By Carol A. Cates, MSN, MBA, RN
Chief Nursing Officer
Odessa Regional Medical Center
I have been thinking about writing about violence in health care for a while now. But I’ve struggled on how to say what I am thinking and feeling, without being overly emotional. I’ve also wanted to get a little bit of distance between when I write this and the latest headline. Unfortunately, the headlines just seem to keep coming on this subject. Violence against healthcare workers is at an all-time high and it is something we encounter far too often at all levels of health care.
In my 30-year career, I have been hit, spit on, bitten, kicked, scratched, pushed, grabbed, groped, and cursed at more times than I can count. The vast majority of this I never reported because it was people who didn’t know what they were doing, and it was something that didn’t require more than basic first aid if I had an injury.
When I say, “didn’t know what they were doing,” I mean people with dementia or delirium related to their disease processes, and people who are so drunk or high they are more dangerous to themselves than anyone else.
In the first and second decades of my career as a nurse, I can only think of one incident of violence where the person knew what they were doing. I can’t say that in the last 10 years though. The last 10 years, especially the last 2, have been really disturbing when it comes to violence from people who are very aware of what they are doing.
I read an article recently that stated that 25% of nurses reported being verbally or physically assaulted in 2021. Unfortunately, I am quite sure that number is quite a bit higher, because like me, many healthcare workers don’t report violence because the person didn’t know what they were doing. Statistically, healthcare workers are 5 times more likely to be assaulted on the job than any other profession. That means a nurse, doctor, medic, patient care assistant, respiratory therapist, and all the other specialties in health care are more likely to be assaulted on the job than police or soldiers.
So much of the violence lately seems to be directed at people with little to no control over the trigger for the violent behavior. A close friend was verbally attacked at a grocery store while wearing a hospital t-shirt because the person was angry about the COVID pandemic. That friend in no way deserved or provoked such outrage, nor could she do anything to solve the issue. I have had multiple experiences where hospital staff have been cursed at and even had things thrown at them over masking mandates.
The mask rules come from the Centers for Medicare and Medicaid Services (CMS). Acting violently towards the people in the hospital does nothing to change the rules, they aren’t in the hands of anyone at the local level. The amount of violence about how medications are prescribed is scary. Again, this is something that is highly regulated, and rarely in the control of the people who become the targets of the rage and violence associated with medication prescribing.
Unfortunately, our friends in law enforcement have their hands tied in this regard as well. The extreme violence is very well prosecuted. Unfortunately, the “minor” things are rarely dealt with. The resources required to arrest and prosecute someone who is cursing at and threatening to harm a healthcare professional (aka verbal assault) just isn’t “worth it” when it comes to the limited resources of our law enforcement officers and court system. That problem is further exacerbated by the fact that the level of penalty can differ when violence occurs against healthcare workers.
Texas law treats an assault against a healthcare worker as a different level of felony based on the location where that assault occurs—even if it is the same behavior. The problem with this is that even “minor” incidents of violence can really add up for those of us in health care.
It is extremely difficult to go to a job where you want to take care of others and make the world a better place, and in return you, or a significant number of your friends and colleagues, are assaulted regularly. And many people are leaving an already thinly stretched profession because of it. Too few healthcare workers will negatively impact this community and every community in the U.S. Healthcare workers need to be safe in their workplaces.
A dear friend told me as I talk about this subject, that I am “preaching to the choir,” and I probably am. But I also firmly believe in the old saying, “Evil flourishes when the good do nothing.”
As you go about your day today, if you encounter someone who works in health care, please tell them thank you and let them know with your words and deeds that you find violence towards healthcare workers unacceptable. Please help me spread the word that to have a healthy community, we must protect the people that provide health care and not tolerate violence in any form directed at them.
