A recent “pulse check” survey of Emergency Nurses Association members revealed more than half of the responding emergency nurses had been either physically or verbally assaulted or threatened with violence in the previous 30 days.
In the survey conducted Feb. 11 – March 11, ED nurses described being head-butted, kicked, slapped, punched, stabbed with a pencil or hit with thrown objects, among other types of aggression.
The verbal assaults and threats also have an impact:
“The patient threatened to cut my throat and says he would find out where I lived,” one nurse reported.
“They were upset and threatened to hurt me when I was done with my shift,” stated another about a patient’s relatives who were violating the hospital visitor policy.
With the National Institute of Health recognizing April as Workplace Violence Prevention Awareness Month, ENA continues to speak strongly about the crisis of violence toward emergency nurses and remind the public that it is not “just part of the job.” The association has long supported legislation and other measures that aim to reduce the frequency and severity of workplace violence incidents in healthcare.
“The violence and incivility against emergency nurses and their emergency care team partners – who are in the ED around-the-clock, every day, ready to care for anyone who enters – is unacceptable,” says ENA President Chris Dellinger MBA, BSN, RN, FAEN.
Of the nearly 500 ENA members who responded, approximately one-in-10 says they are considering leaving nursing because of ongoing workplace violence.
The survey also asked members for their perspectives on how their EDs prevent or respond to such incidents and what they see as positives in their workplace. Members cited de-escalation training, response teams, publicly stated policies and use of technology — such as flagging in electronic medical records — as things working well in their particular facilities.
Generally, members cited positives in how their ED addresses workplace violence, but also lamented that it is still viewed as “part of the job” and expect little to change despite its ongoing pervasiveness, calling for better enforcement of policies and better follow-up by police and prosecutors.
Responses called attention to the various systemic issues that contribute to the overall problem beyond an increased lack of common consideration for others. These include staffing issues and the increase in patients with behavioral health needs who are boarded in the ED for sometimes weeks while waiting for appropriate placement.
“During Workplace Violence Prevention Awareness Month especially, we encourage people to listen to emergency healthcare professionals, hear their challenges and support the changes needed,” Dellinger says. “Workplace violence is a problem with complex roots that requires resources and responses from many channels. The health, safety and well-being of emergency nurses and their patients are at stake.”
From flight nurses to military members and mayors to parents, emergency nurses go beyond the call of duty and the 2023 ENA Connection 20 Under 40 class has it all.
ENA announced the third class of 20 extraordinary nurses as part of the celebration of Emergency Nurses Week.
Each honoree in the 2023 class has achieved significant milestones in their healthcare careers and demonstrated positive contributions beyond their professional work. One nurse from Bhutan created the BEAR, or Bhutan Emergency Aeromedical Retrieval Team, which uses his country’s only helicopter for rescue missions. Another helped launch a program called “Caring for the Caregiver” to help nurses cope with critical incidents. Those are just the beginning of what this class of honorees has accomplished.
Many in the new class were inspired by nurses they had encountered in the past. Some followed in their family’s footsteps, while others fell into the profession later. One thing they all have in common is the goal of helping people and inspiring and teaching the next generation of nurses.
“Having seen what these 20 nurses have accomplished, I can say with certainty that the future of emergency nursing is in good hands,” says ENA President Terry Foster, MSN, RN, CEN, CPEN, CCRN, TCRN, FAEN. “The amount of knowledge, passion, drive, and skill we have among the ENA membership is outstanding. I can’t wait to see how these young professionals continue to contribute to emergency nursing throughout their careers.”
Meet the ENA Connection’s 2023 class of 20 Under 40 honorees featured in the magazine’s October issue.
Jessica Wilson, MS, RN, CEN, CPEN, TCRN, EBP-C, of Maryland
Each class of honorees is chosen by a panel of reviewers who assess their accomplishments in their profession and communities, their contributions to emergency nursing, and how they plan to shape the future of the specialty. Their peers nominated 44 nurses, and 75 nurses submitted applications.
Emergency nurses need additional knowledge of abortion-limiting legislation and the related clinical, ethical, and legal implications for emergency care staff and their patients, a study published in the Journal of Emergency Nursing found.
The findings also highlight the increase in pregnant patients seeking care in emergency departments as the number of “OB deserts”—regions with limited or absent perinatal care—grows. Through interviews with ED nurses, the study explored the clinical decision-making processes of emergency nurses caring for patients with obstetrical emergencies in the context of limited or no access to abortion care.
“This was an important study to conduct. First, laws surrounding access to appropriate care for patients having pregnancy emergencies have been in flux in large areas of the country. Second, EDs are seeing more and more obstetric emergencies in communities where no OB services are available,” says Lisa Wolf, PhD, RN, CEN, FAEN, FAAN, associate professor at UMass Amherst Elaine Marieb College of Nursing, who is also Director, Emergency Nursing Research at ENA and lead the study. “Emergency nurses are not commonly trained in identifying and treating OB emergencies.”
Anna Valdez, PhD, RN, PHN, CEN, CFRN, CNE, FAEN, FAADN, JEN editor-in-chief of the Journal of Emergency Nursing says the study is an excellent example of the current and relevant research nurses conduct that assesses and explains the ways policies and laws impact EDs.
Whether in a mass shooting, urban violence, self-harm, or intimate partner violence, the damage caused by firearms is something emergency nurses know firsthand – they see it and experience their trauma every day while simply trying to save the lives of those injured by a firearm.
As the leading voice for emergency nurses, the Emergency Nurses Association (ENA) has a vested interest in the impact of firearms violence because of its direct relationship to injury prevention, patient care, and the health and well-being of the nurses who repeatedly experience trauma while caring for victims of gun violence.
ENA released its strongest firearms safety-related position statement in the association’s 53-year history. It calls for, among other things:
A ban on assault weapons, as defined by the Bureau of Alcohol, Tobacco, and Firearms
Raising the minimum purchase age to 21 for all firearms.
Establishing a federal prohibition on ghost guns and their components.
Implementation of emergency department screening tools to help identify individuals at high risk of death or injury from a firearm.
Measures to support more consistent firearms research and data collection.
Providing healthcare workers with resources to educate patients about firearm safety and injury prevention.
Collaboration with and support of evidence-based school or community programs focused on firearm injury prevention.
“The true toll of the gun violence epidemic in this country goes deeper than the headlines we see on a weekly, sometimes daily, basis,” says ENA President Terry Foster, MSN, RN, CEN, CPEN, CCRN, TCRN, FAEN. “Mass shootings and frequent gun violence in many cities across the country get more attention, but emergency nurses understand firearm injuries and deaths attributed to domestic violence, suicides, and accidental discharges are also a devastating part of this public health crisis.”
A 2022 Pew Research Report indicates the rate of gun deaths among Americans reached its highest level – 10.6 per 100,000 people – in 2020. Further, the Kaiser Family Foundation reported in 2022 that firearms are the leading cause of death for U.S. children.
“This updated, evidence-based position statement reflects ENA’s evolving perspectives on the multi-faceted issue of firearms, and it sends a clear message that more must be done to reduce the frequency and severity of firearm injuries and deaths,” Foster adds.
The Emergency Nurse Association (ENA) named longtime emergency nurse and educator Cam Brandt, MS, RN, CEN, CPEN, the recipient of the 2023 Judith C. Kelleher Award, the ENA’s most prestigious honor.
Driven by a passion for caring for children, as well as teaching and mentoring ED nurses, Brandt’s impact could be felt in the emergency departments where she worked and across the emergency nursing community through continual contributions as an ENA leader in Texas and key volunteer with many of the association’s committees – most notably as part of the team that develops the cornerstone Emergency Nurse Pediatric Course.
“The ED and education are where it’s at for me,” says Brandt of Keller, Texas. “I’m just a basic nurse who loved sharing my passion for education and whatever my passion in pediatric emergency care was at the time. This award is surreal. I never would have dreamed of where I am today.”
ENA President Terry Foster, MSN, RN, CEN, CPEN, CCRN, TCRN, FAEN, praised Brandt for her contributions to ENA and the entire emergency nursing community.
“Cam is the epitome of an emergency nurse: fierce, loyal, knowledgeable, persistent, driven and yet very caring,” Foster says. “Her dedication and many years of direct emergency nursing experience speak volumes. She is a role model for many of our ENA members.”
The ENA also announced the recipients of 12 other individual awards, including the annual State Council Achievement Awards and the Team Award.
Foster congratulated this year’s recipients for their inspirational work amid the numerous challenges faced by emergency nurses today.
“It never ceases to amaze me how impactful ENA members are in their emergency departments and as volunteers with this wonderful organization,” Foster says. “These awards are a reflection of how emergency nurses live ENA’s mission every day.”
The 2023 ENA award recipients and other honorees will be recognized during Emergency Nursing 2023 in San Diego on Sept. 21-23.
Here is a complete list of this year’s ENA award winners.
Barbara A. Foley Quality, Safety and Injury Prevention Award:Delfa Soto, MSN, RN, CEN, of California
Behind the Scenes Award: Vicki Sweet, MSN, RN, CEN, FAEN, of California
Diversity, Equity and Inclusion Initiatives of the Year Award (Individual): Anna Valdez, PhD, RN, CEN, FAEN, of California
Diversity, Equity and Inclusion Initiatives of the Year Award (State Council):Texas ENA State Council
Frank L. Cole Nurse Practitioner Award: David T. House, DNP, RN, CEN, of Texas
Lifetime Achievement Award: Mary Ellen Wilson, MS, RN, CEN, FAEN, of Ohio
Media Award: Gary Kleeblatt, The Middletown Press, Connecticut
Nurse Manager Award:Hannah Longoria, BSN, RN, CEN, of Texas
Nursing Competency in Aging Award: Jennifer A. Noble, MSN, RN, CEN, of Texas
Nursing Education Award: Teri Diloy, MSN, RN, CEN, CPEN, of Virginia
Nursing Practice and Professionalism Award: Leslie Hinson, MSN, RN, CEN, of Texas
Pediatric Readiness Improvement Award: Nancy McGrath, MN, MSN, RN, CPNP, of California
Rising Star Award:Stephanie Jensen, MSN-L, RN, MICN, of California
Team Award: Cook Children’s Trauma Nurse Leaders, Texas
In addition to the individual honors, nine states – Arizona, Illinois, Louisiana, Maryland, Minnesota, North Carolina, South Carolina, Texas and Washington – received 2023 State Council Achievement Awards for their outstanding local efforts last year.
