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Oftentimes, I am the only staff member on my psychiatric unit. If something should happen to me, is there anything I can do?

Friday September 28, 2012
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Dear Nancy,

I work on a small unit in a psychiatric hospital where the patients are, for the most part, emotionally stable. Often there are times when I am the only staff member on this unit. When I voice concerns about potentially aggressive patients, I am told that I should be able to handle it, despite being the only staff member on the far end of the hospital. When I accepted the position, I was not aware that I would be expected to put myself at more of a risk than on regular inpatient psychiatric units. If something should happen to me, is there anything I can do?


Nancy Brent replies:

Dear Star,

One should not be permitted to work in a setting where the risk for injury or risk to one's safety is high, without safeguards to try and prevent these instances from happening to both patients and staff. Staffing ratios and the potential for violence are two areas that need to be addressed with nursing administration, the risk manager and the chief medical officer of the facility. Two references for you to review when you raise your concerns are the American Psychiatric Nurses Associations' position statements, "Staffing Inpatient Units" (2011) and "Workplace Violence" (2008). Both are available on the association's website at www.apna.org. Click on the publications tab.

Another resource for you is the Centers for Disease Control/National Institute for Occupational Safety and Health's publication, "Violence Occupational Hazards in Hospitals," publication number 2002-101. It can be downloaded from the CDC's webpage at www.cdc.gov/niosh/docs/2002-101/.

Should you be injured by a patient while on duty, your first legal option is to file a workers' compensation claim. You should have a nurse attorney or attorney who concentrates his or her practice in this area to represent you. Other options that may be available to you, such as filing a police report or a criminal case against the patient, can only be discussed with your attorney who will know what your state law provides.

It would be best, however, to avoid having to be in a position to file any case after being injured at work. Therefore, raising your concerns sooner rather than later is in your best interest. If your concerns go unheeded, you need to consider leaving this workplace for one that is more protective of its nursing staff and its patients.


Nancy J. Brent, RN, MS, JD, is an attorney in private practice in Wilmette, Ill. This information is for educational purposes only and is not intended as legal or any other advice. The reader is encouraged to seek the advice of an attorney or other professional when an opinion is needed.