Patient-on-nurse violence is not addressed. Photo Courtesy: Agencia De Noticias/FLICKR
Photo Courtesy Agencia De Noticias/FLICKR

Ryerson nursing students aren’t prepared for work violence

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By Jacob Dubé

Nurses and nursing students experience one of the highest rates of workplace violence, and a gap in Ryerson’s curriculum means that Daphne Cockwell School of Nursing (DCSN) students are entering the workforce without training or support.

According to the Canadian Nurses Association (CNA), healthcare workers are most likely to be attacked at work compared to other professions. Nurses are at the highest risk among them.

Sarah Cooke*, a third-year nursing student, said that Ryerson’s program mainly addresses nurse-on-nurse violence, also called horizontal violence, which occurs when a nurse bullies or attacks a colleague.

But violence from a patient towards a nurse becomes one of the biggest issues they face when students don’t know how to go into the industry prepared.

Cooke said that because nurses are usually the first people to interact with a patient, and on a more personal level—by handling needles and treating wounds, for example— they’re more likely to be abused by them, especially if there are obstacles such as a language barrier, or they have a condition like Alzheimer’s or dementia.

In her second year of clinical place- ment, Cooke had a patient that hit her, pulled her hair and grabbed her arm. In the moment, she felt as though she should know exactly what to do. The truth is, she didn’t. Her courses had never prepared her for it.

“I do feel scared. It’s definitely made me worried about sometimes being alone with a patient, because you never know what they’re capable of,” she said.

Cooke said because nursing is about providing care, fighting back could risk her job. But she said leaving an aggressive patient on their own can be detrimental to their care.

“No other nurse or doctor wants to approach that patient because they’re scared, and it’s just an endless cycle of bad things,” she said.

Nursing student Jim Wong*— who chose to be anonymous to avoid trouble with faculty that he said warn students against speaking out about the nursing program— said that many people just view violence against nurses as a “part of the job” that they have to get used to it. It was brought up only once in their first year, and he said that everyone was scared.

Ryerson’s nursing program currently has no class dedicated to addressing how students would react and prepare for different instances of violence.

York University, however, offers a nursing course that focuses on mental health, and includes a module on how to recognize and deal with harmful situations for nurses and patients.

Healthcare facilities in Ontario have a set of codes to react to certain incidents in their workplace. An aggressive or violent situation is considered a Code White. When a Code White is identified, nurses can either call it in or use a personalized button that they carry around, remove themselves from the situation and wait for a team to respond.

But afterwards, it’s hard for nursing students to process and cope with what happened. Cooke said that students have weekly sessions where they talk about their experiences in their placements. It’s a good place to hear similar stories about the incidents and fears of other nursing students, she said.

But she describes methods like those as more self-directed. She’d rather see the school take action and create a class where issues around workplace violence and their experiences can be addressed more directly, she said.

“It’s always patient-centered,” Cooke said. “And I feel like we don’t get a good understanding of what it’s like for a nurse to actually be attacked.”

Ryerson’s nursing program holds “simulation”—where an actor plays out a scenario and the students have to respond to it, and analyse their choices later—and Wong said it would be a good place to test out different responses to workplace violence.

The Eyeopener reached out to several nursing professors, as well as the DCSN interim director elaine Santa Mina, but none were available to comment prior to publication.

*Names have been changed

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