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The Nurse Manager's Immediate Role in Response to Violence

I am a firm believer that healthcare leaders exist in the role because somewhere in the timeline of their career they truly believed that they could make a significant difference, not only for our patients but for our colleagues as well. Then, we find ourselves in these mid level nursing management roles with no real leadership training struggling to find a path forward.

There is a saying in medicine that goes, “See one, do one, teach one.

It speaks to not only the significant responsibility to teach that our career entails, but also touches on the swiftness with which we are forced to do so.

The evolution of healthcare has always come from a place of necessity.

It was not created in a garage by some guys in rock band t-shirts who wanted to change the tech world as part of their ambitious side hustle.

The art of nursing was forged using a mixed-medium of blood, sweat and tears painted by tired hands brushing linen aprons in a rapidly changing environment. This canvas was filled with fear, chaos, joy and death.

We innovate, we create; swiftly, in order to meet the demand of operational tempo and to cheat death.

We constantly observe our patients for results and know immediately if we have corrected the issue.

The systems that we work within do not operate this swiftly. They are mammoth beasts that take a tremendous amount of leverage to move. There are no fast acting vasopressors to correct the declining blood pressure of a 300 bed hospital. This leads immediate response trained healthcare clinicians to feel like “It's not working”, making us the most resistant to change of any professional organization. If healthcare workers had a background in systems analytics, process improvement and an understanding of business evolution we would be able to sit back, make our adjustments and move. But nurses aren’t designed like that. We have to learn it, but we first have to be taught it. This progression is a necessary evolution of professionalism that must occur in nursing leadership.

We all want to make impactful and observable change. While some may argue that it's impossible from a lower or middle level of management, I would say that’s bullshit. Is it really hard? Yes. Does it require an insane amount of creativity? Yes. Should we quit? No.

We should get better at it.

One of the ways that I have done this is to reach out to other industries outside of healthcare.

You can take a young google engineer and put him in a room full of cold brew, and vegan snacks and say, “Come out when you figure out how to change the internet!” and they will do it.

You lock a nurse in a room with coffee and doughnuts and they come out frustrated and angry because they will have come up with something awesome in 6 months ago to the problem you are just recognizing then work at an organization that says, “No. We don’t see the need.” Or “Prove to us the financials?”

Do you think they asked the tech engineer to prove to them how it would save Google money? No. They just told him to do his job, create the next greatest technology and the CFO found the money to make it happen.

When did organizations get to the point where we expected nurse leaders to operate without the authority or expertise to do so?

Are there significant differences between my two examples like gender, the food they are eating, the place they work… yes. Why? Because they are all significant issues we see in healthcare leadership. But it shouldn’t be a barrier towards progress.

I am not a systems change expert, my niche and expertise lies in bedside healthcare security so as a nurse leader, I am doing my part to help advance my profession by offering you these practical and observable ways to be a great middle manager in response to when your employee is assaulted.

Be careful out there and happy Innovating!

Sending you light and love,


CEO and Founder - Cortex Gold



Sympathy is not the same thing as empathy. We know it sucks. But we don’t have to agree and add to the negativity when the issue comes across your desk. Learn the art of Tactical Empathy. When a nurse comes to you and says,

Patient in room 202 just hit me!”

Awfulizing is basically agreeing with the negativity and focusing on it. Here is one example;

I know Katie! They are such a jerk. You know when I was a floor nurse I had a patient kick and hit me. Be lucky it was just a light punch. This is part of being a nurse.“

Instead you should first listen. Ensure her physical safety. “Are you ok Katie? I need you to take 5 minutes over here and address your feelings. Would you like me to call someone for you? The Chaplain? Let’s utilize our EAP? This is not your fault. This is inappropriate behavior. I see that you are doing your best and your best is always good enough. We are going to refer to this protocol and I will call the nursing supervisor right now.“

2. Have a plan in place to RESPOND

The violence is going to happen. A lot. So make sure you are ready. Have a policy, have a plan, write down your responses if you need to in order to ensure that you have responded the way you want. Do not just react. It is ok to have an emotional response. Especially if it is something particularly scary and significant. But remember, your emotions are just a chemical response to stress. Help the staff to regulate their nervous systems, then respond. The response should include security, upper management and psychological and emotional support for yourself and the staff.


If an assault victim came into the ER, would you blame her for being in the wrong place at the wrong time, or having too much to drink or saying she wore the wrong thing? Absolutely not. So don’t do that to your staff. Not everyone has had the same training, upbringing and everyone responds to stress differently. Until you have taught your team, don’t expect them to respond as you would like especially if you were not there to observe. The time to teach and correct will come, but it is not immediately after the trauma has occurred. Involve your chaplain services and employee assistance program. Don’t just suggest it, have some sort of system where the inquiry is made on their behalf, let them turn it down. And please, don’t make it some cookie cutter program delivered by an overworked employee health nurse.

If you need some suggestions on how to implement these and many other techniques feel free to contact me. No sales plug. No expectations. I just want you to know that I can’t begin to count the times I’ve cried in my office too. I am here for you.

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