The Epidemic of Violence in US Hospitals: Healthcare Workers at Risk

2023-08-07 21:14:29

Last month, a rumor spread at a hospital in Oregon, US, that a visitor was causing trouble in the maternity ward, and nurses were warned the man might try to remove the newborn from his partner.

Hours later, the visitor opened fire, killing a security guard and pushing patients, nurses and doctors to take cover.

The shooting at Legacy Good Samaritan Medical Center in Portland is part of a wave of gun violence affecting hospitals and medical centers across the United States, which have struggled to adapt to growing threats.

These attacks have helped make health care one of the most violent areas in the country. Data shows that American healthcare workers today experience more non-fatal injuries from workplace violence than workers in any other profession, including law enforcement.

“Healthcare workers don’t even think regarding that when they decide to become a nurse or a doctor. But when it comes to actual violence, statistically, health care is four or five times more dangerous than any other profession,” said Michael D’Angelo, a former police officer who focuses on health care. workplace health and violence as a security consultant in Florida.

Other industries exceed the health sector in terms of overall danger, including in terms of fatalities.

Similar shootings have taken place in hospitals across the country.

Last year, a man killed two Dallas hospital workers when he came to attend the birth of his child. In May, a man opened fire in the waiting room of a medical center in Atlanta, killing one woman and injuring four others. Late last month, a man shot and wounded a doctor at a Dallas health center. In June 2022, a gunman killed his surgeon and three others at a doctor’s office in Tulsa, Oklahoma, because he blamed the doctor for his continued pain following surgery.

Three-quarters of workplace injuries

It’s not just the fatal shootings. According to the US Bureau of Labor Statistics, healthcare workers suffered 73% of all non-fatal injuries from workplace violence in 2018, the most recent year for which figures are available.

A day before the July 22 shooting in Portland, hospital workers were warned in meetings to be prepared for a possible “code orange” announcement in case the visitor tried to remove the child, according to a nurse with direct knowledge of the meeting who spoke to The Associated Press. She spoke on condition of anonymity because she feared reprisals at work.

Fifteen minutes before the shooting, someone at the hospital called 911 to report that the visitor was threatening staff, according to a timeline provided by Portland police.

“He slipped through the cracks,” said the nurse. I don’t know how many chances he had. It got to the point where the staff didn’t know what to do or what they might or mightn’t do with him.”

The police arrived at the maternity ward within minutes, but it was too late. Bobby Smallwood, a security guard who had been called in from another Legacy hospital for replacements in the understaffed Good Samaritan security team, had been shot and killed. Another hospital worker was injured by shrapnel. The suspect fled and was later killed by police in a nearby town.

The hospital declined to respond to the nurse’s comments because the matter is still under investigation.

“Events like this are unpredictable, but our team demonstrated professionalism and great courage in the face of extraordinarily difficult circumstances that day,” Legacy Health said in a statement released to the AP.

Legacy Health in Portland plans to install additional metal detectors, require bag searches at every hospital, and direct patients and visitors to controlled entrances. More security guards will be equipped with stun guns, the hospital said, and bullet-retardant film will be applied to some interior windows and at main entrances.

According to the American Nurses Association, some 40 states have passed laws creating or strengthening penalties for violence once morest health care workers. Hospitals have armed security guards with batons, stun guns or handguns, while some states, including Indiana, Ohio and Georgia, allow hospitals to create their own police forces.

Critics say private policing of hospitals can exacerbate the inequities in health care and policing that black people already suffer from. They also claim that private police forces are often not required to disclose information such as the frequency of the use of force or the disproportionate detention of members of minority groups.

The dysfunctions of the health system in question

According to Deborah Burger, a registered nurse and president of National Nurses United, security teams cannot address all the factors that lead to violence, because many of them are due to the dysfunction of the health care system.

Patients and their families are often tossed between emergency rooms and their homes, and are frustrated by high costs, limited treatment options or long wait times, Burger said.

“Hospitals don’t really have a complaints department, so the only real target they have is the nurse or the staff right in front of them,” she said.

Understaffing forces nurses to care for more patients and gives them less time to assess each patient’s behavior problems. Efforts to defuse abuse aren’t as effective if nurses haven’t had time to bond with patients, Burger added.

Understaffing is an “absolutely catastrophic formula for increasing workplace violence,” D’Angelo said. Today, there is not even the good old system of mutual aid between two colleagues who monitor each other.

Some hospital administrators encourage staff to calm visitors and aggressive patients because they fear getting bad reviews, Burger said. Indeed, the Affordable Care Act tied a portion of federal reimbursement rates to consumer satisfaction surveys, and low satisfaction translates to lower bottom line results.

“The results of these investigations should never take priority over the safety of personnel,” D’Angelo said.

Eric Sean Clay, president-elect of the International Association for Healthcare Security & Safety and vice president of safety at Memorial Hermann Health in Houston, said the rates of workplace violence attributed to healthcare facilities are “widely underestimated”.

“I think a lot of that is because caregivers are very tolerant and they come to see it as part of their job,” he said. If they’re not hurt, sometimes they don’t want to report it and they don’t think there’s going to be a change.”

Mr. Clay’s hospital uses both armed and unarmed security guards, but he hopes they will all be armed eventually.

“We actually have our own firing range,” Clay said. None of his security guards have drawn their guns in the past few years, but he wants them to be ready due to the increase in gun violence.

Mr. Clay and Memorial Hermann Health declined to answer questions regarding whether an armed security force might negatively impact access to health care or existing inequalities.

The Portland hospital nurse said the shooting terrified her colleagues and made them feel unusually solemn. She worries that promises of improved security made by Legacy Health are only temporary due to the cost of finding, training and retaining security guards.

Some of his colleagues have quit because they don’t want to be faced with another “money code,” the alert issued when someone in the hospital has a gun.

“You know, we always say these patients and their families are very vulnerable, because they’re having the worst day of their life here,” the nurse said, making many staff reluctant to demand a better behavior.

“We have to put an end to this talk,” she said. To be vulnerable is to bleed out following being shot in the chest. To be vulnerable is to have to barricade yourself with your patients in a room because of a money code.

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