Emergency Departments (EDs) have the highest levels of violence of any hospital units, and according to a 1994 survey, 97% or nurses in these reported verbal violence and 87% physical violence. All EDs have large numbers of uninsured patients, many of them with drug, alcohol of psychiatric problems, which increase the normal stress and anxiety of this environment and make violence far more likely. This problem is compounded by the fact that only 3% of EDs had full-time security on-site, which means that "prevention is the best method to deal with violence in the ED" (Hoag-Apel, 1998, p. 60). All EDs should do a risk assessment that includes the location, design, history and security measures in the facility; the type of in-house security staff, training and weapons, communications with local police and hospital security; nighttime lighting, parking areas, numbers of chemically dependent...
It should note whether access is monitored and guarded, where panic buttons are installed, and if patients and visitors can be observed and monitored at all times. Written protocols on how to control violent patients and visitors and report verbal and physical threats should be in place. Obviously EDs located in poor and inner-city areas will see large numbers of victims of gun violence, drug overdoses, and the uninsured, so violence there might very well be an everyday occurrence, although almost all emergency rooms will experience it at some point during the tear.
Fear and anxiety are the most common causes of violence in EDs, and staff members should be trained to defuse these in a calm and professional manner while reassuring patients that their problems will be addressed. Studies show that in the hospital, the most normal type of fear is of the…
