By Zack Budryk
At the executive level, hospitals nationwide must establish both preventive plans and plans for violent scenarios, which factor in training and responses to different levels of violence, Christine Pontus, R.N., (pictured right) an occupational health nurse and associate director in the Massachusetts Nurses Association's (MNA) Division of Health & Safety, told FierceHealthcare in an exclusive interview
"From there, they need to have a plan that spells out what is going to happen and train nurses and doctors and allied personnel to that plan, so everyone knows what they're doing," she said.
Such a plan, Pontus said, must be more than a reaction to acts of violence; rather, she said, any hospital plan should have strategies for patients who are belligerent and threatening as well. "It needs to be taught, and people need to understand, that assistance happens before someone acts violent," she said. "There needs to be a plan for response at different levels of violence."
"Why the problem isn't addressed is mind-boggling … they're not even thinking about it as an issue, as a problem," Pontus told FierceHealthcare. "The hospitals have to look at it, we need to start looking at the types of patients that are coming in, we have to start understand that a lot more patients are violent that are coming in nowadays, we have to understand how to categorize our patients. These are all things that we're not doing. Systematically, nothing's being done."
Proactively tackling hospital violence can be logistically difficult, in large part because hospital leaders must strike a balance between necessary security measures and maintaining the open environment a hospital needs to function.
A good first step is understanding the nature of hospital violence. Violent patients and visitors generally fall into two categories. The first are those who commit violence spontaneously, due to mental illness or strong emotions in response to the death or serious illness of a family member. The second, meanwhile, carry out premeditated attacks.