I came across an article written by Julie Carr Smyth from the Associated Press titled, "Violent assaults on ER nurses rise as programs are cut". The article pointed out that alcohol and drug related visits to the emergency room rose from 1.6 million in 2005 to 2 million in 2008;  and the number of these visits resulting in violence increased from 16,277 in 2006 to 21,406 in 2008 (Federal Substance Abuse and Mental Health Services Administration).  The increase appears to be related to a decrease in services provided to individuals with alcohol, drug, and mental health related conditions. 

Workplace violence in the Emergency Department is not a new concept. The Journal of Nursing Administration published a study in the July/August 2009 issue titled: 'Violence Against Nurses Working the U.S. Emergency Departments"  which demonstrated that violence against ED nurses is higly prevalent. Twenty-five percent of the respondents reported experiencing physical violence more than 20 times in the past 3 years and other studies have found that 30% to 80% of hospital staff have been physically assaulted at least once during their careers.  In addition to the increaase in the number of alcohol, drug, and mental health related issues, the overcrowding of emergency departments,  poor enviornmental design, lack of adequate security measures, and lack of training of staff in handling assaults contributes to the issue of emergency department workplace violence.  This past week, the Journal of the American Medical Association published a study which discussed the trends and characteristics of U.S. emergency department visits from 1997 to 2007. The study clearly showed that ED visit rates almost doubled compared to what was expected in relation to population growth. Medicaid visits accounted for most of this increase.

The problem of workplace violence in the emergency department is not going to go away as long as visits continue to increase, support services for alcohol, drug and mental mental health conditions are cut, and there is a lack of safety and security measures at the emergency department level. The Emergency Nurses Association and the American College of Emergency Physicians have made recommendations to help keep staff safe and secure. As the front line caregivers, we need to be at the table when safety and security issues are discussed.