Melanie Sanchez is nurse manager of a 30-bed skilled nursing unit (SNU) in an urban hospital. Patient confusion and aggression are not uncommon occurrences for her staff. Nursing and assistive staff have been trained on conflict resolution and methods for dealing with aggressive patients. Sandra Porter, RN, has worked in the SNU for the past six years. Today, while administering medication to patients before lunch in the common dining room, Sandra noticed a newly admitted patient, Mr. B, yelling obscenities at another staff member. Sandra secured her medication cart and came to the aid of the nursing assistant. Sandra attempted to verbally de-escalate the situation, but Mr. B became increasingly aggressive. When Sandra turned to instruct the nursing assistant to clear patients from the dining room, Mr. B. picked up a chair and struck Sandra in the arm and shoulder. The nursing assistant alerted Melanie and several nurses to the problem. Melanie immediately called the hospital operator to request that security respond to a violent patient on the SNU. Upon entering the dining room, nursing staff were able to restrain Mr. B while Melanie accompanied Sandra to the emergency department for treatment of her injuries. Sandra sustained a broken arm, a laceration to her shoulder, and several contusions. As soon as Sandra’s injuries were treated and she was released from the emergency department, Melanie contacted the medical/surgical nursing division director and the human resources department about the assault and filled out an incident report. She also completed an injury report for Sandra’s worker’s compensation claim. Melanie contacted the security department and requested a meeting with the security director to determine if a police report should be filed regarding Mr. B’s assault of Sandra. The next day, Melanie contacted Sandra at home and informed her that a case manager from human resources would call her within the week regarding her worker’s compensation claim. Melanie also checked to see how Sandra was doing and encouraged her to call Melanie directly if she had questions or concerns.

 Manager’s Checklist

The nurse manager is responsible for:

 ● Ensuring that appropriate action is taken to secure the safety and well-being of the injured employee, patients, and other staff immediately following a workplace violence incident

● Securing immediate and appropriate treatment for the injured employee

 ● Informing administration and human resources departments of the incident

 ● Completing required injury and incident reports in a timely manner

● Following up with human resources regarding the worker’s compensation process for the injured employee

● Contacting security to determine if a police report should be filed regarding the incident.

 ● Contacting the injured employee at home to express concern for their well-being and follow up with any questions they may have

● Ensuring any scheduling problems due to the injured employee’s absence are resolved