1. Coward, Kelly RN

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I am writing in response to "Workplace Violence Training Using Simulation" (Cultivating Quality, October 2018). The authors highlighted the effectiveness of Summa Health System's simulation training for workplace violence. I would like to suggest the mandatory addition of simulation labs to workplace violence training in all health care facilities.


Each year I am required to complete my hospital's workplace violence training program. My coworkers and I halfheartedly attend the eight-hour class, which includes lectures and hands-on training. We practice verbal deescalation, holds, and escape stances on each other. But the training is ineffective; in fact, taking the class seriously is hard when a coworker is playing the role of perpetrator. In simulation labs, participants are involved in scenarios in which the roles are played by a variety of personnel. These personnel do not hold back and the scenarios are allowed to play out until finished.


Having worked in both rural and urban EDs, I have witnessed violence and felt fearful while working. I have been bullied, intimidated, and yelled at by patients, and I witnessed the attack of a coworker who sustained multiple facial fractures and broken teeth. In both instances, the techniques taught in class had little impact on self-protection and violence prevention.


By requiring simulation lab training, hospitals create an atmosphere of vigilance. Scenarios that involve role-play and debriefing allow health care workers to practice their skills and understand how to protect themselves.


Kelly Coward, RN


Monroe, NC