As nursing students, we were interested to read about the system for calling "a code for violence" (AJN Reports, "Violence and Nursing," February). But we take issue with the statement "the nurse has a responsibility to report abuse and to learn how to deal with it" made by the former president of the American Organization of Nurse Executives. While we agree that nurses must report abuse, do they really have to "deal with it"? At the time of admission, hospitals should gauge a patient's history of violence, aggressiveness, or threatening behavior. And a new nurse's orientation should include training on workplace violence. All nurses should know what their options are when faced with violent patients.

Kimberly Brown

Jen Hall, Milton, MA

We hope "Violence and Nursing" will encourage abused nurses to fight for their rights and protect themselves. As nursing students in clinical placements, we've observed little support for nurses and a disregard for the violence they experience. Where is the line between caregiving and protecting ourselves? Confusion about whether to accept or report violence may occur when an institution's protocol is not clearly defined and followed by all.

Nicole Cochran

Cambria Macki

Krystal Proctor

Milton, MA

I was shocked by the magnitude of violence reported in "Violence and Nursing." In my time in nursing school, not one class has prepared me for a potentially violent patient. I am also surprised and disappointed to learn that nurses feel unsupported by managers or administrators when a violent incident occurs. The Joint Commission requires organizations to implement measures that ensure the safety of both employees and patients. The Emergency Nurses Association suggests the use of remediation measures such as debriefing hospital personnel who have been exposed to workplace violence, counseling, and using trained and equipped security personnel to deter violence. I am happy to see that they are standing up for health care workers' rights and that some organizations are beginning to recognize violence against nurses as a problem.

Jalahan Sisay

Norfolk, MA