More than half of nurses who work in emergency departments report they've been physically assaulted on the job, according to an online survey of more than 3,000 ER nurses by the Emergency Nurses Association.
Responding to the 69-question survey, the nurses said they have been spit on, hit, pushed, shoved, scratched or kicked by patients while on duty.
The incidents are partly a result of the nature of the job and the fact that emergency rooms accept all comers, association president Bill Briggs says.
"It's the safety net when you can't get help anywhere else," Briggs says. "Every type of patient comes to the emergency department.
"We accept patients under the influence of drugs and alcohol, (and) psychiatric patients. … It's very unpredictable."
Other precipitating factors: a shortage of ER nurses, patient crowding and prolonged wait times. One in four nurses reported experiencing assaults more than 20 times in the past three years, and one in five said they had experienced verbal abuse more than 200 times during the same period.
The incidents have led one in three nurses to consider leaving their department.
"The public wants a safe place to go and get help in an emergency, and that's what we want," Briggs says. "The Emergency Nurses Association wants to promote a safe working environment … safe for patients and visitors and staff members, and we're looking for ways to do that."
Laws protecting emergency department nurses vary widely by state, and some states have no laws. The nurses association plans to work with the Occupational Safety and Health Administration to make safety precautions a requirement in all states.
"Every emergency department should have its own plan in place," Briggs says. To start, he says, hospitals should have more security available, alarm buttons and a security committee to assess the ER and create a plan for a safe environment.
"I've had bumps and bruises and, certainly, it has an emotional impact," says Briggs, a nurse for 30 years. "I've wondered, do I want to stay? How often do I want this to happen?
"Most people enter the profession to help people, not to get beat up and not to see your co-workers get beat up."
The survey's findings are reported in the current issue of the Journal of Nursing Administration.