"The nurse is often the first to know of an incident and plays a valuable role in preventing workplace violence and collecting data to assist in the development of additional prevention strategies," says AAOHN's position paper. "The occupational health nurse also serves as an educator to employees, management, the outside public, and stakeholders."

AAOHN says the OHN is qualified to implement secondary prevention strategies for early recognition and prompt intervention. By conducting a risk assessment, the OHN can intervene when an incident occurs to minimize the crisis at hand and make decisions about how to manage the situation and persons involved. After an incident occurs, the OHN can direct strategies to minimize the negative effects by conducting analysis and providing or arranging psychological counseling and support for employees and their families following an incident.

Try the Team Approach

Monika Fischer of AAOHN tells HRWire that occupational health nurses should be involved in workplace prevention programs because of their knowledge and experience, and their expertise in emotional counseling. Human resources should involve OHNs by using a team approach to addressing and preventing workplace violence. Fischer says the HR professional should handle disciplinary actions and nurses should deal with the emotional aspect. An outside threat assessment team as well as security or police should also be involved. For larger employers, a public relations representative may need to participate. "This core group should deal with prevention, investigations and dealing with policies and procedures," says Fischer.

Threat assessment

Without an effective prevention program and proper education, companies may not be prepared for the threat of violence. The Hawaii Occupational Safety and Health Division recently cited Xerox for two safety violations in connection with a 1999 shooting that resulted in the death of seven workers at a company warehouse. The Hawaii OSH Division claimed that the company did not have an effective workplace violence program and did not properly train managers to recognize and reduce potential hazards. Byran Uyesugi was sentenced to life in prison after being convicted of murder. A copier repairman for Xerox, Uyesugi had kicked an elevator door six years earlier, but was allowed to return to work after he was no longer deemed a threat.

Targeting employees

Fischer says the occupational health nurse can also play a significant role after incidents occur. First, the OHN should ensure that any physical injuries are taken care of. "The core group should assess why the incident occurred, review policies and procedures and evaluate what could have been done to prevent the incident," says Fischer. In a recent robbery attempt, three gunmen invaded a closed Culver City, Calif., Target store and ordered about 60 employees to the floor at gunpoint in a botched robbery attempt. No shots were fired and no one was injured. Target corporate spokesperson Patti Morris said crisis plans are in effect at all stores and the procedures were apparently followed during the robbery attempt.

Awareness

OHNs can play a significant role in prevention by evaluating potential risks. "Nobody wakes up in the morning and says, 'I think I'll kill my boss,'" says Old Dominican University Chief of Police William Rice. "There's a pattern of behavior that people can really observe, but they brush it off." Fischer says that occupational health nurses can assist in conducting a "fitness for duty" evaluation.

On Nov. 7 a stockbroker who had been fired because of discrepancies in his accounts and aggressive trading practices returned to the First Union Securities brokerage and killed the manager who dismissed him. Joseph Ludlam told at least one person in the office, "You'd better get out of here," before he shot his former manager and fled. In September, Ludlam was arrested and charged with failure to appear in court on a misdemeanor charge, and while in the U.S. Navy he was charged with drunken driving and possession of marijuana. Fischer says an OHN could have evaluated the emotions of the employee and determined whether firing was even the proper course of action.

Culture and the recovery process

Mark Braverman, principal of CMG Associates in Newton, Mass., says First Union should be worried about its other local workers. "They're going to need to do some work in this office and help these people recover from this," says Braverman. "They need the top people from corporate to come in and show that we care, we are horrified, we want to learn from this."

According to Minnesota public health nurse Mary Elizabeth Berglund, a violence prevention specialist, companies should examine their "human environment." Berglund asks, "What is the workplace culture? Does it promote intimidating, bullying behavior, or is it a place where people can bring issues forward?"

"Employees need input in the workplace. The culture is a significant factor in preventing violent workplaces," says Fischer. "How are grievances handled? How good is security?" She adds that OHNs are also needed to help employees recover emotionally.

Fischer says the day-to-day tasks of a full-time OHN can include ensuring that there is a good emergency assessment program in place. Additionally, she says, wellness and health programs can help. "Occupational health nurses should train supervisors and managers how to read the signs during the hiring process."

This article is courtesy of HRWire. All rights reserved.

.