The
following form serves as an example of what might be used or modified by employers
to help ensure a program of support is available for employees that
have experienced violent behavior.
I. Purpose:
To establish a formalized procedure to ensure that resources are available to provide
support to all hospital employees who have recently been assaulted and/or battered. II. Policy:
Each employee who is assaulted and/or battered will have access to treatment and
services to manage the trauma.
III. Implementation:
- Definition:
Assaulted employee: Any employee who is
reasonably put in fear of being imminently struck by a patient, either by a menacing
gesture, sudden move alone, or accompanied by a threat. Battered employee: Any employee who experiences actual
physical contact from another (whether or not a physical injury
occurred).
- Procedure:
- Assaulted Employee:
- Following an assault, the employee must notify his/her immediate supervisor The
supervisor must complete VA Form 10-2633 on all patient-on-staff assaults.
- The Supervisor should refer the employee to the Employee Assistance Program. Timely
referral, via electronic mail, is encouraged.
- A member of the Employee Assistance Program staff will make contact with the employee to
assist the employee with the services needed which may include: counseling, legal advice,
information regarding workmens' compensation/medical insurance.
- Following an assault, a community meeting must take place on the unit where the assault
occurred, including patients and staff to process the incident as soon as possible.
IV. References:
Hospital Memorandum, 003.07, Patient Injury Control, Preparation of VA Form
10-2633, Report of Special Incident Involving a Beneficiary.
Hospital Memorandum #05.18,
"Employee Assistance Program."
V. Rescissions:
Hospital Memorandum #118.13, May 14, 1991. |
2. Battered
Employee:
Following an incident whereby an employee is battered, the employee must notify his/her
immediate supervisor.
At the time of the incident, a CA- I form
and VA form 2162 must be completed. If the employee is unable to do so, it must be
completed by the supervisor. The supervisor must also complete VA Form 10-2633 on all
patient-on-staff assaults.
The battered employee must report to
Employee Health for evaluation and treatment of injuries. If the battery occurs on
non-administrative duty hours, the employee should report to admissions to be
evaluated by the O.D.
Following evaluation and treatment of
injuries by Employee Health, the individual is referred by the Employee
Health Practitioner to the Employee Assistance Program. Timely referral, via
electronic mail, is encouraged.
The Employee Assistance Program initiates
contact with the battered employee and
- Informs employee of the service available.
- Assists employees in attaining these
services such as: counseling, legal advice via police service,
workmens' compensation and medical benefits via Personnel Service, etc.
If a battered employee determines on
his or her own to file an application for criminal prosecution with the Concord
District Court, the treating psychiatrist may accompany the employee to court
without need for legal process either to an informal hearing before a
clerk-magistrate or a hearing before a judge. The physician may testify to facts known to
him. He may not bring VA patient records unless a court orders them to be produced. The
physician may, if asked by the court, offer an opinion regarding the competence or
capacity of the patient to understand the nature of the court's proceedings. The VA
psychiatrist may not agree to undertake an evaluation of the patient in order to report
back to the court. These duties may be performed by the court psychiatrist or, in the case
of a period of hospitalization for evaluation, a state hospital. A court order or a
request for the presentation of a medical record to the court must be referred to Medical
Administration for Processing.
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*This form was taken from:
Guideline for Preventing Workplace Violence for Health Care and Social
Service Workers. OSHA 3148 1996.
Reprinted with permission of Marilyn
Lewis Lanza, D.N.Sc., A.R.N.P., C.S.; Judith Keefe, R.N.; and Margaret
Henderson, R.N., M.Ed., Edith Nourse Rogers Memorial Veterans
Hospital, Bedford, MA.
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