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

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      “They don’t know who they’re dealing with!”

      “I’ll show them a thing or two!”

      “I guess they must be right, I am useless”

      “They’ll be sorry when I’m gone.”

      “I might as well be dead, no one cares anyway”

      Behavioural Clues

      Testing limits:

      Comments/Questions?

      “What would you do if I punched you in the stomach?”

      “What would happen if I took all my pills at one time?”

      “I am leaving here and there’s not a thing that you can do about it!”

      “How many aspirin does it take to kill a person?”

      Intolerance of authority: (questioning authority, defying the rules)

      Observable Behavior: frequent questions, attempts at dominating conversation or monopolizing authority figure’s attention, irritability, obvious “put-downs”, gossiping

      Comments/Questions:

      “Who died and made you God?”

      “When did you go to school, if you did?”

      “Who said that you’re the boss?”

      “We’ll see about that!”

      Need for personal space:

      Observable Behavior: sometimes they have to pace indoors or maybe get outside, can’t stand to have anyone near them

      Comments/Questions:

      "I need some room to breathe."

      “I’ve got to get out of here!”

      “The walls are closing in on me”

      Posture:

      Observable Behavior: sitting on or moving to the edge of the chair

      Speech:

      -rapid, high pitched

      -anxious tone

      -sudden voice change

      -muttering

      -swearing

      -sighing audibly

      Motor Activity:

      Observable Behavior:

      -unable to sit still

      -appears to be tense

      -pacing

      -startles easily

      -increased agitation

      -exaggerated movements

      -moving things without purpose

      -darting eyes

      -staring/avoiding eye contact

      -retreats when approached

      -not sleeping, (when they should be)

      -rocking

      -banging objects

      -restlessness

      -destruction of physical property

      -tapping of hands, fingers, feet

      Others:

      Observable Behavior:

      -increased confusion

      -eyes narrowed

      -looking angry

      -body tensed ( neck, jaw, arms)

      -fist clenched

      -withdrawal

      -threatened aggression

      -self-abuse

      -physical aggression

      -sensitivity to noise

      -refusal to take medication

      -flat, dull affect

      -dilated pupils, (indicator of fear)

      Chapter Two Summary:

      Violence is increasing in society and this is reflected in healthcare, a field predominantly composed of women. The statistics of workplace violence may actually be higher than reported as many incidents of violence are not reported to the employer.

      We defined and described the most recognizable forms of violence as physical assault and sexual assault. We then expanded upon that definition to include: emotional abuse, verbal abuse, sexual harassment and economic abuse.

      We explored how workers are impacted by violence in the workplace. We then focused on how violence presents itself in our healthcare work settings. Defining violent and aggressive behavior helped us to better understand the range of language that is often used in literature to describe workplace violence.

      The Signs of Disturbed Behavior Quick List introduced us to the broad range of behaviors that we might see in our workplaces. Quick Lists are designed to be printed and discussed. Perhaps a staff meeting or in-service would be a perfect place to get the dialogue on acknowledging that workplace violence exists and to take steps toward preventing it from happening in your worksite.

      We then explored the different emotions that disturbed individuals might display.

      In Chapter Three we explore risk assessment for violence in our work settings and triggers for aggression. We will be challenged to consider how we personally view working with potentially violent individuals and techniques to communicate with disturbed individuals are introduced.

      Chapter Three

      ASSESSMENT

      Risk Assessment for Violence

      Purpose:

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