Facing Escalating Workplace Violence, Hospital Employees Have Had Enough

CALAAEM News Service calaaem.news.service at gmail.com
Tue Apr 9 09:04:39 PDT 2019


April 8, 2019


Facing Escalating Workplace Violence, Hospital Employees Have Had Enough


90408> NPR


April 8, 20194:26 PM ET




Across the U.S., many doctors, nurses and other health care workers have
remained silent about what is being called an epidemic of violence against


The violent outbursts come from patients and patients' families. And for
years, it's been considered part of the job.


When you visit the Cleveland Clinic emergency department these days -
whether as a patient, family member or friend - a large sign directs you
toward a metal detector.


An officer inspects all bags and then instructs you to walk through the
metal detector. In some cases, a metal wand is used - even on patients who
come in on stretchers. Cleveland Clinic officials say they confiscate
thousands of weapons like knives, pepper spray and guns each year. The metal
detectors were installed in response to what CEO Tom Mihaljevic is calling
an epidemic.


"There is a very fundamental problem in U.S. health care that very few
people speak about," he says, "and that's the violence against health care
workers. Daily - literally, daily - we are exposed to violent outbursts, in
particular in emergency rooms."


Many health care workers say the physical and verbal abuse comes primarily
from patients, some of whom are disoriented because of illness or from
medication. Sometimes nurses and doctors are abused by family members who
are on edge because their loved one is so ill.


Cleveland Clinic also has introduced other safety measures - such as
wireless panic buttons incorporated into ID badges and more safety cameras
and plainclothes officers in ERs.


But these incidents aren't limited to emergency rooms.


Allysha Shin works as a registered nurse in neuroscience intensive care at
the University of Southern California's Keck Hospital in Los Angeles. One of
the most violent incidents she's experienced happened when she was caring
for a patient who was bleeding inside her brain.


The woman had already lashed out at other staff, so she'd been tied to the
bed, Shin said.


The woman broke free of the restraints and then kicked and punched Shin in
the chest - before throwing a punch at her face.


"There was this one point where she swung, and she had just glanced off the
side of my chin. If I hadn't dodged that punch, she could have knocked me
out," Shin says. "And she very well could have killed me."


The encounter left Shin shaken and anxious when she returned to work days
later. She still has flashbacks.


She used to be afraid to speak about these types of attacks, she says,
because of what she calls a culture of accepting violence in most hospitals.


"It is expected that you are going to get beat up from time to time," Shin


According to the Occupational Safety and Health Administration, incidents of
serious workplace violence are four times more common in health care than in
private industry.


And a poll conducted by the American College of Emergency Physicians in 2018
found nearly half of emergency physician respondents reported being
physically assaulted. More than 60 percent of them said the assault occurred
within the previous year.


Groups representing doctors and nurses say while the voluntary safety
improvements that some hospitals have enacted are a good first step, more
needs to be done.


There is still a code of silence in healthcare, says Michelle Mahon, a
representative of the labor group National Nurses United.


"So what happens if they do report it?" Mahon says. "In some cases,
unfortunately, they are treated as if they are the ones who don't know how
to do their job. Or that it's their fault that this happened."


"There's a lot of focus on de-escalation techniques," Mahon adds. "Those are
helpful tools, but oftentimes they are used to blame workers."


In California, the nurse's labor union pushed for a law giving OSHA more
authority to monitor hospital safety. The group is now backing a national
effort to do the same thing.


"The standard that we are recommending federally holds the employer
responsible," Mahon says. "It mandates reporting of incidents and


The Workplace Violence Prevention for Health Care and Social Service Workers
Act, recently introduced in Congress, would require hospitals to implement
plans to prevent violence. And any hospital could face fines for not
reporting incidents to OSHA, Mahon adds.


The goal of the legislation - and of the union - is to hold administrators
more accountable for acts of violence in their hospitals.



Brian Potts MD, MBA
Managing Editor, CAL/AAEM News Service


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