A new grant program in Texas aims to help hospitals and other health care facilities implement training programs to reduce verbal and physical violence against nurses.

So far, the grant consists of at least $600,000 over two years. The Texas Board of Nursing will transfer $328,000 by August 31, 2018 and an additional $339,000 in fiscal year 2019 to the Texas Department of State Health Services.

Ellen Martin, director of practice with the Texas Nurses Association, experienced violence in her workplace when she was early in her 30-year career as a nurse.

“When I was a new nurse, I was assaulted,” she said. “I know now that there were things I could’ve done if I had been trained to prevent that from happening or to prevent injury and I changed by practice accordingly at the time. But [I] was learning the hard way and new nurses should not have that kind of experience.”

Some hospitals, emergency departments and other health care facilities in Texas already have certain training programs in place.  

“There are all different kinds of training,” Martin said. “Verbal de-escalation techniques are really important. There are rapid response teams for behavioral health issues. Some hospitals have done what they call a dynamic situation protocol where people at risk are identified in advance.”

There currently isn’t a statewide system that tracks violence against nurses in the workplace in Texas.

Sheila Fata, chief nursing executive of St. David’s HealthCare, said all emergency departments within their facilities have had de-escalation training for more than a decade.

“It’s important for our professional nurses to be able to interpret signs that might show that a patient or a family member might be at risk to have a violent episode,” Fata said.

In 2013, Texas made it a felony to assault emergency room nurses. When the state researched the issue in 2016, around 80 percent of nurses surveyed said they had experienced violence at work.

“I’ve had friends who’ve had broken thumbs,” Melissa Rivera, an emergency room nurse and a member of the Texas Nurses Association, said. “I had a friend who had broken ribs from physical assault from a patient.”

Rivera received training when she worked in a psychiatric hospital setting on verbal de-escalation techniques.

“It’s being able to manage situations preventatively,” she said. “You want to get ahead of it and see if you can bring someone away from aggression and find a middle of the road path and help the patient find what their goal is, while achieving your goal as well.”

Pamela Lauer with the Texas Center for Nursing Workforce Studies says any decreases in workplace violence will be beneficial to both nurses and patients.  

The grant would be administered by the Nursing Resource Section of the Health Professions Resource Center and facilities that receive the grant will be required to send in reports describing the results of the training activities funded through the grant. Funds for the grant will come from the Texas Board of Nursing through an increase in nurse licensure fees.