Earlier this year, a gunman critically injured a doctor at Johns Hopkins Hospital, then killed himself and his mother. In another incident, a man who was unhappy with a relative’s treatment killed a nurse and another employee in a Georgia hospital, before being shot himself. In late 2010, an emergency nurse told CNN that she’d been scratched, bitten, spat on, and struck across the face so hard that her jaw broke.
Welcome to another day in the life of the healthcare workplace.
By its very nature, a hospital setting is a pressure-cooker environment – triggered by mental illness, drugs, alcohol abuse and mounting frustration from patients, some of whom may wait for hours to be treated by an overburdened system.
As a result, healthcare institutions are confronting a steadily increasing number of physical assaults that pose a unique danger to healthcare workers. As one might guess, most incidents take place in the emergency room setting. CNN reported a survey last year that revealed over half of all ER nurses had been physically and verbally assaulted on the job.
While the violence is not likely to improve soon, hospitals can adopt strategies to reduce violence and help prevent their employees from becoming victims. NIOSH (the National Institute of Occupational Safety and Health) recommends the following steps:
– Develop emergency signaling, alarms, and monitoring systems.
– Install security devices such as metal detectors to prevent armed people from entering the hospital.
– Design the triage area and other public areas to minimize the risk of assault: provide staff restrooms and emergency exits, install enclosed nurses’ stations and reception areas with bullet-resistant and shatter-proof glass enclosures.
– Arrange furniture and other objects to minimize their use as weapons.
– Design staffing patterns to prevent personnel from working alone.
– Restrict the movement of the public in hospitals by card-controlled access.
Other good suggestions: establish a system for alerting security personnel when violence is threatened, and train employees to recognize and manage violent situations and resolve conflicts.
Equally important is knowing what to do if an employee becomes the victim of violence:
– Have the manager check in with the employee to ask how they can be supportive and make them feel safe.
– Allow employees to go home or continue their shift, whichever they choose. If they decide to go home, urge them to contact a friend or family member for support so they’re not alone.
– Be prepared for a wide range of reactions — people respond differently to trauma.
– Assess how the employee is responding to the incident and determine the need for on-site counseling. Give an employee the option of counseling, but don’t require it.
– Check in with the employee over the following days and weeks to ensure they are coping.
