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V – Violence in Health Care

Greenwich Hospital

It’s a little known fact, that as a group health care workers experience more non-fatal violence in the workplace than any other industry.  Statistics indicate the highest incidence of violence is against nurses, mental health worker and security staff. These non-fatal assaults include hitting, punching, biting and having things thrown at them, but occasionally can be as devastatingly extreme as shootings and rape.  Non-fatal assaults in health care account for 70% of all violent assaults across all industries.

Now, in my mind hospitals should be really safe place, with hushed halls and people who speak in low, soothing tones and the swishing of crisp uniforms going through the halls.  Unfortunately, that is not the case anymore.  I have experienced it.  I have had things thrown at me by patients and their families (and one time by an Obstetrician – that’s another story).  I have been kicked and bitten. I have had families, patients and the friends of patients’ families swear at me, call me every name in the book and this is not uncommon.  A survey was done, the National Crime Victimization Survey (2005-2009) and over 150,000 nurses interviewed recounted some type of assault.  Those are some staggering statistics.  These statistics don’t include the verbal abuse nurses endure routinely.

All of these statistics, and the increasing reports of violence against health care works raises the question as to why the frustration and the anger. Why are people so confrontational and abusive towards health care workers?  What makes it okay to lash out at the people who are there to help?  It is safe to say that people are more stressed today, feeling helpless against economic woes, and frustrated toward corporations that wield their might and treat the consumers that made them what they are as insignificant ants.

Everyone comes into the hospital already carrying their own baggage and stressors, pile onto that worries about a sick family member, child or perhaps themselves.  Add to that long wait times, difficult and sometime delayed access to care, or denial of care because of insurance issues and you have a walking, talking, emotional caldera ready to explode. And who is there to suffer under the fallout, the people nearest them; the nurses, the doctors, the mental health care workers and anyone else with whom they may come into contact. Nurses and doctor provide direct care, they are in close proximity with the patient, and so they are first to come into the contact with the anger, the desperation or frustration.

Nurses don’t seem to have much recourse in dealing with this abuse.  If it is reported, the Hospital Administration in many cases (not all cases) will try to keep the incident quiet.  It is the patient and the family who are appeased.  If the nurse does report the assault, for most, nothing is done.  In one of the articles I read, the nurse who had been assaulted, she was told by the judge he felt like being clobbered was just part of the job and the assault charges against the perpetrator were dropped.  What the heck?  Maybe being clobbered is ‘part of the job’ for a WWF participant, but not for people who work to help others.

Hospitals have made a half-hearted move to offering violence prevention classes.  These are not mandatory for hospitals to institute.   Other hospitals are encouraging nurses and other personnel to report incidents of assault without fear of reprimand (which to me seems rather puzzling – why should someone be reprimanded for reporting a physical assault while trying to do their job).  But again, the literature indicates the commitment to these types of programs is insipid at best.  Where can changes be made to protect the people who help others?

It needs to start at a really basic level.  We are all consumers of health care, and we can start the ball rolling.  We need to understand the health care field is going through some major changes, and it isn’t changes we are all happy about.  Access to care is even more difficult these days, many people are turning to the Urgent Care clinics and the Emergency Rooms, which means longer wait times and bigger bills.  I have tried twice within the last 6 months to see my Primary Care Provider, both times I was quite ill with fevers, and each time I was told the next appointment was in 2 weeks.  Well by then I would either be dead or better.

Despite all of this, it is not the doctors or the nurses we need to flail at, because they too are in the midst of this maelstrom of shortages, not being able to deliver the care they deem necessary because of the constraining vices applied by the insurance companies.  The nurses and the doctors are all dealing with the same issues as the patients and the families, but from a different perspective.  It isn’t easy for them either.   So clobbering them, kicking them, verbally abusing them is not going to help and will only drive them away from the health care industry altogether, which in turn will lead to more shortages, longer wait times and less access to care. Perhaps everyone should just be a little more patient and know that the health care professionals are there to help, they are not thinking up ways to anger or injure the patients. The doctors, the nurses, the mental health care professionals spent many years in school preparing to help their patients.  Why would they do anything other than that? They work to heal, but that is hard to do in fear.

ADDENDUM:  There is a really good article regarding a study done with Emergency Room nurses and their experiences with violence.  Unfortunately all the sites I went to would only allow me access to the abstract, but here is the reference.

Wolf, L.A., Delao, A.M. and Perhats, C.  Nothing Changes, Nobody Cares: Understanding the Experience of Emergency Nurses Physically or Verbally Assaulted While Providing Care (2013). Journal of Emergency Nursing.

Also, I have found a website created by created by three nurses who are victims of assaults while at work.  Please take a look. STOPHealthcareViolence.org

Thanks to commons.wikimedia.com for the use of photo.

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