Radko Kari Radko April 6th, 2009 English 102 Unit 3 Nurse and Patient Abuse

Picture this: its another late night working as a Registered Nurse on the emergency floor in a hospital. Youre not too busy because its the middle of the night, but every now and then there will be a random spurt of patients (most of them drunk because its late). Just like every night, some of the drunks can get out of line. But security is always near just in case. However, this night is different. One of the drunks goes too far and starts yelling and cursing at you. Before you have time to react, hes got you pinned up to the wall and continues to get in your face about how he needs to be treated. By now one of your fellow staff members has called security and they wrestle him off. You are safe, but you still were a victim of abuse. It was both verbal and physical. You were not punched or slapped, but you were pinned up against a wall and being screamed at. Things couldve been way worse, but you still count yourself lucky. Now imagine having to go through all this on a weekly basis. Nurses who work in hospitals are victims of abuse almost every day. It could range from being yelled at by a fellow staff member or patient to actually being harmed by a patient. Either way, it is still classified as abuse and it happens more often than you would think in hospitals. Now imagine this: A bedridden elderly woman in a Florida facility had developed pressure sores on her leg, which were caused from being malnourished and dehydrated. Sores had developed due to her not being moved enough by the staff while she was in bed. The

Radko wounds had become severely infected and amputation of the leg had become a sad reality (Nursing Home Negligence Stories 1).

This is only one of the countless stories where elderly patients were being abused by the nursing home staff. The abuse ranged from the nurses not fulfilling a request by the patient or a patient actually being hit, slapped, or not taken care of properly. Like the previous story, it does not matter whether someone is being abused verbally or physically, it is still classified as abuse. First off, for my argumentative paper I am addressing two arguments. I am arguing the abuse that nurses receive from staff and patients, and arguing the abuse patients receive from nurses and staff. I believe that any type of abuse is not acceptable. No one should ever be abused, let alone be abused and not be able to defend yourself; as shown in the second story with the elderly woman who was in the nursing home. I cannot possibly imagine how a person can think to abuse someone. But before I state all my opinions, I want to give a background to nurse abuse and patient abuse. When telling other people what I planned on writing my paper on, they seemed so shocked that nurses are actually abused in hospitals. Nurses are subject to abuse from a staff member, a patient, or a patients family and friends. The statistics of nurse abuse are astounding and appalling. In the United States, to abuse or harass a teacher, bus driver, or a fellow prisoners is a felony, but to do so to a nurse is a misdemeanor (Jackson 13). I find this crazy because a nurse is only doing her job, which is to help and treat patients. I see nurses as the backbone of a hospital; they are able to care for others, help save lives, and help doctors out. And they are rewarded by being abused, harassed, and not having the ability to report incidents. The types of abuse that are geared towards nurses are bullying, physical violence and assault, verbal abuse, and sexual harassment (15-16). A study showed that in the emergency room, 82% of nurses at

Radko some point experienced physical harassment by a patient and 29% of the nurses indicated that the assaults were not reported (14). It is bad enough to be abused by a patient or a patients family member, but not being able to report it I believe is wrong. Obviously there are lots of cases of nurse abuse that lead to actual reports. And as shown in Figure 1, nurses do stand up for themselves. But instead of keeping the abuse silent when the cases get to
Figure 1: Assertive and Nonassertive Ratings of Verbal Abuse

management, nurses should be able to stand up for themselves and trust that management will come up with ways to protect their nurses and reduce the abuse. After reading a discussion board designed for nurses to state their opinions about the abuse they have receive, I was astounded at how the management handled things. One lady states I got the impression they [management] really didnt care about changing the way the hospital deals with violent patients, they just wanted to make sure I didnt run to an attorney and sue them for unsafe work conditions (Nurse Abuse: Management Just Doesnt Get It 3). Nurses should not feel this way. After what they put themselves through, they need to at least feel comfortable and confident that their staff management will take care of things. However, hospital management is not the only one who let down nurses. Physicians and fellow staff members are known to abusing their nurses. Working with physicians that are verbally humiliating, degrading, and have a total lack of respect for us as a professional nurse, are also a fact in the life of a nurse. In a recent study published by the Association of OR Nurses, over 90% of nurses that were polled were subject to verbal abuse by a physician (Dealing With Nurse Abuse 1).

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To be subject to your own physician verbally abusing you would definitely put a dent in a nurses career. I would not want to be constantly yelled by my boss and be treated like dirt. With all these statistics it is hard to imagine why nurses continue to work in this environment. Nurses are able to put aside their own feelings, opinions, rights, etc. to get their job done and help people. I know I would have issues with hiding my feelings and not stating my opinions, but knowing that I am a part of the healthcare environment and saving lives seems to be a good alternative. I have the utmost respect to those nurses out there who really care about their job and those who are willing to do whatever it takes to help their patients. I hope to be like these nurses when I enter the nursing field. Even though the statistics I mentioned earlier are quite shocking, there are some recommendations I found that will decrease the abuse that nurses receive from patients and staff. First off, to reduce a physician verbally abusing a nurse, Kate Christmas advices to fine and/or cite the physicians if they are caught verbally abusing their nurse (Workplace Abuse: Finding Solutions 2).

Conduct a zero tolerance policy that firmly states verbal abuse is not tolerated, as seen in Figure 2. As for dealing with abuse from patients family, let them know

Figure 2: An example of no policy for abuse. http://www.southportandormskirk.nhs.uk/News /news_item.asp?NewsID=197

the standards the hospital has for them (2). Communication seems to be the key to these ideas so far. As stated in Communication in Health Care, the essence of any helping process is communication; a significant correlation appears to exist between problems in human relationships and problems in communication (vii). It is big that nurses, physicians, staff, and management are all on the same page. With effective communication, everyone can get to know

Radko how each person is and learn how to act around them. This could prevent disrupted disagreements, fights, misunderstandings, etc. The next big recommendation I found that can decrease nurse abuse is to set policies for nurses that will provide guidelines for self protection (Jackson 19). The guidelines will teach nurses how to recognize the signs of abuse, what to do about it, and how to intervene if a fellow nurse is being abused (19). These are only a few ways in which a hospital can help their nurses

out by finding solutions to decrease abuse. To sum it all up, nurse abuse does go on in hospitals, and it should not be tolerated. Nurses put up with a lot from patients, patients families, and staff members, but if they are put in harms way, the hospital needs to do whatever it takes to protect them. Now moving on to my second argument, which is patients being abused by nurses. Ill specifically be talking about patients in nursing homes and how they are abused. It is said that in 2001, 1,600 (nearly one-third) of the United States nursing homes were cited for abuse (Whitaker 1). The type of abuse varies greatly from yelling, spitting, slapping, punching, choking, causing bedsores, neglect, and dehydration. All these types of abuse can easily result in death. Refer to Figure 3 as an example of a patient being abused by his nurse. It is really heartbreaking to know that there are nurses out there who abuse the elderly. They are put in a nursing home to be taken care of and they trust the staff, but how are they able to
Figure 3: An example of a nursing home patient being abused. http://newoldage.blogs.nytimes.com/

Figure 4: There are numerous counts where the abuse of a patient is not reported. http://www.elderlyabuse.com/elder_abuse_signs/

Radko defend themselves? What turns neglect or other harm into abuse is the situation: when the person who is being exploited or hurt is at the mercy of someone he or she should be able to trust (Andrews 20). Figure 4 shows the states that have nursing homes that only got 1 star on their evaluation. In the dark blue states, more than 29% of nursing homes got 1 star. I find all of these statistics appalling. The elderly are fragile and go to nursing homes to be helped, but some end up being victims of abuse. There are a few ways to prevent this type of abuse. The first way is to listen to the patients observe their behavior and how they act around their nurse (Andrews 20). Another
Figure 3: A state-by-state look at the lowest rated nursing homes, which the government assigned a 1 star (out of 5) for overall quality. http://www.nursinghomesabuseblog.com/2008/12/a rticles/resource/nursing-home-rating-system-revealsinferior-care-provided-at-forprofit-facilities/

recommendation that can help in decreasing nursing home abuse is through careful training and supervision, by assessing the value systems of nurses, and setting the dignity, ethical and safety standards of any care organization at the highest possible level (Andrews 20). These suggestions to lower the nursing home abuse all seem to be common sense. Fellow staff and family members of the patients just need to keep a close watch on the patient and look for any signs that show they are being abused. In conclusion, I believe that abusing nurses in hospitals
Figure 6: Another example of a patient being abused. http://www.wral.com/news/local/story/ 130351/

and abusing patients in nursing homes is unacceptable. Management who does not take care of its nurses when they are

abused need to learn to do so, otherwise patients will start to get away with more and more

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abuse, resulting in dangerous attacks. And as for nurses working in nursing homes, they need to learn to grow up. Nursing is all about leadership the primary purpose to studying leadership is to learn how to work with people (Tappen 1). If other nurses start to observe strange behavior between a fellow nurse and her patient, they need to be a leader and step up to defend that patient. The elderly cannot speak for themselves as well as other patients can. Meaning it is up to the fellow staff and family members to stand up for their patients and not tolerate any form of abuse. I hope that this argumentative paper was eye opening and useful to those who did not know much about the abuse that goes on between nurses and patients. I enjoyed researching my topic from a different point of view, and I am continually learning more and more about my topic in general.

Radko Works Cited Andrews, June. Travesty of trust. Nursing Standard 23.7 (22 Oct. 2008): 20-21. Academic Search Premier. EBSCO. Albertsons Library, Boise, ID. 30 Mar. 2009

<http://search.ebscohost.com.libproxy.boisestate.edu/login.aspx?direct=true&db=aph&AN=352 21225&site=ehost-live> Christmas, Kate. Workplace Abuse: Finding Solutions. Nursing Economic$ 25.6 (Nov. 2007): 365-367. Academic Search Premier. EBSCO. Albertsons Library, Boise, ID. 30 Mar. 2009 <http://search.ebscohost.com.libproxy.boisestate.edu/login.aspx?direct=true&db=aph&AN=285 2171&site=ehost-live> Highway Hypodermics: Dealing With Nurse Abuse. 5 Mar. 2009 http://travelnursinghighway.blogspot.com/2005/11/dealing-with-nurse-abuse.html Jackson, D, J Clare, and J Mannix. Who would want to be a nurse? Violence in the workplace a factor in recruitment and retention. Journal of Nursing Management 10.1 (Jan. 2002): 13-20. Academic Search Premier. EBSCO. Albertsons Library, Boise, ID. 30 Mar. 2009 <http://search.ebscohost.com.libproxy.boisestate.edu/login.aspx?direct=true&db=aph&AN=601 3217&site=ehost-live> Nurse Abuse: Management Just Doesnt Get It. 5 Mar. 2009 http://allnurses.com/general-nursing-discussion/nurse-abuse-management-344990.html Nursing Home Negligence Stories. 5 Apr 2009 http://legalcatch.wordpress.com/2007/12/02/nursing-home-negligence-stories/

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Tappen, Ruth. Nursing Leadership: Concepts and Practice. USA: Library of Congress Cataloging in Publication Data, 1983. Whitaker, Bill. Nursing Home Abuse Increasing. 5 Apr 2009 http://www.cbsnews.com/stories/2001/07/30/national/main304038.shtml