Today, despite much progress on the national and worldwide issue of violence, nurses rank just after police and firefighters for rates of injury and even death on the job. Through the course's didactic and Case Study units, we have underscored this crucial point: Violence against healthcare workers is never acceptable.
A closer look at this very complex and multi-faceted issue affirms that there is no easy answer or single strategy for its prevention. Workplace violence is not JUST about skilled crisis intervention and de-escalation tactics; it's not JUST about failed workplace safety policies; it's not JUST about psychiatry and mentally ill persons; it's not JUST about easy access to guns; it's not JUST about a culture of violence and heated political debate; it's not JUST about stereotyping on ethnic and gender grounds; nor is it JUST about nurses bullying one another. Rather, violence and its prevention are about all of these factors. And I hope this course inspires injured and abused nurses to not only sharpen their communication and crisis care skills, but also stop bullying one another, and look upstream to the larger policy and cultural factors contributing to their vulnerability in the workplace.
The Course assumes that nurses' expert communication and crisis intervention skills are necessary for immediate violence prevention, but not sufficient for a long-term impact on the problem. We have emphasized teaching and learning by positive example, especially in the Case Studies. We have also avoided a subtle form of victim-blaming that can result from a de-contextualized emphasis on individual nurse behaviors and action in the absence of necessary policy and supervisory roles in preventing workplace violence. My vision is one of "Education as Prevention and Intervention" and my hope is that this Course can make a difference for all affected by violence and abuse in the workplace.