Is a hospital not a symbol of security, care, and compassion?  Why then is violence towards healthcare workers in hospitals a widespread phenomenon?  Violence in healthcare settings seems counter-intuitive to the socially held expectations regarding hospitals and their mission to provide care and comfort to those in need.  However, it seems the general public fails to realize violence in the healthcare settings mirrors society in general. 

In the wake of the mass shooting at Chicago’s Mercy Hospital last week you have to wonder what can be done to protect staff and patients.  “A hospital is supposed to be a place of healing and recovery… and we’re seeing that it’s now a place where amass shooting can take place,” said Alice Johnson, executive director of the Illinois Nurses Association. “Chicago area hospitals are now reviewing their safety precautions and preparing to meet the requirements of a new law that mandates violence-prevention training and other security measures.”   

 A perfect storm is defined as a particularly bad or critical state of affairs, arising from a number of negative and unpredictable factors.  Violent events are an inevitable consequence of many contributing factors, but why is healthcare considered the most dangerous profession outside of law enforcement?     

Violence in healthcare can be the result of interacting factors encompassing staff behavior, patient behavior, organizational conditions, long wait times and disgruntled employees who commit random acts of violence.  Interested parties, providers and patients involved in a violent event experiences feelings of fear, frustration, loss of control and overriding stress. 

Contributing factors of patient related violent incidents ranged from mental health issues to poor communication among healthcare providers and patients.  A patient’s lack of understanding of how to navigate the hospital system coupled with poor communication between patients and providers  create expectation gaps that lead to patient dissatisfaction and in some cases violence.  

Providers and staff are an integral part of the healthcare system and  aren’t exempt from being a factor in the violence that plays out in the hospital setting.  Staff is under tremendous pressure with increased workloads, patient-related factors, as well changes in organizational and environmental conditions.  This coupled with the trend of conducting healthcare like a business without the proper balance of patient/family considerations contribute to the frustrations being felt by healthcare providers.  These factors potentially,and inadvertently, lead to the emergence of violent events.  

To prevent and reduce the frequency and severity of violent incidents in healthcare settings lawmakers proposed The Healthcare Workplace Violence Prevention Act in March 2018.  After recent events in Chicago two state legislators are reviving a push for a law that would mandate metal detectors in hospitals.   Unfortunately, there is not an easy or magic solution to this growing problem.  The key to success will lie in routinely assessing locations for security effectiveness and importantly training staff appropriately. Facilities will need to delicately balance welcoming patients and visitors while providing a safe and secure environment.