Is Being a Nurse Dangerous?

Is being a nurse dangerous? 2017 has been a tragic year for nurse’s country wide. Horrendous acts have catapulted a long standing issue into the limelight.

Nurse injured, suspect in custody after shooting inside Ocala emergency room

 2 nurses taken hostage during Geneva hospital standoff; suspect fatally shot

Officials: Gunman killed police chief before shooting 2 others at nursing home, self

Nurse Was Raped at Gunpoint During Hostage Standoff at Suburban Hospital: Suit

According to a 2015 study published in the Journal of Emergency Nursing, 76 percent of nurses at a private hospital system in Virginia said they had experienced physical or verbal abuse from patients in the previous year. Advisory.com

This epidemic is on the rise, often resulting in tragedy. To add insult to injury the attitude of the healthcare system today and to be honest many professional nurses is that a certain level of abuse and mistreatment of our nurses is tolerable and expected when entering the nursing profession. While no one questions how dangerous the police profession is, the assault on a police officer or his K9 partner could result in a felony charge. The everyday assault nurses experience is often considered “part of the job.”

What confuses this situation, however, is that in many cases these outburst towards nursing staff is a result of underlying conditions such as Dementia or confusion. I have been bitten, scratched, had things thrown at me as a nurse, in my case these were the result of very confused patients with memory impairment and in the first few years of my career often because of my own inexperience in approach and redirection. There is a distinct learning curve here that takes time and experience to overcome. My question then becomes what are we doing on a global scale to ensure the safety of our nurses while they are overcoming this learning curve?

Part of the problem is cultural, Ross says: “It’s long been looked at, when you get spat on or verbally abused, pinched, hit over that head with something … not just by the nurses and health care workers themselves, but by people in positions of authority, that this was just part of the job, and it’s something you know you accept when you decide to go, for example, into nursing.” Health.usnews.com

The issue of assault by patients is complicated by the recognition that, in most instances, it’s not deliberate, Ross says: “Most of these people are not trying to harm you.” Patients whose thinking is clouded by drugs or dementia may believe they’re protecting themselves, Ross says, when staff members attempt to start an IV line or prevent patients from putting themselves at risk by yanking out a urinary catheter. Health.usnews.com

It’s a unique issue with unique problems, but problems that need to be solved nonetheless.

In preparing this article, I began my research looking for what systems are in place today on a global scale to protect nurses. I found nothing. If procedures are in place, it is due to specific hospital protocols with minimal requirements from a state or federal level. In fact according to Nursingworld.org only CA, CT, IL, MD, MN, NJ, OR has anything in place to that requires employers to run workplace violence programs. NY has such policies but only for public employers.

What also struck me when doing research is much of the research is years old. In fact, many sites are citing research from 2010 to 2013 with very little from 2014 through 2016. Now, this may be due to incidents like what has happened recently sparking research to be conducted more thoroughly through these time frames but this hasn’t stopped in fact in much of research with the rise in mental health, and substance abuse there has been ever increasing the problem.

…there has been a 110 percent spike in the rate of violent incidents reported against health-care workers. In one informal survey, as many as one-in-four nurses suggested that they had been attacked at work between 2013 and 2014 alone.* Patients often kick, scratch, and grab them; in rare cases even kill them. In fact, there are nearly as many violent injuries in the health-care industry as there are in all other industries combined. Health-care workers make up 9 percent of the workforce. TheAtlantic.com.

As a nurse leader, I think we have a responsibility to not only speak out and speak up for better working condition including nurse staffing ratios but be a voice in coming up with solutions. We know what it takes to do our jobs and do them well, just yelling and lobbying isn’t enough we also need to be a voice in the creation of laws and the education of our healthcare system.

The first step is to raise awareness about how dangerous the nursing profession has become. I challenge nurse bloggers and nurse leaders to raise awareness and bring the spotlight on this rising concern.

Next week we will discuss strategy and techniques for identifying these dangerous situations and diffusing them.

 

 

 

 

 

 

 

 

 

Servant Leadership in Nursing

Servant Leadership is not a new concept. It has been around a while now. While many companies try to emulate it, few succeed. Robert K Greenleaf in 1970 coined the phrase in his essay The Servant as Leader.

“The servant-leader is servant first… It begins with the natural feeling that one wants to serve, to serve first. Then conscious choice brings one to aspire to lead. That person is sharply different from one who is leader first, perhaps because of the need to assuage an unusual power drive or to acquire material possessions…The leader-first and the servant-first are two extreme types. Between them there are shadings and blends that are part of the infinite variety of human nature.” – greenleaf.org

I believe this is an important concept for Nurse Leaders. Many times I think we tend to go to the extremes. I have said it here before “not all Nurses naturally make great managers.” Nursing in itself is about service to others. It’s showing compassion and caring to those in need and those in pain and doing everything in our power to bring relief and promote healing.

In the first extreme, we focus so much on serving others it’s difficult to take a step back look at the big picture or the long-term goals. These nurses find it difficult to make tough choices and manage personnel.

In the second extreme, we focus on being a “boss” and forget to step into the much and get our hands dirty. These leaders often find themselves caught up in power trips, always fighting to get ahead and prove their worth.

“The difference manifests itself in the care taken by the servant-first to make sure that other people’s highest priority needs are being served. The best test, and difficult to administer, is: Do those served grow as persons? Do they, while being served, become healthier, wiser, freer, more autonomous, more likely themselves to become servants? And, what is the effect on the least privileged in society? Will they benefit or at least not be further deprived? “-greenleaf.org

Finding the balance I believe is important. To be a servant leader, you must put others first and build up your team. In doing so, you will also build yourself up, not an easy task in corporations who don’t value the employees.

“However, servant leadership is problematic in hierarchical, autocratic cultures where managers and leaders are expected to make all the decisions. Here, servant leaders may struggle to earn respect”.-MindTools.com

I get it. I work for a large corporation who values the servant leadership model, but that has not always been the case. As a nurse, you will find many varying degrees of leadership styles. However, what I have found is sometimes the companies that don’t value this type of leadership are the ones that need it the most.

When looking at leadership models for many years, a pyramid has been used to describe the hierarchy and reporting structure.

Servant Leadership Wrong Pyramid model
Copyright: koya79 / 123RF Stock Photo

Now many companies are making the switch to turn this pyramid on its head. In this way, the focus is to support those supporting the customer and improve employee satisfaction and retention.

Three quick tips to becoming a better servant leader.

Listen to your team.

I often think of a servant leader as a moderator. When someone has an opinion, a servant leader will listen. If the opinion is right and has credence, they will be humble enough to accept it and move forward. If the opinion is missing the mark, they will take the time to mold the thought process and help teach the person why it doesn’t work, instead of shutting them down.

Every moment is a teachable moment for the servant leader.

Every servant leader must teach and be able to learn. Don’t let mistakes go unnoticed. It doesn’t matter if the mistake was made by you or someone on your team. This is an opportunity to learn and grow.

Invest in others.

“That means the leader is not always leading, but instead giving up power and deputizing others to lead.” Skip Prichard

If you have never read the book The Dream Manager I highly recommend it. In this book, Matthew Kelly and Patrick Lencioni speak about creating an environment that invests in the employees and helps them fulfill their dreams, dreams like buying their first house, going back to school, learning a new language and many others.

If you want more tips on being on being a better nurse leader with a servant’s heart follow us on facebook and twitter.

 

5 Steps to Handle a Crisis Like a Pro

Being a nurse leader when everything is going smooth is one thing, but being a nurse leader when a crisis comes along is a whole other beast. Many Nurses shy away from leadership roles because they fear to be the one in charge when it hits the fan. What do you do when all eyes turn to you for answers? How do you step in and lead your team? Here are 5 steps all nurse leaders need, to take charge.

1. Slow it down

via GIPHY

When you’re frantic, there is no thinking, decision making, or acting to resolve the issue at hand. Slow down the situation and those involved. The only way to do this is to control your thinking. Instead of letting your inner dialogue go down all the ways this bad situation could get worse, focus on what is going on now, and what steps are needed to correct it. There will come a time to come up with a plan to counter the fallout. But in this first step keep it simple. What is the path of least resist that bring the most positive outcome and resolve the situation at hand?

“Slow is smooth, Smooth is fast” – Mel Gibson in The Patriot.

2. Get “Most” of the story

Nurse Crisis 80%
Copyright: viperagp / 123RF Stock Photo

Once you have slowed it down get the information you need to make informed decisions. Ask questions. Often key facts are left out in the heat of the moment, so it’s important to make sure to dig a little deeper until there is enough information to act swiftly. I remember a situation when a resident was choking. It was lunch time, and one would assume the resident was choking in the dining room. In fact, when the caregiver came running up to us, we immediately ran off in that direction. Luckily, the caregiver stopped us long enough to tell us where the resident was so we could move in and act swiftly.

With that said once we knew where the resident was had enough information to act. Now could have we asked more questions and gotten more information? Yes but that would not have helped this resident.

Bernstein Crisis Management speaks to the 80% rule.

80% rule. Leaders certainly want to make the right set of decisions. Strong leaders understand they will not always have all of the information they might like. They know that making an imperfect decision can often be better than making no decision at all. Even if the decision needs to be “fine tuned” for implementation, they are comfortable making it.”

3. Exhale

Nurse Panic Stop and Breath
Copyright: vipervxw / 123RF Stock Photo

pan·ic1 – a sudden overwhelming fear, with or without cause, that produces hysterical or irrational behavior, and that often spreads quickly through a group of persons or animals. – Dictionary.com

Before rushing into battle take a deep cleansing breath. Here is the weird part, in a panic situation, you can’t do it. First, you need to exhale. Force all the air out of your body completely emptying you diaphragm then breath in.

“When you feel like you can’t catch your breath, it’s because you forgot to do something.

You forgot to exhale.

That’s right. Before you can take a deep breath, you have to give one away. Why? Because, when you’ve been breathing in a short, shallow manner (from your chest), if you try and take a deep inhale, you just can’t do it. All you can do is take a more labored, shallow breath from your chest. That will give you all the air you need, but it won’t feel good.” Anxiety Coach.

4. Be ready to work

Crisis Nurse leader

The quickest way to lose the respect and trust of your staff is to sit there and delegate out all the sacrifice that must be made. However, By being the first to put yourself in the front of the fight, you will gain the respect and loyalty of your staff and be able to model how to handle the situation at hand.

“If there are sacrifices to be made – and there will be – then the leaders should step up and make the greatest sacrifices themselves. Everyone is watching to see what the leaders do. Will they stay true to their values? Will they bow to external pressures, or confront the crisis in a straight-forward manner? Will they be seduced by short-term rewards, or will they make near-term sacrifices to fix the long-term situation?”- Developing a Leader

5. Rely on your training

 

Crisis Nurse Training
Copyright: leremy / 123RF Stock Photo

It’s interesting that when people need to perform CPR they often come away saying something to the effect of “I can’t believe I remembered how to do it. It’s like I just knew what to do”. This is why state regulations often require us to complete our CPR training every 1 – 2 years. Hopefully, when the situation comes to hand, we are able to react and have our muscle memory primed to handle the emergency. The old adage “hope for the best, prepare for the worst” is a mantra every nurse leader should become intimate with. The one thing anyone can do to prepare for the worst, keep calm in a crisis, and be the leader the situation needs, is to keep learning, keep training, and keep drilling.

Have more tips for crisis management? Please comment below! Also, drop us a line if you have subject matter requests.