As a practicing psych nurse on a busy acute care county unit, I have seen and experienced my share of violence.
I am disappointed that patients who assault are rarely charged and I have been told by law enforcement that nurses shouldn't bother to press charges since the DA will drop it and label them mentally ill and not competent.
I am writing a letter to my local DA to ask for support to change the perceptions of the mentally ill and the practice of treating patients exactly the same. I try to define the spectrum of disease from mild depression to personality disorders, patients with co-morbidity of substance abuse and psychotic, delusional and disorganized ill patients.
I highlight the literature on predictors of violence and that the most violent patients are usually patients with personality disorders and substance abuse.
Research by Rice (2002); Haim (2002); Junginger (1998); Sacks (2009); and Svindseth (2008) has shown that patients with schizophrenia and psychotic symptomatology to be less violent. Individuals at high risk of violence towards staff are more likely to be substance abusers, have personality disorders and are angry because of a perceived lack of respect or a denial of service; e.g. asked to pull up their pants or has to wait to use a phone. Many of these patients have narcissist, antisocial or entitled traits.
These patients have no remorse and I have had these patients brag they could get away with killing a staff person. A mood disorder should not be a get out of jail free card.
I would like to have legislation that mandates felony charges with health care staff assault.
What are other states doing about staff violence? I would love to hear about the consequences of staff violence in any acute care setting.
I am working on a literature search for predictors of risk for violence. Has anyone done work on this topic? I would love to read your research.