The one thing that I have found while educating the staff over the years, is a mix of psychology where most nurses are taught between 2-4 weeks of psych in their rotation and want more understanding about how to treat this population.  The next area is negative reinforcement by rewarding the bad behavior, such as ordering more pain medication, giving PRN’s on a timed basis just so they “will have a good shift and not get beat up”.  When a nurse understands the importance of why reporting is necessary, I have found they are more receptive.  The holes of the computerized system not relaying the “misc” data, which is where WPV is reported, does not label or track the data.  The computerized reporting system does not have WPV as an option and if it is charted as miscellaneous, it is not capturable for statistical reasoning.  The average time for reporting in the computerized system is 10-15 minutes juggled between the other 4-6 patients that also may not be staffed according to acuity.  The nurse simply does not have time.

Another barrier, which is pretty huge, is the fact that when a nurse is hurt and reports the incident, there is no provided light duty so the nurse is forced to out on worker’s compensation and to use their banked time (PTO) to make up the difference.  Let me stress…the nurse is not only injured, but they are victimized again by being forced off the floor due to not having provided light duty and a third victimization by losing their hard earned and rewarded PTO time.  In some facilities, sick time is PTO.  As a result, the injured nurse forces themselves to manage, report it to the next nurse, and keep on moving with a smile as patient satisfaction is #1.  The end result, the nurse developing burn-out and possibly Post-Traumatic Stress Disorder.

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