Letter to the Editor by Allen to “Overview and Summary: Patient and Visitor Violence: What Do We Know? What Can We Do?”

Patient and Visitor Violence: What Do We Know? What Can We Do?

July 12, 2013

Reponse by Cheryl A. Allen to “Overview and Summary: Patient and Visitor Violence: What Do We Know? What Can We Do?”, by Jonathan Rosen’s (January 31, 2013)

Dear Editor,

It was with interest that I read Jonathan Rosen’s (2013) recent article concerning violence in our patient and visitor population. During a recent employee meeting that I attended, there was discussion about actions to take when being threatened by someone with a weapon such as a gun. Mr. Rosen makes a valid point that a roadblock to finding solutions may be a belief that, due to the unpredictability of violence, it may not be perceived as preventable.

While I am not so naïve to believe we can prevent all violence, in my opinion there are actions and strategies to help decrease the possibility of violence in our work environment.  Being prepared is the first step, and this is includes being familiar with your employer’s policy on visitors, violent behavior, and presence of weapons—just to name a few.  I ask you, though, to take this preparation to the next level and actually think through possible concrete actions based on your area, such as planning escape routes and being aware of areas that can offer safety (e.g., a nearby closet).  Develop a set of ‘safety’ habits such as keeping your cell phone always in your pocket (in the silent mode); never going to an isolated area without first telling someone where you are going; paying attention to that gut feeling when something seems wrong or out of place. Also, if possible, don’t have your back to a patient (or family) and do not make a habit of letting them come between you and the door.  The last two suggestions are not always feasible in an in-hospital setting; it would be wise to design ambulatory and emergency room settings where the computer terminal is close to the entrance of the patient space so that direct sight lines remain intact.

Fear has a way of warping situations.  Thinking through various scenarios and practicing good safety habits may buy precious time in the event of a violent situation.  We already know that being prepared for unexpected events such as fires and cardiac arrests helps us to think clearly when faced with the actual event. Though we may not always be able to predict workplace violence by planning ahead, we can be better prepared if and when it occurs.

Cheryl A. Allen RN, BSN-BC


Rosen, J., (2013). Overview and Summary: Patient and Visitor Violence: What do we know? What can we do? OJIN: The Online Journal of Issues in Nursing, 18, (3). DOI: 10.3912/OJIN.Vol18No01ManOS