that the physician suspect any decompensated behavior to be the result of a medical or surgical condition, until proven otherwise. Treatment of conditions that may cause agitation, such as hypoxia, may in fact resolve behavioral problems. But often, the behavior itself will need to be addressed before definitive care can take place."
http://www.ferne.org/Lectures/violent%20patients%200501.htm

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Understanding and Treating Violent Psychiatric Patients:"The evaluation and management of violent psychiatric patients is one of the most complex, difficult challenges in the practice of psychiatry. There are only two kinds of clinicians: those who have had patients commit violent acts and those who will. Although the dust jacket touts this book as a "comprehensive guide to assessment, management, understanding and treatment of violent patients," it is a selected up-to-date review for the clinician."
http://jama.ama-assn.org/issues/v284n5/ffull/jbk0802-2.html

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Violent Patients, William R. Dubin, MD:"The threat of violence is an increasing concern in modem society and health care delivery settings. Within the hospital setting, the emergency department appears to be the clinical site at highest risk for violence. Because EDs are open 24 hours a day, and provide unrestricted access to the public, the staff constantly is exposed to an unscreened, and potentially high-risk population for violent behavior."
http://www.thrombosis-consult.com/articles/Textbook/153_violent.htm

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Strategies for the Management of disturbed and violent patients in psychiatric units:"This represents a review by the College of its policies, not just for seclusion (Royal College of Psychiatrists, 1990) but also for the overall management of violence and aggression. It has been carried out in conjunction with the Royal College of Nursing which already had a similar process in train, producing a paper on seclusion (Topping Morris, 1993). Over the same time the Special Hospitals Service Authority has reviewed its practice, publishing its own policies on the use of seclusion and the alternatives (Special Hospitals Service Authority, 1993)."
http://www.graap.ch/disturbed.html

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Recommendations from the Joint Task Force on Treatment and Discharge Issues Pertaining to Violent Patients:"In the wake of tragic events involving patients who escaped from state psychiatric centers, the NYS Office of Mental Health and NYS Commission on Quality of Care established a Joint Task Force to address treatment and discharge related issues, especially as they affect a subset of patients served by the mental health system who both pose and experience special problems in recovery and community living. On August 11, 1995 the Task Force submitted its report and recommendations. These recommendations address the following major areas."
http://www.cqc.state.ny.us/recs.htm

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GPs tackle violent patients:"SURGERIES are taking steps to combat the threat of patients who are aggressive towards GPs and staff. South Manchester Primary Care Trust, which manages 39 surgeries across the area, has joined other Manchester trusts in introducing a scheme to strike off and then rehabilitate violent patients. A spokesman said: “Under the scheme, such patients are allocated to a general practitioner for period of 12 months."
http://www.southmanchesterreporter.co.uk/news/index/articles/article_id=3469.html

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Violent patients prompt safety plans, Thursday, 29 August, 2002:"Doctors and health staff in Wales are to be given clear guidance on how to deal with violent and abusive patients. Health authorities have been told by Health Minister Jane Hutt that they must be operating schemes to cope with disruptive members of the public by March 2003."
http://news.bbc.co.uk/1/hi/wales/2222427.stm

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More Psychotic Symptoms Don't Mean Greater Violence Risk:"CHAPEL HILL -- May 2, 1997 -- People with two psychotic symptoms are more likely than other people to become violent, but when symptoms increase beyond two, the risk of violence actually drops significantly, a new study shows."
http://pslgroup.com/dg/25062.htm

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Violence and Violent Patients, The Harvard Mental Health Letter:"Violence is both a major public health problem and a serious concern for mental health professionals. One and a half million aggravated assaults and a half million incidents of child abuse are reported each year. More people die from murder or manslaughter than from bronchitis, emphysema, and asthma combined. Battery is the main cause of injury to women. Homicide is the most common cause of death among black men aged 15 to 24."
http://www.mentalhealth.com/mag1/p5h-vio2.html

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Psych unit for violent patients to close, By Ellen Barry, Globe Staff, 9/3/2003, NAMI Of Massachusetts Alliance For The Mentally Ill Of Massachusetts:"The Department of Mental Health is shutting down the state's only psychiatric unit specially designed to control violent, severely mentally ill patients who have not committed a crime. Every year, about three-dozen of the state's most disruptive psychiatric patients are treated in the locked 11-bed ward at Taunton State Hospital, which has extra staffers to monitor them, using restraints when they deem it necessary. By closing the unit and transferring its patients back to the hospitals that originally treated them, the state hopes to save $2.2 million a year. The unit's population has already been reduced to just four men, said Lester Blumberg, chief of staff at the mental health department."
http://www.namimass.org/news/news03/art8.htm

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Friday, 23 August 2002, Violent Patients will not be Tolerated:"NORTHERN Lincolnshire and Goole Hospitals NHS Trust has issued a warning to violent and aggressive patients that their behaviour will not be tolerated. The warning follows a number of incidents over the last year where members of staff, particularly in A and E, have been threatened, abused and even assaulted on occasion. Divisional Manager for Medicine (which runs the A and E service) Frank Hazlehurst said such behaviour was not acceptable towards professional staff working hard for the benefit of the patients. "Although these incidents are extremely rare, when they do occur they can cause considerable distress to the staff members concerned and to the overall morale of the department."
http://www.nlg.nhs.uk/news/display_media.asp?ID=150

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Violent Patients, Thursday, August 22nd, 2002:"North Lincolnshire Primary Care Trust 100% supports the Government initiative of zero tolerance towards violent or abusive patients." "No one has the right to abuse, intimidate, harm or injure NHS staff and then to expect the same staff to respond with their usual care and compassion."
http://www.nlpct.nhs.uk/whatsnew/docs/2002/august/220802-1.asp

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18/06/2002, Violent patients face treatment ban:"Violent patients who make repeated attacks on NHS staff could be refused treatment under new draft guidance to improve health and safety in Scotland's hospitals, GP surgeries and dental practices. The 'Health at Work' guideline, drawn up by the Partnership Information Network (PIN) - which includes NHS professional groups, unions, and representatives from the Health Department - covers all the major health and safety issues that could affect staff as part of their day-to-day."
http://www.scotland.gov.uk/pages/news/2002/06/SEHD098.aspx

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Treatment denied to violent patients, 01 November 2001:"NHS staff have new powers to refuse treatment to violent and abusive patients. New national guidelines to protect staff will be published tomorrow intended to balance the need to protect staff with the duty to provide health care. Verbal threats, violence, vandalism and drug and alcohol abuse will all be grounds for refusing treatment. However, patients with severe mental health problems or suffering life-threatening conditions will not be denied care."
http://www.nhs.uk/nhsupdate/news.asp?newsid=330

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Thursday November 1, 2001, Treatment ban for violent patients, :"Hospitals and clinics will have the right to impose 12-month treatment "bans" on patients who are violent towards staff, in a bid to tackle a rising tide of abuse in the NHS, the health secretary, Alan Milburn, confirmed today. New guidelines say NHS trusts can draw up their own criteria for withdrawing care from patients who assault, threaten or verbally abuse staff, who take illegal drugs or act drunkenly on health service premises, or who damage hospital property."
http://society.guardian.co.uk/NHSstaff/story/0,7991,585002,00.html

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December 18, 2000, Violent Patients Loose in Homes, By: Thomas Zambito, The New York Daily News:"Residents of New York City nursing homes have been killed, sexually assaulted and beaten by unlikely assailants in the past few years: their fellow residents. A Daily News investigation found that resident-on-resident abuse has emerged as a little-acknowledged threat in nursing homes in New York City and elsewhere."
http://www.globalaging.org/elderrights/us/violentpatients.htm

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Created on August 5, 1999

Last updated by Andrew Lopez, RN on Wednesday, August 19, 2014


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