Five easy ways to protect staff from violent patients

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By Scott Wallask, for HealthLeaders Media, October 20, 2009

When a professional fighter allegedly went haywire in a Nevada hospital and attacked nurses, it briefly brought some national attention to a long-standing problem: violence against healthcare workers.

Of course, it's not just famous people or athletes who can cause trouble, which makes the challenge of protecting hospital employees daunting.

Ultimate Fighting Championship (UFC) star Junie Browning was arrested by police October 6 after the incident at St. Rose Dominican Hospital's Siena Campus in Henderson, NV, according to the Las Vegas Review-Journal.

Friends of Browning brought him to St. Rose's fearing he may have purposely overdosed on an anti-anxiety drug. While at the hospital, Browning allegedly became angry, pushed a female nurse, and punched a male nurse in the face, according to police report details UFC fired Browning following his arrest.

If your security team hasn't reviewed hospital violence procedures recently, it's time for you to start such an assessment because ER problems may get worse soon, said Fredrick Roll, MA, CHPA-F, CPP, president and principal consultant at Healthcare Security Consultants, Inc., in Frederick, CO.

Federal healthcare reform could increase wait times in ERs across the country, and prolonged wait times are the No. 1 reason for violence in those settings, Roll told attendees at the American Society for Healthcare Engineering's annual conference in August in Anaheim, CA.

Some simple precautions can keep healthcare workers safe should they find themselves in a violent situation. The trick is all in what they wear, said Barbara Bisset, PhD, MPH, MS, RN, executive director of the Emergency Services Institute at WakeMed Health & Hospitals in Raleigh, NC, who spoke to HCPro's Healthcare Security Alert earlier this year.

Below are five easy steps your staff members can take:

  • Store stethoscopes in pockets. Although it's traditional to see physicians and nurses with stethoscopes slung around their necks, they can become a choking device if aggressive patients get their hands on the stethoscopes.
  • Don't wear dangling earrings. A violent or confused patient might cause injury by pulling on the jewelry.
  • Keep long hair up or pulled back. "It's long and flowing, it looks beautiful, but working in [a hospital], it's not appropriate from an infection control perspective and from a safety perspective," Bisset said.
  • Don't wear ties. Yes, ties look professional, but there are again risks of being choked by the accessory. Bisset recommended clip-ons if staff members feel a necktie is needed.
  • Wear a breakaway lanyard. Staff members may be accustomed to hanging a fabric cord around their necks to display ID badges or keep access cards handy. If this is the case in your hospitals, make sure the lanyards are breakaway-style so that the fabric and cards can't immediately be used as weapons.


Scott Wallask is senior managing editor for the Hospital Safety Center. He can be reached at