By Christina Orlovsky, senior staff writer
Filled with patients in volatile states, the emergency department isn’t a place that’s typically classified as calm. In fact, the majority of emergency nurses report being victims of workplace violence in the past three years. Still, despite the risks of attack by patients and the overcrowding that plagues the ED, emergency nurses remain dedicated to the care they provide.
In honor of Emergency Nurses Week, Oct. 8-14, the Emergency Nurses Association (ENA) released the results of a job satisfaction survey in which 1,000 ENA members commented on workplace violence, career challenges and how both affect job satisfaction. Results indicated that despite numerous challenges, 64 percent of respondents reported being very or extremely satisfied with their job.
According to 2006 ENA President Nancy Bonalumi, RN, MS, CEN, there are two standout reasons why emergency nurses are so attached to their work, regardless of the challenges that come along with it.
“Our members really value the work they do,” Bonalumi said. “Ninety-three percent said they love the patient interaction, followed closely by the camaraderie. The emergency department is a very team-oriented unit. That camaraderie helps us all get though tough times.”
Unfortunately for ED nurses, these tough times often include instances of violence projected by patients and their families. In the ENA survey, which specifically asked respondents if they have been victim to workplace violence—defined as any hostile behavior, including hitting, punching, spitting and verbal abuse—86 percent acknowledged that they had experienced at least one incident in the past three years; nearly 20 percent reported that workplace violence was a frequent occurrence.
In addition, 40 percent reportedly felt their workplace was only somewhat safe or not safe at all. According to Bonalumi, there are several underlying issues at hand in the ED that may lead to reduced safety for health care providers.
“One is the lack of mental health services, which are extremely underfunded,” she said. “People can’t get to services that will help them, so when their behavior escalates, their family or the police take them into the ED.”
The second issue, she said, is a societal one.
“The influence of drugs and alcohol makes people behave differently than they would if they were sober,” she explained. “People are more likely to have an outburst if they are under the influence.”
Finally, a third issue is one that has been addressed frequently in reports by the Institute of Medicine: ED overcrowding.
“Overcrowding leads to delays,” Bonalumi added. “These delays can increase anxiety, and when anxiety escalates, it can lead to hostility from patients and their families.”
Bonalumi and ENA joined with the Institute of Medicine in a call to action to improve the state of emergency care in the United States. Until then, however, Bonalumi asserted that emergency nurses will remain dedicated to their jobs and to the care of their patients.
“Nurses really do believe our job is to take care of patients. That puts us right at the bedside, but it also puts us directly in harm’s way,” she said. “Still, that’s viewed simply as a risk of the job. We try to be careful and conscious, but we see it as a risk we have to take.”
For more information, visit the ENA and IOM Web sites.
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