1. VIOLENCE
In the WorkPlace

2. Objectives: After completion of the
presentation, the participant will be able to:
Identify 4 signs of a potentially
violent situation.
Identify 3 methods of controlling
disruptive behavior.
Describe how to report an incident
at GBMC.
Describe 5 security measures you
and/ or the facility can take to
prevent violence.

3. Introduction:
Violence is a serious problem. It occurs
EVERYWHERE...
.............Even in the WorkPlace! GBMC
HealthCare, Inc. has developed this
program to address this issue.
This self learning packet will provide you
with the knowledge to prevent and deescalate disruptive and potentially violent
situations in the workplace.
Policy # 807 is found in the safety
manual. It can also be found on the
GBMC Intranet under Employee Health
policies. FAMILIARIZE yourself with
the policy: ZERO TOLERANCE is the
position of our management at GBMC.

4. HOMICIDE IS THE
LEADING CAUSE OF
WORKPLACE DEATH
FOR WOMEN AND THE
SECOND LEADING
CAUSE OF DEATH FOR
ALL WORKERS
(Center for Workplace health and safety, Inc.)

5. Incidence:
One in 6 violent crimes occur
on the job.
Highest incidences occur in
places:
– where cash is regularly
handled
– where employees work alone
(late @ night)
– where there is regular contact
with prisoners
– AND.......................

6. Incidence cont.
WHERE THERE MAY BE
HIGHLY EMOTIONAL
SITUATIONS, SUCH AS
HOSPITALS AND SOCIAL
WORK/ SOCIAL SERVICES
ORGANIZATIONS.

7. Incidence cont.
INTENSIVE CARE UNITS,
ORs, MEDICAL-SURGICAL
FLOORS, NURSERIES,
NURSING HOMES, AND
COMMUNITY HEALTH
SETTINGS HAVE ALL
BEEN THE SCENES OF
VIOLENT ACTS!

8. OF 1209 EMERGENCY
DEPARTMENT NURSES
RESPONDING TO A
RETROSPECTIVE
SURVEY, 97.7% HAD
EXPERIENCED SOME
TYPE OF
VICTIMIZATION
(Journal of Emergency Nursing, 1991)

9. Causes of Violence
Robbery is the number 1
cause in the workplace. BUT,
Violence occurs from:
Coworkers, visitors, outsiders,
and customers under emotional
stress
A relative, friend, or
acquaintance entering the
premise to do harm (Domestic
Violence situations)
Individuals under the influence of
a substance
Prolonged waiting

10. PREVENTION:
“UNIVERSAL PRECAUTIONS
FOR VIOLENCE”
It should be expected but can
be avoided or mitigated
through preparation

11. Security Procedures:
Self:
Alert security of
unusual behavior
Identify visitors
Wear ID badge
Store briefcase
and purse locked
and out of site
Do not walk
alone at night
Facility:
Visitor registration
Lighted hallways &
stairwells
Lighted garage
Cameras
Panic buttons
(garage)
Safety surveillance
– security;
– plant operations;
– safety committee;
– management

12. Security Procedures
cont.
Facility Layout
Unit Layout: location doors,
windows, furniture
Identify items that may cause
injury: chairs, small
equipment
Identify items that could help
protect: mattress, pillows,
sheets

13. RECOGNITION OF
POTENTIALLY
VIOLENT
SITUATIONS
TAKE THREATS OF
INTIMIDATION
SERIOUSLY!!
DO NOT IGNORE!
Threats may be:
verbal, written, physical, over
the phone, or through e-mail

14. Signs of Potential
Violence
Threats
Tantrums- may be sign of
more violent behavior
Withdrawn
Angry
Blames others
Becomes verbally/ Physically
Abusive
Talks about guns

15. MORE SIGNS!
Unreciprocated romantic
obsession
Expressions of hopelessness
or heightened anxiety
Violence towards inanimate
objects

16. Levels of Disruptive
Behavior
1. Anxiety,
discomfort,
anger
2. DefensiveVerbally
Threatening
3. Physically
Acting Out
4. Stimulation/
Stress Reduction
ACTION
:
1. Supportive/
Reassurance
2. Directive: Set
reasonable,
consistent,
clear limits
3. Proper
physical control
4. Staff establish
Rapport

17. Setting Effective Limits
Explain which behavior is
inappropriate
Explain why the behavior is
inappropriate (focus on
behavior; not person!)
Give the individual
reasonable choices
Allow time for the individual
to make a choice
Enforce Limits

18. Setting Effective Limits
Remember:
Speak in calm, soft voice
Do NOT intervene alone!
Adopt a supportive posture
(no arms across chest; no
hands in pockets!)
Be aware of personal space:
Don’t allow yourself to be backed into a
corner!
Do not convey negative
feelings
Listen, Listen & Listen!

19. Methods of Controlling
Disruptive Behavior
Verbally
Chemically (medications)
Physical Control Techniques

20. Disruptive Behavior
Causes:
FEAR AND ANGER TO
THOSE IN THE
ENVIRONMENT

21. TRAINING:
Will assist staff in:
– control of actions and
emotions
– Provide framework to develop
emotional support and
– provide a team for physical
safety

22. If you find yourself in an
escalating situation:
MAKE NO HEROIC
ATTEMPTS TO SUBDUE
OR CONTROL PATIENT/
INDIVIDUAL!
INSTITUTE PROCEDURE
AND GET HELP!

23. GBMC Procedure:
POLICY # 807: SAFETY
MANUAL

24. If incident occurs which
includes threats:
Report threat or act to
supervisor IMMEDIATELY!
Complete Employee Medical
Referral Form and seek
appropriate medical
treatment (ER or EHS based
on extent of injury and hours)
Consider use of Employee
Assistance Program (410938-3200 or 1-800-8231337)

25. Manager will contact:
Employee
Situation
– Human
Resources
– Security
– Employee
health and
Safety
– Management
Visitor*/
Patient
– Security (may
call BCPD)
– EHS if
employee
involvement/
injury
– management
*Visitor may be
friend or
acquaintance
of employee

26. Employee Situations are
taken Seriously!
Employee who threatens/ acts
violently will:
Be evaluated by EAP to
determine if threat to
workplace
Remain off work until
healthcare provider
authorizes release
Need to undergo treatment/
counseling if recommended
by Healthcare Professional.

27. Staff will:
Be supportive to each other
Be supported by
management
Offered EAP services (EAP
will determine if debriefing
necessary)

28. SUMMARY:
WORKPLACE VIOLENCE IS
A REALITY!
PROPER TRAINING AND
PREPARATION, AS WELL
AS SUPPORTING SYSTEM
PROCESSES AND
PROCEDURES CAN
MINIMIZE THE THREAT OF
VIOLENCE.
BE PREPARED! DON’T BE A
VICTIM!

29. Resources:
Human Resources x2204
Employee Health x2239
Security x2222