We need to stop being silent about violence towards healthcare workers

1truekhaleesi

In light of a nurse being killed from injuries she sustained from a patient attacking her, I think it's time we talk about violence in healthcare. All healthcare workers take the same oath to provide their patients with the best care that they are capable of giving. Last June, I was strangled by a patient because she said the voices in her head told her to do it. A coworker saved me because healthcare workers are not allowed to even hit a patient in self defense. (but police officers are allowed to shoot if they feel scared but that is for another discussion) A part of me died that night and I still have nightmares about that night.

We need to stop being silent about violence towards healthcare workers

Nurse killed from injuries due to a patient attack.

I would have gone to the emergency room but the supervisor for that unit (not my direct supervisor luckily) made condescending comments that made me weird and embarrassed for my insistence to even file a police report. A few days later, my manager contacted me and was very upset I didn't go to the ER. She made me take a week off. Last I heard, the patient will be in a inpatient psych facility for (likely) the rest of her life. What she did to me is public record, she lost her job, and custody of her child. That's only the beginning. I have been hit, kicked, groped, and spit on. I even had a patient who brought a stun gun to the hospital. I know a doctor who was repeatedly stabbed with a scalpel. My hospital had an almost shooting but luckily police intercepted the man.

Robert, a 78-year-old patient, requests help getting to the bathroom. When the nurse, Ellen, enters the room, Robert’s lying in bed, but when she introduces herself, he lunges at her, shoves her to the wall and punches her repeatedly. Ellen gets up from the floor and leaves the patient’s room. She tells her colleagues what happened and asks for help to get the patient to the bathroom. At the end of the shift, Ellen has a swollen calf and her shoulder aches. One of her coworkers asks if she’s submitted an incident report. Ellen responds, “The patient has so many medical problems, a history of alcoholism as well as a history of drug addiction. What difference would it make if I filed a report?” All the difference in the world. We will now know that Robert has violent tendencies and can prevent this from happening.

Workplace violence is a serious problem. Different organizations have defined workplace violence in various ways. The National Institute for Occupational Safety and Health defines workplace violence as “violent acts, including physical assaults and threats of assault, directed toward persons at work or on duty.” Enforcement activities typically focus on physical assaults or threats that result or can result in serious physical harm.

Former patient kills three healthcare workers at veterans home

In hospitals, nursing homes, and other healthcare settings, possible sources of violence include patients, visitors, intruders, and even coworkers. Examples include verbal threats or physical attacks by patients, a distraught family member who may be abusive or even become an active shooter, gang violence in the emergency department, a domestic dispute that spills over into the workplace, or coworker bullying.

We need to stop being silent about violence towards healthcare workers

VA nurse assaulted by patient

Healthcare workers are at an increased risk for workplace violence. From 2002 to 2013, incidents of serious workplace violence (those requiring days off for the injured worker to recuperate) were four times more common in healthcare than in private industry on average. In 2013, the broad “healthcare and social assistance” sector had 7.8 cases of serious workplace violence per 10,000 full-time employees.

Unfortunately, violence in healthcare is practically ingrained in us. From the day you decide to pursue a degree in healthcare, it is drilled into your head that you must protect your patient and no harm must come to them. Even if the expense is your own health and safety.

We need to stop being silent about violence towards healthcare workers

Nurse stabbed by patient and in critical condition

So what can we do to prevent this? Lets start by not coddling patients and treating hospitals like they're hotels. Find a way to decrease wait times, remove objects that can be thrown (pictures, vases, other kinds of furniture) from crisis treatment areas, arrange staff schedules so that nurses and doctors are not alone when they must be in close contact with a patient to treat them, and take mental health and substance abuse more seriously. And of course, have a no tolerance policy towards violence. Even if the violence comes from a patient.

Personally after the patient strangled me, I now take serious measures to prevent it. For example, I make sure to always have a clear path to escape should a patient suddenly get violent. Additionally, I am always an arms length away from patients, I never block me into a corner or barrier, if a patient or a visitor is even yelling at me I make a call for backup, if a patient has a history of violence I take it seriously, and I take the stance that everyone has potential to be violent.

Five nurses injured by patient

We need to stop being silent about violence towards healthcare workers

I concede that violence against healthcare workers will never completely end. In part because many patients lack the cognitive ability to control themselves, especially in stressful environments like emergency departments. Whereas, myself and my coworkers are trained to handle these sort of stressful situations. We already have a nursing shortage but in about 10 years, we are going to have a serious nursing shortage. It’s difficult to sell the profession when people see this kind of garbage.

We need to stop being silent about violence towards healthcare workers
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Most Helpful Girl

  • Sweetascandy1990
    Thank you for writing this and bringing awareness to this topic. I'm getting my masters in social work and considering working/counseling individuals with a mental illness/veterans in the healthcare setting. I'm very passionate about advocating for people's safety. You have many great points and it is interesting to see this from a nurse's perspective. I commend you for what you do... it is not the easiest population. There is a lot of stigma against people who have mental illnesses and many times they are are not treated with the dignity and respect they deserve just like any human being deserves, especially in mental health hospitals/wards. At the same time, like you said there needs to be solutions to protect healthcare providers. Your solutions seem cost-effective and doable. You seem passionate about this, especially after the strangulation incident. I hope you can advocate for yourself and if I ever end up working with this population after I graduate I will definetly keep this in mind. I will speak about this in my class discussions :-)
    Is this still revelant?
    • Definitely. I'm still passionate about treating those mentally ill with compassion. In fact, an overwhelming amount of people who are mentally ill are very compassionate people who would rather hurt themselves than other people.

    • Yeah I agree they are very compassionate <3 Your patients are very lucky to have you as their nurse :-) You're a trooper for persevering through your incident. It was not easy what you went through, yet you still are very gutsy to wake-up and choose to serve this population. That's dedication... many other nurse's would had fleed after this. A lot of self-care is needed... hopefully you are providing yourself with that :-)

      On a personal level, I was strangled almost death by an abusive ex who had a mental illness. I loved him a lot, but I had to realize that my safety was a priority. Whether a person has a mental illness or not no matter how compassionate you are... abuse is never okay. I have PTSD because of my situation and I had to walk away for my self-care and well-being. My point is, it doesn't make you a bad person or less compassionate for thinking about yourself and your safety and learning to put boundaries. What you are asking is more on a macro level, but essentially boundaries is what you are asking for in regards to safety. How can nurses serve this population effectively without proper safety? If this is a prevalent issue that means something on a macro level is failing as you pointed out. Higher, effective safety for nurses=better quality of care for patients :-)

    • I definitely agree. You can't take care of other people if you don't take care of yourself. I had a poor relationship with my ex. While my ex never physically hurt me, he couldn't care less when this incident happened. He didn't even check once to see if I was okay. That was a wake up call for me.
      I'm so sorry to hear about what happened to you. I hope you are healing well.

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Most Helpful Guys

  • WalterBlack
    I appreciate that you are bringing attention to this issue. It is interesting to me that nursing staff are taught to never hit the patient, even in self defense. In my experience as an EMT, I've found that my training is much more similar to law enforcement, at least as far as self defense goes. Of course, use of excessive force is not tolerated. We are trained in deescalation and avoiding situations where violence is imminent. But we are also taught to fight for our lives and use improvised weapons (like an oxygen cylinder - we aren't allowed to carry regular weapons) if we are cornered by an assaultive patient with no way out. Fortunately I've never had to fight a patient but if only one person is going to make it out of a bad situation alive, I will make sure that I'm going home to my family.
    Is this still revelant?
    • Just to put things in perspective, I have been bitten, scratched, punched and shoved by patients. I've had to restrain out-of-control intoxicated people and psychiatric patients. Fortunately, most of those patients did not have the strength to do any real harm to me. But if I felt that I was in real danger, I would definitely be defending myself. I'm a stocky, somewhat muscular guy which is an advantage in these situations. I worry about some of my coworkers who are barely 100 pounds, that find themselves dealing with the same individuals.

    • We're taught de-escalation and how to recognize potential violence techniques. Earlier this year, I did a continuing education course on dealing with violent patients. This course was approved by the nursing board. There's literally a slide that excitedly says violence is part of the job and we must learn to deal with it. The techniques they say to use is just defensive techniques. Like putting your arms up to block their punches like a boxer. I also weigh 100 pounds and luckily my coworkers are protective of me. One co-worker said it's because he fears that if a violent patient got a hold of me, I'd end up in ICU.

    • Blocking techniques may work when you're being attacked by a 98 year old dementia patient. But if you are dealing with a 20-something year old muscle head who is high on PCP, that doesn't do much good. Unfortunately, I think hospitals are more worried about being sued by the patient than they are about protecting their staff.

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  • taleswapper
    Actually, my experience is that healthcare workers are the most likely to treat patients as if they're recalcitrant children, rather than adults with agency and an equal participant in the healthcare they receive. "I know better, and you have to do what I say, no matter how stupid it is!" may work on a five year old, but not an adult. And that very attitude is what contributes to most of the workplace violence the healthcare worker receives.

    In short, you bring it on yourselves. Adjust your attitude, and it will fix itself.
    Is this still revelant?
    • Hmm okay. Well you're welcome to think whatever you want.

    • Just my experience. YMMV, or course.

    • Well then this was just my experience. Don't know what YMMV means but whatever. And I have the therapist and statistics to back me up. Whether or not you choose to believe it, facts are right.

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What Girls & Guys Said

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  • DamnSam
    Problem here is, people who work in healthcare most times want to help people... the healthcare system itself just want to save (tax) payers, the psyche of patients isn't necessary cared about... which produces angry patients

    I had a colapsed lung wing with liquids in it... the doc said "it could be a bit itchy", right before he pushed a pinky finger thick needle about 20cm in my back while two nurses hold me down (no painkillers), inclusive nerous breakdown... he saved my life, but if I see that doc again at night in a shady street, I swear to god, he would need a doc too...
    The nurses in the hospital needed 12 days to notice something is wrong, at that moment I was already down on 42.5kg (while 6'33)...
    I still fight the side effects of their solutions in that 9 weeks hospital (5 years ago)

    I lost my trust in the healthcare-system... and anyone who hear my complete story understands that...

    If you want to help people, dont work for health-care system, its too much build on profits... and im not talking about the profits nurses make (thats most times just a "fuck you" from the system for the hard work they do)
    • No I thought about it and I don’t want to be doing anything else. Sorry having what sounds like a chest tube shoved into you wasn’t pleasant. It’s not meant to be. Sorry you had a bad experience. Better not come to the hospital if you’re dying since you don’t trust us. Doctors and nurses saved me when I crushed my temporal lobe on asphalt as a 1 year old.

    • idk777

      You remind me of a YouTuber who said she was sexually assaulted because someone pulled her out of a lake when she was drowning and gave her CPR. I didn't like getting shots when I was five, enough to have to be held down by nurses, but you learn how to grow a pair of balls and suck it up, because that's what's good for you. That doctor wasn't concerned with your fear of needles at the time. He saw someone with a collapsed lung and did what it took to save him. Hopefully you learn that being a little uncomfortable for a few days is a small price to pay to keep your family from having to conduct your funeral.

    • @idk777 people amaze me. In order for CPR to be effective, compressions must be hard enough to crack ribs. If you think inserting a chest tube is bad, try intubation. That is far from pleasant.

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  • SexyAshh
    Wow, tbh this is ridiculous. I find it hard to believe y'all are not allowed to fight back. Especially when police officers are in fact allowed to shoot when threatened (which i agree on), there should definatly be something allowed for y'all to do in such a violent situation. Sorry to hear, i wouldn't have been as strong as you and probably had my degree revoked due to fighting back.
    • Thanks! I wouldn't call it being strong. I just froze

  • MackToday
    Take a step back and look at the larger picture. The more "diverse" a country gets the more of this you will see. This kind of thing can be laid right at the feet of globalism, nihilism, "multiculturalism" and the loss of tradition. Aside form psych patients who will always be violent a lot of this stuff comes directly from the breakdown of the family and traditional culture.
    • The woman who strangled me was white and a native of our country.

    • MackToday

      Which country do you live in?

    • The United States. I live in Nevada.

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  • chriscdi
    honestly i think we should stop being silent about violence in general, people try to hide it in many ways but why not just accept the fact that violence is part of real life and it exists
    • See, the point of this my take was to say that a large amount of work place violence happens in healthcare and it is getting worse. I can't even name a single coworker who hasn't been assaulted, that's a problem. This is like saying we should have more funding to treat cancer in general not just lung cancer, even though lung cancer is the biggest cancer killer.

    • chriscdi

      yea but focusing on the whole problem then just a part of it would help on not just different parts but the whole thing, lets use your example, if you just focused on lung cancer then people would die of cancer to other parts, sure lung cancer percentage would decrease but the cancer in other areas would increase, besides honestly i dont think that the most common violence is happening in healthcare, i think the most violence is happening in the poor countries that are starving and dont have many options but to fight for survival like in venezuela or certain parts of africa or brazil, thats if we are talking worldwide of course but even here in the US i still think that the most violence comes from the street violence that most if not all states have, unless you are talking about assault violence then that im not sure but when it comes to violence in general then i think the top is the street violence

    • The statistics is based on violence that is reported and happens in the workplace. Not the street corner or wherever you said. Neither of those places you stated is a job. But you have the right to not believe facts. Facts are true whether you believe them or not. Now you know about cancer? Interesting. The cancer example you used is so not how that works but go ahead.

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  • Muhammad1999
    That's because your country doesn't have effective laws , if someone is responsible for talking an innocent life they should either be hanged or killed by electric chair .
  • Nuremberg45
    As a direct care staff, working with special needs, I would get assualted every day almost, to the point I sprained my knee because they took a guy off his meds for a week. We dont need to be quiet about it at all.
  • Poppykate
    Unfortunately, healthcare will never have a zero level of violence towards its members. Unfortunately, there is many health conditions which cause aggressive behaviour.
  • Redstang88
    Is this not common knowledge? I’ve got a few buddies working hospital security, it’s a straight up war zone some days.
    Honestly it’s mostly healthcare officials that are to blame, as in your case they basically make it so you have to just take whatever abuse is thrown at you.
    Just a few weeks ago one of my friends got chewed out by a nurse when he took down some methed out schizo that went at her with a needle.
    • They've been better but I have been vocal about how the assault shouldn't have happened. I never got a report on her and didn't know she was that violent. I was worried she was going to trip over her IV pole because she was being so impulsive and wasn't listening to me. One of the nurses responsible for making the hospital safer sat down with me. She asked what they could do to make the hospital safer and I told her the hospital failed me. Now, all security guards are armed additionally with guns. Before they had mace, tazer, and handcuffs.
      She chewed him out? I love my security guards and love that they don't have to be nice to patients.

  • Wharvey98
    There defenitley need to be better protocols for patients that are known to be, or are at a higher risk for violent behavior. Perhaps more orderlies or security personnel, and the ability for healthcare workers to defend themselves from violent parients. Their job is to save lives not risk their own. Other than that it’s difficult to do much else other than spread awareness. It’s an inherently dangerous high stress work environment. When caring for injured or mentally impaired patients there’s always a risk that something can go wrong, but like I said there definitely need to be better safety protocols.
  • IlyaTheImpaler
    I was hospitalized few years ago and I was always on my best behavior around nurses, it feels so good to be taken care of when you're weak, can't believe these people attacked them. I might even flirt with them depends on how high on ‎OxyContin I am.
  • In my mind, knowing how patients are treated, especially in institutions, I'd say at least 8/10 of people who are attacked by patients had it coming.
    • I'm going to give you a hint. This isn't Grey's Anatomy and this is a hospital not a hotel. This is my job and violence has no place here. If I wanted that, I'd go to a war zone. Then again, I know an Iraqi doctor who said patients treated him better in Iraq than America

    • If people there weren't in a position where they could care for themselves, they wouldn't be there. Dumbass

    • And? I went to the hospital at the age of 12 because I shattered my foot. I didn't assault the nurses or doctors. I also have PTSD from the incident of my patient assaulting, I haven’t assaulted anyone in return. The opioid crisis is huge and people don’t take mental health seriously enough. It’s no mistake that they are big reasons why healthcare staff is assaulted.

      I thought I liked you but I guess people show true colors all the time. If you don’t trust us, that’s fine. Dont come to the hosptail when you need us. And I guarantee there will be a time when you do.

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  • tartaarsaus
    I know someone who works at the emergency services, and they say they just refuse to go to certain places in the night without a police escort. They've been assaulted, attacked with pepperspray, beaten up and more. Usually by drunks though.

    My mom worked at a healthcare center where one nurse almost got strangled by a patient.

    My dad worked for a week at a hospital in The Hague where some people actually tried to assault some doctors for not being able to save the life of some family member of them.

    So these are just some examples of them, it's truly terrible and definitely should be paid more attention to.
  • Waffles731
    Oh my god, I never knew this was an issue.
    Its absolutely insane what is going on
  • oddwaffle
    It's a chicken and egg problem. You can't sue people without money, insane or not in their right mind.

    People with money would rarely do anything without private help. The insane and just not quite right people wouldn't be there if they were sane and stable.

    So you are left with:

    #1 increase pay and work conditions for nurses. Except, some idiots decided wages for nurses should be lower than doctors because doctors spend more time studying. Even though they are overflow with doctors and not enough nurses.

    #2 create protocol and training for medical personnel to avoid accidents. Works great on paper but until people can ping lawsuit on the hospital and the insurance companies pound on hospital practices, this isn't going to happen.

    Did you know that the female officer strip search female suspect is not in the law? It's something the insurance companies forced up on the police forces to avoid lawsuits.
  • intjgamer
    I have family members that are nurses and they experience these things sometimes.

    There needs to be better protocols for handling people who abuse drugs, having a psychotic break, or are obviously high when they arrive.

    I recommend hiring more orderly personnel that have the stature of bouncers and have them no more than 3 yards away from a dangerous patient.

    You say hospital personnel cannot hit a patient in self defense. Implement a waiver form or notice that allows for self defense when the patient is admitted into the hospital. Everyone has the right to defend themselves from harm or future harm.
  • sockandshoes
    aw man im studying to be a nurse...
  • Good take..
  • legalboxers
    I've seen my share of violent pts and EDPs..
  • High-Inquisitor
    Stay safe. You do not deserve such treatment.
  • LuWe22
    Violence at work should never be okay.
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