PROtect Yourself! Empowering Tips & Techniques for Personal Safety: A Practical Violence Prevention Manual for Healthcare Workers. Rae Stonehouse
being taken advantage of by others; can make decisions and free choices in life; can recognize and acquire more of his/her interpersonal needs; and can verbally and non-verbally express a wide range of feelings and thoughts, (both positive and negative).
This is to be accomplished without experiencing undue amounts of anxiety or guilt and without violating the rights and dignity of others in the process.
Abuse, assault and violence are terms used interchangeably in the literature to describe behaviors ranging from verbal abuse and emotional harm, to criminal activities such as common assault (which includes wounding, maiming, disfiguring, or endangering life).
We can consider three terms in helping to define the area of aggression and violence.
These are:
•Assertion
•Aggression
•Violence
1.Assertion is a generic term for all behaviour, as described above, without hostile intent, which is designed to gratify a need.
(Assertion (Latin asserera; claim, affirm) To state positively, To affirm, To maintain insistently)
2.Aggression is a specific form of assertion that has hostile intent.
(Aggression (Latin aggressio; a going towards, attack)
3.Violence pertains to the use of physical force and is the exertion of physical force so as to injure or abuse.
(Violence (Latin violentia; vehemence, ferocity)
The use of definitions vary between organizations, therefore the following definitions will be used to define the behavior that this manual is targeting.
(a)Workplace Violence is:
•a hostile or aggressive behavior resulting in physical or emotional injury to [Hospital] staff members or damage to [Hospital] property. The incident or act may be committed by a patient, resident, volunteer, visitor, physician or staff member and may involve but is not limited to name calling, swearing, threats, use of a weapon, sexual harassment, assault and/or battery, any of which may occur in the normal course of the regular duties and job responsibilities.
(b)Assault is:
•any action by another which creates a situation in which a person has reasonable cause to feel afraid for his or her safety, whether or not an injury (physical or psychological) occurs.
Comment: The two components of assault are the threat and the ability of the person to carry out the threat. Examples of assault are hits, grabs, shoves, kicks, pinches, sexual assaults, threats with an object such as a chair, cane or sharps container, or with a dangerous weapon such as a knife, gun or blunt instrument, any physical injury, and verbal hostility and abuse.
(a)Aggression is:
•the verbal or physical acting out of anger or hostile feelings. Aggressive behavior may be directed towards self, other people or objects and may include everything from: agitation, restlessness, threatened aggression, offensive gestures to destruction of environment, self-abuse and physical injury to others.
Threats:
•Threats generally involve any communication of intent to injure that gives a worker reasonable cause to believe there is a risk of injury. A threat against a worker’s family arising from the worker’s employment is considered a threat against the worker.
Examples of threats include:
•Threats (direct or indirect) delivered in person or through letters, phone calls, or electronic mail
•Intimidating or frightening gestures such as shaking fists at another person, pounding a desk or counter, punching a wall, angrily jumping up and down and screaming
•Throwing and striking objects
•Stalking
•Wielding a weapon, or carrying a concealed weapon for the purpose of threatening or injuring a person
Editorial Comment: Years ago, while working in psychiatric hospital, I received a phone call from a distraught family member of a patient who was incarcerated under a Warrant of the Lieutenant Governor, having committed murder. I was told “I know where you live and I’m coming to get you and your family.” As one might expect, this was quite disturbing. I first notified my wife and advised her of the situation. I then notified my shift supervisor who was of little help. “I don’t know … do whatever you think needs to be done Rae …” I notified the police and they apprehended the individual. Alcohol was a factor in the individual making the call and they were not considered to be an ongoing threat. The situation was rather unsettling and has definitely been influential in my promoting workplace violence prevention.
Signs of Disturbed Behavior
Quick List
It is important to be aware of “signs” that may indicate impending violence, aggression or assault. Be alert for the following warning signs:
•Pacing
•Hyperactivity
•Muttering
•Swearing, chanting, loud speech or shouting
•Exaggerated movements
•Sudden movements or pointing
•Staring
•Avoiding Eye Contact
•Eyes Narrowed
•Looking angry, threatening stance
•Body tensed (neck, jaw, arms)
•Rapid respirations and flared nostrils
•Clenched fists
•Restlessness
•Withdrawal
•Rocking
•Banging Objects
•Restlessness
•Threatened Aggression
•Destruction of Physical Property
•Self-Abuse
•Physical Aggression
Signs & Symptoms of Aggressive Behavior
Disturbed behavior can easily escalate into aggressive behavior. It is important to be aware of the early warning signals, such as restlessness, toe tapping, pacing, etc. and the expression of fear, anxiety, anger, frustration, loss, hopelessness, despair.
These emotions communicate the potential for aggressive behavior toward others, self or property.
Proactive Tip:
* Acknowledge these feelings with the person. This is the single most effective form of defusing and preventing aggression at the early stages.
Emotional Clues
We can gain valuable information from their conversation or observing their outward emotional state.
Examples of emotional clues you can expect to encounter are as follows:
Disorientation:
Comments/Questions?
“Where am I?”
“What's going on?”
“Where's my wife/husband?”
“Who are you?”
“Why