Emergency room nurses are under attack. Despite the instigation of zero-tolerance programs all over the country, legislation passed at the state level, and OSHA cracking down on Workplace Violence, it isn’t getting any better.

The 2011 Emergency Department Violence Surveillance Study reports that violence against Emergency Department nurses has not decreased in the last two years.

Verbal abuse is bad enough; 53% of nurses surveyed reported being yelled at, sworn at, or worse. But what is really alarming is the number of nurses subjected to physical attacks: 13% of ED nurses reported being physically assaulted.

Emergency department nurses rank with police officers and prison guards when it comes to on-the-job violence. And the most dangerous place for a nurse to be? In a patient’s room.

Close proximity puts nurses at risk

More than 80% of assaults against nurses occur in the patient’s room. Nurses are often alone with their patients in their rooms, and they must, of course, get in close proximity to their patients to treat them. Without distance from a potentially dangerous individual, there is less time to react and get clear of an attack.

What’s the solution? MOAB®, or Management of Aggressive Behavior, offered by PSTI, teaches healthcare workers: how to identify emergent situations; how to defuse tense, and potentially violent situations; and, if need be, how to defend themselves.

In fact, in the May 2011 issue of the Journal of Emergency Nursing, MOAB® is specifically cited as an “education program [that] meets the recommendations of the various agencies and reports to help identify and quell workplace assaultive behaviors” (page 256).

Both MOAB® and AVADE® training can teach you how to keep yourself safe at work. (AVADE® training and AVADE® Healthcare Workplace Violence Prevention e-learning were specifically developed for healthcare workers, to meet requirements of state and federal laws for Workplace Violence Prevention training.)

But if you haven’t had this kind of training yet, learn one simple strategy and use it: Own the door!

David Fowler is a foremost expert on Workplace Violence Prevention, and author of "Be Safe not Sorry: the art and science of keeping YOU and your family SAFE from crime and violence," called "THE manual for personal safety" by security experts.

“Own the door” means that you ALWAYS keep your escape route clear. Never let a patient get between you and the door. Position yourself so that you can escape if the situation becomes uncomfortable or dangerous. The environmental design of a facility can be limiting, but your awareness of your escape routes is the most important. With multiple individuals (visitors/guests/family members) in a room, politely ask them all to move to the furthest side of the room, away from the doorway.

The best defense is to not be there when the attack takes place, but if your escape route is compromised, your last resort may be to defend yourself from an imminent attack. Always position yourself with an escape route in mind.

If your hospital does not offer Workplace Violence Prevention training, ask for it. Attend one of our seminars, or bring PSTI to your workplace. Please, BE AWARE. Own the door. Keep yourself safe!

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A few months ago, I was blessed to meet and become friends with Caroline Rochon, a professional organizer, coach, and author from Gatineau, Quebec.

Gatineau is a big city, with a population of more than a million people, but Quebec is renowned for its low crime rate. So I was shocked when Caroline shared her story with me: Last July, in an upscale bar, Caroline was drugged and raped.

I’ll let Caroline tell you her story:

A friend and I went out to dinner early, around 4:30 or 5:00. I had one glass of wine with dinner, then she and I decided to go to a bar that’s in a nice area.

We got to the bar around 6:30. We sat at the bar at first, but moved around a few times. Early in the evening, a woman came up to me and asked me if I was Caroline Rochon, she had recognized me from my book, so we invited her to join us.

I remember taking two glasses of wine, and then the third one was when my memory started getting shaky.

We were sitting with some younger guys in their twenties (I’m 42), but I thought nothing of it. I was joking and flirting with one guy, but for me, it was all very innocent because he was so young.

My girlfriend left, but I was still with this woman (who contacted me the next day, and helped me piece together the events of that night) and we were sitting with these young guys. They offered to buy us shooters, and I am certain THAT was the drink that was drugged.

Incidentally, after telling other people my story, I have heard twelve or fifteen stories from other people who were drugged in that bar—including one man. No one else was raped. I don’t know why anyone would drug me or anyone else.

After that shooter, I went to the washroom with this woman I had met. When I went to the washroom, I could not stand upright. I came back from the washroom, and someone—a bouncer, a bartender, one of those guys—should have realized I was… I was not right.

The other woman went around a corner to speak to someone, came back, and I was gone.

After the washroom, all my memories are just snapshots. Rather than a ‘video memory’ of that evening, I just have flashes. My next memory is leaning on the young guy I’d been flirting with, and then I lost consciousness.”

[When someone has been drugged with one of the “date rape” drugs, they can appear conscious and speak and walk, but may have no memory of the events.]

My next memory is lying on a cement surface, and bushes around me. I kind of had an out-of-body experience, and I looked down and saw this man on top of me, and said to myself, “Oh my God, you can’t scream.”  Even if I had wanted to, I couldn’t scream, I couldn’t defend, I couldn’t do anything. I was just a lump. I had no control over myself.

He had taken me to this open space next to a government building. I’m not sure, but I think people were walking by, just on the other side of the bushes. I have no idea if we were in plain sight or if we were concealed.

I remember leaving, I remember us walking again, and me throwing up. I don’t remember how long after I threw up, but he put me in a cab. That is where I remember pulling every ounce of energy I had to give my address. That was a really weird moment because I pulled together everything I had in me just to give my address. As I gave my address, I checked to make sure I had money.

When I got home, I vomited all night. I woke up the next morning with leaves and sticks in my hair, feeling incredibly sick.

I did not go to a doctor, or the police, because I thought it was my fault. I was still groggy that morning, and around noon I started to think, ‘OK, something’s wrong.’ I had a doctor’s appointment five days later, so that’s when I got checked out. Thankfully, I am fine. I am continuing to have regular tests to make sure.

Then I took what happened, and my feelings about it, and put them in a little box.

A few weeks later, Caroline and I were at a seminar. That’s when her “little box” burst open. After one of our exercises in the seminar, the story came spilling out of Caroline. I listened and told her, “It’s NOT your fault. You didn’t do anything wrong. Caroline, you were drugged.” She had suspected she’d been drugged, but as I listened to her story, I was sure of it. I gave her my book, and I urged her to read it.

After she read it, Caroline told me, “I wish I’d read it before I became a statistic.”

Now Caroline is on a mission to prevent other people from being victims of this type of crime. After reading the book, she now tells people:

• Your evening will end the way you intend it to. Are you clear on what kind of outcome you expect?
• Friends who come in together, leave together – have a plan.
• Keep a close watch on your glass and never accept a drink from a stranger.
• Always have money for a cab fare.
• Don’t take for granted the reputation of a bar or a restaurant; it gives you a false sense of security.
• Learn the AVADE® principles explained in Be Safe Not Sorry
• If you have been a victim, or you think you have been drugged but are not certain, please report it to the police. You don’t have to make an official complaint against anyone, just report the incident so that the police can track incidents per bar, time of the year, etc. If we don’t talk, their hands are tied.
• Don’t take your personal safety for granted as I did. Please, PLEASE, learn from my experience.

Caroline’s experience was awful. There is no way to gloss over that. Please do as she suggests: learn the AVADE® principles, BEFORE you become a statistic, and enjoy your holidays SAFELY.

And thank you, Caroline, for sharing your story with the world.

Please, Be Safe!

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Holiday shopping seems to start with Halloween these days. Lots of running around, lots of shopping, lots of distracted people.

This time of year, opportunistic predators are looking for distracted, over-burdened people they can steal from–or worse.

The following recommendations are excerpted from my book, Be Safe, Not Sorry: the art and science of keeping YOU and your family safe from crime and violence. During your holiday shopping, you will probably be in and out of parking lots and parking garages regularly. Remember these tips. Follow these guidelines. And BE SAFE.

SAFETY IN PARKING LOTS AND PARKING GARAGES

David Fowler is a foremost expert on Workplace Violence Prevention, and author of "Be Safe not Sorry: the art and science of keeping YOU and your family SAFE from crime and violence," called "THE manual for personal safety" by security experts.

Parking lots are risky areas, especially at night. People get abducted, assaulted, mugged and carjacked in parking lots. These are some simple, even obvious, parking lot safety guidelines. Don’t be complacent. Use these precautions. Always be aware of your surroundings in parking lots or garages; be aware and be vigilant.

• Always park in well-lit areas.
• Do not park near shrubs or other potential hiding areas.
• Get a security escort. Especially at odd hours, when the parking garage or parking lot is deserted. Even shopping malls have security personnel, and it’s their job.
• Use a buddy system. Always walk in groups when possible—there’s safety in numbers.
• When approaching your vehicle, look around for loiterers before you get into or near your car. If you’re walking out to the parking garage and you see trouble, turn around, walk back into the mall, store, or workplace and get help.
• Have your keys ready in hand as you approach your vehicle.
• Have your cell phone handy.
• Know your location when calling for help.
• Report suspicious activity to security or police—but go to a safe public place to call for help.
• Keep your valuables and packages locked in your trunk. If you’re carrying packages, try to keep one hand free, even if it means making an extra trip.
• Don’t loiter in the parking lot. Don’t sit around in the car making calls, checking email, or balancing your checkbook.
• Always turn off the ignition. Remove the key and lock your doors no matter how soon you plan on returning.
• Walk in the center aisle rather than close to parked cars, especially in parking garages. This will give you time and distance if someone tries to assault, rob or abduct you.
• Do not park next to vans, trucks with campers or other vehicles whose size and structure can provide concealment for a potential assailant—or that a predator could easily pull you into. If you return to your car, and see that there is now a van or a camper parked next to your vehicle that looks suspicious, or gives you an odd feeling, walk back into the store. Get a security escort. Wait for help. Better to be safe than to be sorry.
• Choose parking areas that have an attendant if possible.
• Choose locations that have heavy pedestrian traffic.
• Be aware of occupied cars around you. If someone is loitering in the parking lot, why? If you’re uncomfortable, go back into the store.

Remember: it’s not about being paranoid, or hyper-vigilant. Personal safety is about being aware and prepared. And, as always, personal safety is about trusting your instincts: if something feels unsafe, it probably is.

Dave Fowler is a foremost expert on Workplace Violence Prevention and creator of the AVADE®Violence Prevention Program. Through his company, Personal Safety Training, Inc., Dave offers extensive training on Workplace Violence Prevention for all personnel—from frontline receptionists to security personnel responsible for securing violent individuals. He has trained thousands of individuals, in hundreds of corporations, hospitals, and agencies, in how to recognize emergent situations and prevent situations from escalating to violence.

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It goes without saying that there is no way to measure the cost of a human life in dollars. Due to workplace violence, there are families and friends in mourning all over the country. There are people who have injuries from which they will never fully, physically recover. This article simply deals with another consequence of workplace violence: the cost in dollars and cents.

According to NIOSH, occupational injuries alone cost $121 billion in lost wages and productivity, administrative expenses, health care, and other costs. And that’s just injuries—that doesn’t include the cost of workplace fatalities.

David Fowler is a foremost expert on Workplace Violence Prevention, and author of "Be Safe not Sorry: the art and science of keeping YOU and your family SAFE from crime and violence," called "THE manual for personal safety" by security experts.

But what about the hidden costs? There are things that are difficult to measure, and could be costing your organization money.

Bad Press Can Cost You Money

The US Postal Service isn’t happy about it, but the phrase “going postal” has entered the American lexicon as a phrase that means: “To become extremely angry or deranged, especially in an outburst of violence.”  There’s no way to measure how that bad PR has affected the USPS. Of course, other factors—like the rise of email and internet usage—have affected the USPS’s bottom line. But what about that immeasurable psychological toll? Are people more reluctant to go into post offices now? Has the term “going postal” cost the USPS money? It’s hard to say, but it certainly seems likely.

After the shooting in an IHOP in Carson City, Nevada, the city and victims’ families are now trying to decide whether to tear down the building. Of course the restaurant has remained closed since last month’s violence—costing the employees their jobs, and costing IHOP the revenue from one restaurant. And again—are people reluctant to eat in IHOP restaurants now? Are they choosing other places to spend their money?

What can workplace violence cost in reducing your company’s value? Stocks are volatile. An off-hand remark from a CEO can cause a dip in a company’s stock price; what happens when your company’s name is splashed all over the news, attached to a story about workplace violence? Again, it’s impossible to measure, but it certainly can’t be good.

What’s the cost in worker retention?

According to OSHA, victims of workplace violence suffer from a “fear of returning to work.” This is particularly alarming in the health care field, where we have a shortage of skilled personnel. How many nurses, aides, and other medical personnel have left their professions after experiencing workplace violence? (Considering what health care workers regularly endure, it’s easy to understand why they would.)

Losing skilled, valuable employees costs money. Hiring and training new personnel in any field—whether it’s nursing, or delivering pizzas—costs an employer time and money.

There IS an Answer

There is a solution. There is a way to reduce your organization’s risk of having an incident of Workplace Violence: get your employees trained. OSHA specifically recommends training in Workplace Violence Prevention: “OSHA believes that a well written and implemented Workplace Violence Prevention Program, combined with engineering controls, administrative controls and training can reduce the incidence of workplace violence.”

PSTI’s training will teach you and your staff how to:

• Write and implement a Workplace Violence Prevention program
• Identify and implement proper engineering and administrative controls
• Identify, deal with, and PREVENT situations from escalating to violence

Get all your staff trained to recognize dangerous situations. Get them trained in what to do when faced with an emergent situation. Get your security people properly trained to handle violent individuals. Protect your people. Protect your organization. Protect your bottom line.

Dave Fowler is a foremost expert on Workplace Violence Prevention and creator of the AVADE® Violence Prevention Program. Through his company, Personal Safety Training, Inc., Dave offers extensive training on Workplace Violence Prevention for all personnel—from frontline receptionists to security personnel responsible for securing violent individuals. He has trained thousands of individuals, in hundreds of corporations, hospitals, and agencies, in how to recognize emergent situations and prevent situations from escalating to violence.

Register today for training with PSTI, or find out how to bring PSTI’s training to your workplace.

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Going postal. Flipping out. Going off. There are a lot of ways to say it, but usually we say, “he just snapped.”

Except people don’t “just snap.” There are always signs.

“People who act out violently don’t wake up one morning and snap. There are clues,” says FBI behavioral analyst, Supervisory Special Agent Mary Ellen O’Toole, Ph.D.

David Fowler is a foremost expert on Workplace Violence Prevention, and author of "Be Safe not Sorry: the art and science of keeping YOU and your family SAFE from crime and violence," called "THE manual for personal safety" by security experts.

Of course, the caveat to that is that you may not have the opportunity to see those clues or warning signs. There were victims of the Virginia Tech Massacre, the Norway shootings, the IHOP shooting, etc., who had never interacted with the shooters before.

An individual can show up in your workplace, a stranger you’ve never encountered before, who is on the verge of “snapping,” and you would have no warning, and never have the opportunity to see the danger signals. Emergency room personnel, security people and police officers are most likely to face those situations. You can learn how to defuse those situations, before violence occurs. But, if the worst happens, know what to do when faced with an active shooter.

After close to twenty years training and educating people in Workplace Violence Prevention, I have never encountered an incident where someone truly just snapped one day. There are always, always warning signs.

Aisha worked with an office manager, “Joan,” whom she described as a “meek, quiet, small” woman. There were rumors she had a drinking problem, but Aisha had never seen her drink at work.

Until the day she pulled a shotgun on a co-worker.

“She just… she went postal. That’s the only way I can explain it. She snapped.” But when asked about the days and weeks leading up to the event, Aisha remembered that Joan’s behavior had changed: she’d been particularly short-tempered, easily angered over little things, and she’d made repeated comments about “stress at home.”

The day of the incident, “She was really angry. She started acting out, which I thought was really odd,” recalls Aisha. That day, Joan had an argument with a co-worker, Carl, then took off mid-morning, and “just went drinking, I guess.” (After the incident, she was noticeably intoxicated.)

Joan returned to work, came up behind Carl with a shotgun, and put it to his head. Fortunately, Carl instinctively grabbed it away from her, and no one was hurt.

People claim that “it’s impossible to predict what someone will do,” but as Dr. O’Toole said, there are signs. The Columbine shooters had a website full of threats. The shooter in Norway published a manifesto of violence on the Internet. Joan acted out at work. There are always signs.

Do you know the signs of escalation, and the components of the Assault Cycle? Are you aware of what to look for? Would you know how to defuse the situation if you see the warning signs?

“We all want to believe that if we choose just the right community or just the right neighborhood we won’t be a victim of crime,” Dr. O’Toole says.  But we know that violence can happen anywhere.

You can protect yourself from the co-worker, family member, or patient/client/customer who is about “to snap.” I am NOT talking about arming yourself with a gun; I am talking about arming yourself with knowledge.

These are just some of the danger signals that I teach personnel in the AVADE® Workplace Violence Prevention training programs:

• Sudden changes in behavior
• A “short-fuse”
• Obvious signs of intoxication or drug use
• Seemingly irrational irritability
• Taking offense over small incidents
• Belligerent behavior toward co-workers or others
• Threatening or harassing behavior
• Verbal or written threats, including threats posted on the Internet

ANY verbal or written threat should be taken seriously. Please read that again: any threat needs to be taken seriously. One of the Columbine shooters made repeated threats to another student, and his parents called the police regarding those threats because they believed them to be credible.

Do not minimize a verbal threat. It can be a statement of intention.

Most of all, trust yourself. Trust yourself to recognize the signs when you see them. This isn’t paranoia, or hyper-vigilance, it’s simply smart awareness of your environment and the people around you. You can defuse situations before they get out of hand. Learn how.

Dave Fowler is a foremost expert on Workplace Violence Prevention and creator of the AVADE® Violence Prevention Program. Through his company, Personal Safety Training, Inc.,  Dave offers extensive training on Workplace Violence Prevention for all personnel—from frontline receptionists to security personnel responsible for securing violent individuals. He has trained thousands of individuals, in hundreds of corporations, hospitals, and agencies, in how to recognize emergent situations and prevent situations from escalating to violence.

Register today for training with PSTI, or find out how to bring PSTI’s training to your workplace.

God Bless and Be Safe!

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“Workplace violence” sounds like something that should be the responsibility of police and security personnel, doesn’t it? But it has become such a safety issue in workplaces, OSHA has stepped in. In an article published yesterday at OSHA Online, OSHA reported:

“Workplace violence is a serious recognized occupational hazard, ranking among the top four causes of death in workplaces during the past 15 years. More than 3,000 people died from workplace homicide between 2006 and 2010, according to the Bureau of Labor Statistics (BLS). Additional BLS data indicate that an average of more than 15,000 nonfatal workplace injury cases was reported annually during this time.”

Workplace violence has become so prevalent, you cannot rely on police or security personnel to be able to protect you. Fortunately, there’s a lot you CAN do–BEFORE a situation becomes violent–that will keep you safe.

Rule #1: Be aware. This does NOT mean being hyper-vigilant, ultra-paranoid, and jumping at every little sound. In his excellent book The Gift of Fear, expert Gavin de Becker explains how the human brain processes information faster than we ever realized; intuition truly is more than just a hunch. When you have a fear response, or even an uneasy feeling, LISTEN TO IT!

Rule #2: Be vigilant. This simply means that you should ALWAYS acknowledge–and act upon!–any instinctual feelings you are having. If you have a strong, uneasy feeling that you should not enter a particular store, don’t. How many times, after an incident of workplace violence, did a survivor report, “That guy always gave me an uneasy feeling, but I didn’t know what to do about it…” Be vigilant. Listen to that feeling. Go to a supervisor. Contact security. Listen to your intuition, and trust your awareness.

Called "THE manual for personal safety" by experts around the country

Rule #3: Avoid situations or individuals that seem unsafe. This may seem obvious, but it’s disturbing how often you hear, “I had a weird feeling, but I went along anyway.” All the awareness and vigilance in the world will not help you if you don’t listen to it!

Rule #4: Get the proper training. If you work in an industry with high numbers of Workplace Violence Incidents, such as in health care or a social services setting, ask your employer to get you the proper training for Workplace Violence Prevention. Talk to your organization about being proactive. Get training in Workplace Violence Prevention today, before the next violent person walks through your doors.

Be Safe!

David Fowler, Workplace Violence Prevention Expert

Thousands of individuals, from hundreds of agencies and corporations from all over the world, have been participants in David’s classes. As a certified master instructor in numerous nationally recognized training programs, David’s classes offer Instructor Certification, as well as personal safety and awareness strategies for individuals wishing to create safer work, school, and home environments. David is considered by many to be the most dynamic and motivational speaker and trainer in the industry.

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David Fowler is a foremost expert on Workplace Violence Prevention, and author of "Be Safe not Sorry: the art and science of keeping YOU and your family SAFE from crime and violence," called "THE manual for personal safety" by security experts.

The “active shooter” is one of the scariest things we could face today. You could be working, shopping, eating, walking, and suddenly, someone opens fire.

As a Violence Prevention expert, a father, and a citizen, here’s what I would do, and what I teach in my seminars.

Surviving an Active Shooter:

1. Escape (only if safe to do so). You wouldn’t want to run out into an area where the shooter is; run away from the shooting and screaming. Out a back door. Through a fire exit. Just get away if at all possible.

2. Hide and cover in place, if escape is not possible. I am not a fan of duck and cover if the shooter is in your immediate area. YOU can become a sitting duck.

3. Alert authorities, Police or Security. Call 911. Pull a fire alarm. Go through an exit door that is labeled as a fire exit only; it will send a signal to 911 dispatch. IF YOU ACTIVATE a fire alarm, call 911 as soon as possible to let the dispatcher know to send POLICE because there is an armed assailant.

4. Lock doors in your immediate area. Many lives were saved in the Virginia Tech shooting because teachers had the presence of mind to lock and barricade their doors, or even move students to rooms that locked (many also sent their students out the windows).

5. Place barriers and remain absolutely quiet if you are barricading yourself in. After the Virginia Tech shooting, survivors did exactly this, and the gunman tried their doors, heard nothing, and moved on.

6. If escape is not possible and danger is imminent, attack the attacker. This is a tough decision to make, and only you can make it. Personally, I’ve made my decision, and I have a plan!

7. When Law Enforcement arrives, go face down on ground with palms exposed and up. This shows the police that you are unarmed and not an accomplice or the killer.

My hope my and my prayer is that none of us have to ever face something like this. My hope and prayer is also that if you do…. YOU have a PLAN.

God Bless and Be Safe!

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AVADE™ Train-the-Trainer
“Personal Safety and Self-Defense”

Instructor: Dave Fowler, PSTI – office: 866-773-7763 or cell: 208-691-7481

Date: January 28-29, 2010

Seminar Schedule:  Please arrive early as class will start promptly.

Train-the-Trainer Seminar Session (Jan-28-29): 8:00 AM to 5:00PM ~ $1,200.00 ~

Location:SafeCo Stadium (Home of the Seattle Mariners) 1250 1st Ave So. Seattle, WA 98134

Parking:The parking garage is on Edgar Martinez Drive – 2 North. Please let attendant know you are there for the AVADE Seminar sponsored by Safeco Security Dept. 

Entrance to SafeCo: After parking  in the garage you will take the elevator up to the suite level, walk across the sky bridge and into the ballpark. Once inside you will make a right and walk down the concourse. Walk out the first set of double doors into the second set of double doors which is the the group suites C & D.

Conference Room: Group suite C & D. 

Contact @ Host Site: Ed Mumphrey – E-mail: emumphrey@mariners.com

Register: Please Call – (866) 773-7763

Accommodations: Holiday Inn Seattle Ctr. (211 Dexter Ave. N., Seattle, WA 98109) Contact Edgar Valladares in reservations valladares@hcbmi.com or (206) 728-8123 x 110
Use “personal safety training” corporate code for 104.00 nightly + tax.