“Did you know that Healthcare is the most violent industry outside of law enforcement in the United States?” was the title of the first blog I did to shine a light on the problem. That was 5 years ago. We have had several members comment on this issue since. The pandemic brought a new level to this violence as visitors found that their frustrations over Covid 19 could be transferred to healthcare workers. There were more mental health problems from depression, isolation, desolation, and grief. These emotions spilled into the emergency departments and filled the beds. Patients were sometimes relegated to the hallways to receive care, testing, and imaging. Healthcare workers were heroes for a short period of time only to then become pariahs because they did not deliver care to the patient’s prescription, even if it was wrong.
In March 2018 The Healthcare Violence Prevention Act was passed by lawmakers to prevent and reduce the frequency and severity of violent incidents in healthcare settings. Healthcare workers were hesitant to speak up and identify the incident and the offender. This is becoming less common as the workforce is tired, overworked, and out of patience. Hospitals were prone to err on the side of caution to protect the patient and their reputation. More people outside of healthcare are now aware of this problem but it has become a point of contention with the physicians, nurses, radiologic technologists, and respiratory practitioners. No one wants to be punched, pushed, pinched, or attacked by a violent patient.
In 2019, the case of the Baton Rouge General nurse was investigated as a homicide after the coroner ruled that she died of injuries from a physical altercation with a patient. Coroner Dr Beu Clark said there was a direct connection between the blood clots that killed Lynne Truxillo, 56, and a physical altercation at the job a week earlier. She was described as a “kind and compassionate nurse”.
This radiologic technologist received this from a patient as they were returning to the emergency department after a CT scan. The patient refused to get out of the wheelchair and proceeded to grab the technologist’s hand and twist it backwards. The patient was demanding a hospital room. The technologist relates that she has been bitten, spit on, and her equipment damaged by belligerent patients. They are upset over wait times in the emergency room where one-third of the 15 beds of their very busy department can be occupied by mental health patients.
Hospitals are struggling to retain their workforce and shortages of staff are evident in all geographic locations. The average turnover rate in the United States workforce is 57 percent and 70 percent is voluntary. A staggering 33 percent of new hires depart in the first 90 days. They are calling it the “Great Resignation” as working from home, layoffs and rampant inflation have changed the employment status forever. I am not sure what is so great about any of that. Statistics tells us that 1 in 5 healthcare workers have left their job since the pandemic started. A large number of workers that are dedicated and still on the job are suffering from PTSD.
Violence from patients can lead to time off, surgeries, and even death. The patients’ compounding frustrations keep increasing, and the patients are blaming the healthcare workers that are taking care of them regardless if they are the reason for the frustration. We have been overwhelmed during COVID extending wait times and essentially rationing some of the care that was necessary.
In this brief interlude of quiet as the new variant is on the horizon, patients are returning to receive the healthcare that they delayed because of the pandemic. Doctors are overbooked, schedules are overbooked, and insurance companies are disputing charges. Every bill must be coded correctly, properly identified, and submitted within the guidelines. Nothing has changed in that category except payments can be delayed. Workplace violence is associated directly with higher incidence of burnout, lower patient safety, and more adverse events.
In other words, frustrations from healthcare delivery are not going away. Everyone is seeking a solution to the violence from patients. As one of our nurses stated: Acting as a tribe to protect each other is the ultimate goal. All healthcare workers have a right to be safe on the job. We need urgent measures implemented and support including the resources to make our healthcare facilities safe.