Lessons learned on violence at St. Mary

In September 2005, Charles Kunkle was paged to the St. Mary Medical Center emergency room (ER) to find that a patient had shot and killed one local police officer, and wounded another officer and one of the hospital employees.

Kunkle, R.N., director of Emergency and Trauma Services at St Mary, learned a painful lesson first hand about violence against nurses in the workplace. He has since dedicated himself to improving the situation.

"Bucks County is the third oldest county in the state, and although we are not a city hospital, violence comes from many avenues—psychiatric patients, aging patients with dementias, drug withdraw, etc. No facility can ignore the problem," Kunkle says.  

Kunkle, now travels nationwide, speaking at conferences about workplace safety, sharing the lessons he has learned.

At St. Mary, Kunkle has implemented policies to prevent violence. For example, in his emergency room the highest risk patients (such as incarcerated patients and those patients requiring driving under the influence lab draws) are isolated from the main ER by a patient safety room connected to a medical treatment room. All rooms are secured with magnet locked doors and equipped with bolted down prison benches, gun locker, eye wash stations, and other appropriate equipment.

Crisis prevention and intervention training is mandatory at St. Mary's Medical. Every ER nurse is required to have current CPI training (14 hours every two years). Designated floor nurses must also be trained so that one nurse on every unit during day and night shift understands the protocols.

Over 200 St. Mary employees have been trained in personal safety techniques, non-violent physical interventions and de-escalation. Kunkle says violent events have decreased significantly since implementing CPI training.

"The problem is grossly underreported and violence has become accepted as a daily occurrence for nurses," Kunkle says. "This attitude needs to change, healthcare violence needs to be something our entire society thinks about."

Next up: More stories from nurses.