Violence is no stranger to the healthcare workplace. Yet nurses often fail to report such violence in the skewed belief that assaults are all in a day’s work, or that somehow they failed to anticipate an assault or react properly. Unfortunately, nurses are apt to blame themselves.

But it’s not part of your job to be assaulted in the workplace; nor is it your fault. Your healthcare facility should have policies in place to provide a safe working environment. Nonetheless, you do have an obligation to keep yourself safe.

Staying safe on the job

In healthcare settings, perpetrators of violence may include drug-seeking individuals, unstable patients, and volatile family members. The sheer number of violent incidents against healthcare workers is staggering.

According to some estimates, 35% to 80% of hospital staff will suffer a physical assault at least once in their careers. Not surprisingly, emergency-department staff and home health nurses are particularly vulnerable.

To reduce your risk of workplace violence, follow these guidelines:

• Familiarize yourself with the policies and protocol in place. Has the hospital security force been trained to defuse and defend? Does it have zero tolerance for aggression and violence? Are environmental features in place to discourage violence—adequate lighting, cameras, and panic buttons?
• Use the buddy system, and establish a code word to use with colleagues when you need help or backup.
• Alert the appropriate staff if you become uneasy around a patient or visitor. Don’t ignore your gut feelings.
• Avoid wearing jewelry that is valuable or could become a strangulation hazard.
• Take a self-defense course. You have the right to defend yourself from bodily harm.
• Report violent incidents in writing. Keep a copy for your personal files.
• Know the signs of impending aggression—threatening body language, reddening of the face, clenched fists, and so on.
• Don’t let anyone get between you and an exit if you feel uneasy or threatened.
• Stay calm, keep an erect posture, and maintain eye contact. This may make you less vulnerable to violence.

When violence meets opportunity

Violence can follow you home as well. Predators stalk their prey and look for a window of opportunity, someone who’s not paying attention, and a dearth of witnesses.

Know that your vehicle is a danger zone. You’re most vulnerable when walking to or getting out of a car—a time when no barrier (such as the safety of your locked car) separates you from someone with harmful intent.

Keep your car keys ready and your wits about you.

Beyond such obvious tactics as driving with car doors locked and parking in well-lit areas, pay attention to your surroundings at all times. And be aware that many predators make a dry run before committing violence. So pay attention: Has someone passed by you more than once in the parking lot or on the highway? When you move, does that person or car move, too?

Here are other things to consider:

• Once in your vehicle, get moving! Many women leave themselves vulnerable when they get into a car and check their shopping list or make a phone call.
• Many predators park a van next to the driver’s side of the car. This makes it easy to pull a victim into the van as she tries to open her car door.
• If you’re accosted in a parking lot and have no other option, crawl under a nearby car and grab onto its understructure.
• Don’t pull over for an unmarked car that has what appear to be police lights. Instead, put on your hazard lights, slow down, and drive to a well-lit, populated area. Using your cell phone, call 911 to verify the authenticity of the person trying to pull you over. (For additional tips, see Preventing and defending against an attack by clicking on the o=PDF icon above.)

A predator’s missed opportunity

At age 17, I bought a greeting card at the shopping mall, dutifully locked my Volkswagen door, and turned the ignition. Suddenly a man banged on the window, flashed an official-looking badge, and identified himself as mall security. When I rolled down my window, he accused me of shoplifting and demanded I go with him.

For some reason, instead of my typical “good girl” response, I indignantly held up my card and receipt and told him the accusation was ridiculous. He grabbed for my arm and tried to push the window down further with his other hand. Angry at what I thought was an overzealous security guard, I rolled up the window with all my strength.

He became furious, hitting my car with his fist; then he walked away. I drove home and told my youngest brother (the only person home at the time) about the incident. Though barely in his teens, he instinctively knew something was wrong. He insisted we go back to the mall and talk to the head of security. There we learned that the man who’d tried to haul me off was no security guard. The police were called in, and they told us the man was suspected of committing rapes and abductions around the state. I didn’t realize it at the time, but my indignant response interrupted his window of opportunity.

Staying safe when traveling

Even the nicest hotels can be far from safe, especially for a woman traveling alone. To protect yourself, you can buy a rubber door jam (available at many luggage stores) that sounds an alarm if someone tries to push the door in from the outside. Other gadgets to consider are door alarms that simply hang on the inside door knob and portable door locks that slip into the door frame and lock it securely from the inside. Or you can wedge a chair under the door knob.

When registering at the front desk, request a room away from stairwells, closer to the elevator, and not easily accessible from the street. A room facing an inner courtyard is probably safer than one facing a back parking lot. Ask for both magnetic room keys so no one can ask for an extra key to your room under false pretenses.

To reach your hotel room safely, keep your room key in your hand as you approach, and be mindful of who is around you. Once you’re inside, if your room is on the first or second floor or has a balcony, lock the windows or the balcony door.

Knowledge keeps you safer

At times, violence can be random, and no amount of preparation can prevent it. Thankfully, violent people aren’t hiding behind every tree and bush. You needn’t slink into a corner and cower for the rest of your life. Don’t give your fear that power. Instead, arm yourself with information that will help protect you so you can walk more confidently through the adventures of life.

Visit www.AmericanNurseToday.com/Archives.aspx for a complete list of selected references. For a quiz on staying safe, visit www.AmericanNurseToday.com/archives.aspx and click on the November/December issue.

Joan C. Borgatti is the owner of Borgatti Communications, which provides writing, editing, and coaching services.