PROtect Yourself! Empowering Tips & Techniques for Personal Safety: A Practical Violence Prevention Manual for Healthcare Workers. Rae Stonehouse

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      •One in three B.C. women were victims of assault by a spouse or partner.

      •One in six B.C. women were victims of sexual attack by a date or boyfriend.

      Young women’s experience of violence

      The 1993 Adolescent Health Survey in British Columbia found that:

      •32% of girls and 15% of boys between grades 7 - 12 had been sexually and/or physically abused.

      Grade 11 girls experienced the highest rate of abuse:

      — 28% had been physically abused;

      — 28% had been sexually abused.

      The previous statistics are Canadian but should serve to illustrate the connection between violence at home i.e. nonwork activities and the workplace.

      Let’s look at the concept of violence a little closer.

      The Most Recognizable Forms of Violence Include:

      Physical Assault such as: punching, hitting, kicking, slapping, shoving, biting, choking, using a weapon, withholding medicines or medical treatment, or threatening to do any of the above.

      Sexual Assault such as: forcing any kind of sexual activity on someone without that person’s consent, even in a marriage.

      Violence also includes:

      •Emotional abuse such as: making a person feel worthless; telling them they are the problem; that they invite violence or they need psychological help; humiliating them in front of others; not allowing them to visit friends or family; showing extreme jealousy; withholding documents like immigration or refugee papers; threatening deportation, or depriving someone of their freedom whether in their public or private life.

      •Verbal Abuse such as: telling a person they’re stupid; yelling, screaming, name-calling, or using sarcasm and put-downs; threatening to hurt a person.

      •Sexual Harassment such as: unwanted and suggestive comments or actions of a sexual nature; slurs, jokes, gestures regarding sexuality; unwanted physical contact; requests for sexual favours; or comments about an individual’s sexual orientation or identity.

      •Economic abuse such as: controlling money or stopping a person from getting a job or education.

      The Impact of Workplace Violence on Workers

      Workplace violence may result in physical and/or psychological injuries to the worker as follows:

      Workers

      Physical injury/Psychological injury:

      •Grief, denial, self-blame

      •Depression, anger, disbelief

      •Anxiety, shock, apathy

      •Dependency, helplessness

      •Symptoms of PTSD (post-traumatic stress disorder)

      •Fear of future threats or injury

      •Self-doubt

      •Powerlessness

      •Fear of returning to work

      •Decreased job performance

      •Changes in relationships with co-workers/families

      •Extended time off

      •Physical illness

      •Sleep pattern disturbances

      •Headaches

      •Impaired stress management and substance abuse

      Co-workers

      Psychological impact:

      •Denial, self-blame

      •Blaming of victim, leading to conflict or distrust among co-workers

      •Anger, increased stress

      •Fear for their own safety

      •Lower workplace morale

      •Re-distribution of the workload due to the worker’s leave as a result of physical and/or psychological injury

      Editorial Comment: You may notice that many of the statistics quoted throughout this manual are related to nursing in British Columbia, Canada. From a purely statistical standpoint they can easily be dismissed as being too small of a number to generalize as to the incidence of violence in a worldwide nursing profession. It is not the intent of this book to provide up to date statistics that are applicable to the reader’s geographical region. If these statistics are important to you I suggest that you research your respective Occupational Health & Safety organizations and Workers Compensation Boards.

      Having said that, the intent of this manual is to serve as a resource to you in providing practical techniques in dealing with workplace violence.

      Assault/Abuse Directed Towards Care-Giver

      An Overview

      •Assaults include both physical and verbal aggression.

      •Assaults include: punching, kicking, throwing objects, spitting, biting and severe verbal abuse.

      •Assaults may be either unprovoked as staff perform their duties or sustained as direct result of staff interventions.

      The severity of injuries varies greatly. Three degrees of injury have been identified: (physical contact must have taken place)

      •First degree: no physical injury detectable.

      •Second degree: includes minor injuries such as bruises, abrasions and small lacerations.

      •Third degree: large lacerations, fractures and loss of consciousness, as well as injuries resulting in permanent physical disability or death.

      Let’s look at the concept of assault a little closer and try to define it.

      •Assaults include both physical and verbal aggression.

      Proactive Tip: We tend to think of assault in just physical terms, someone hurting us, but yelling, swearing, threatening, name calling can be just as devastating, especially if the person is capable of following through on the threats. Later we explore the act of “horizontal violence” which includes the afore mentioned actions but from a surprising source.

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