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.
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.
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.
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.
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.
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.