For nurses in New York state, Nov. 1 represented a victory for on-the-job safety. It was the day that the Violence Against Nurses law took effect, making it a felony to assault an on-duty RN or LPN.
For many nurses, including those in home health, dealing with violent or abusive patients and caregivers was considered part of their plight. The New York State Senate passed the legislation in January, noting that, according to the U.S. Department of Justice, nearly 500,000 nurses each year become victims of violent crimes in the workplace. Most commonly reported acts of violence include spitting, biting, hitting and shoving.
“Violence in the workplace for nurses is very under-reported. Nurses were either afraid to come forward or not sure if what was happening to them was classified as violence. …,” says Erin Silk, assistant director of communications for the New York State Nurses Association, which has been working to bring the legislation forward since 2008.
With the Violence Against Nurses law, nurses join the already protected groups of police officers, firefighters and emergency responders. A physical attack against an RN or LPN on duty is a Class D felony, subject to a maximum of seven years in prison.
Nurses have commented that they feel empowered by the law, according to Silk.
”We had [news about the legislation] posted on our Facebook page, and we got quite a lot of feedback,” she says. ”I think they’re excited that somebody has taken notice.”
“Hopefully this bill will deter acts of violence against the approximately 60 RNs and three LPNs at Winthrop-University Hospital Home Health Agency,” says Anne Calvo, RN, BSN, MPS, the agency’s administrator and director of patient services.
Calvo says that, upon hire, nurses are instructed to leave any home situation in which they feel uncomfortable or unsafe and to immediately call their manager. Nassau County police also give Winthrop’s providers training for how to identify and defuse potentially violent situations. “We do serve certain geographic areas that have been identified as high risk due to high crime rates,” Calvo says. ”Nurses, therapists and home health aides can request escorts — off-duty security guards to accompany them to those areas.”
Before the Violence Against Nurses law took effect, Calvo says, it was difficult administratively and ethically to refuse care, even in light of clear safety issues. “In my personal opinion, I think we will be more comfortable in not providing service in cases where we felt the staff was threatened; where before, wed always put patients rights first,” Calvo says.
Calvo says that despite previous safeguards for home care providers, safety continues to be an issue. Winthrop, she says, makes an average of 3,000 nurse visits each month to homes in Nassau County. ”We’ve had staff that have been bitten, smacked … and we’ve walked into situations of potential sexual harassment,” Calvo says. ”But we haven’t had anyone who has wanted to press charges against the patient. I don’t know if that will change.”
Based on each facility’s policy, nurses or their managers should call law enforcement when episodes of on-the-job violence occur, says Eileen Avery, RN, MS, associate director of education practice and research at the NYSNA. ”NYSNA is working on educating nurses, as well as management, on how to proceed so that we are proactive, rather than reactive, in these situations,” Avery says.
The law applies to physical assault, which includes being spit on, bitten, hit or pushed. It does not include verbal assault. Nurses can press charges against anyone, including patients who are delirious or mentally ill. The bill, Avery explains, covers the basic right to press felony charges. The courts will take it from there.
Avery says nurse management also should take this opportunity to update policies regarding violence and make sure their nurses understand those policies.
Spreading the Word
NYSNA is working on a promotional campaign about the law for healthcare providers and the public. It includes news releases and posters for facilities warning readers that assaulting a nurse is a felony.
Roger L. Noyes, director of communications for the Home Care Association of New York State, says the nearly 400-member association supports the law and recognizes the need for providing this protection for nurses. “One thing that we are going to be doing in the coming weeks is making sure that our membership is informed about the law and try and get some more feedback from them in terms of what they think this will mean for them,” Noyes says. ”We’ll also be providing our own recommendations in the area.”
“We can now be empowered to focus on staff safety, while respecting the patients’ rights for care,” Calvo says. “The public should be aware that nurses should not be abused physically just because they are nurses. They’re human beings, and we all need to be treated humanely.”