Hospital Violence: How can Hospitals Deal with an Uptick in Violence?

Since the pandemic, hospital violence has increased consideably. Increasingly, doctors, nurses, and hospital staff are reporting not only more hospital violence, but also threats and aggression from both patients and their families.

Consider the following example:

A private-practice nurse who provides at-home care services was asked to help an older woman who, it was believed, had COVID-19. At the time, there were no tests, so the nurse had to determine if she had the disease based on examination and the patient’s symptoms.

It was clear to the nurse that the patient had the disease. When the nurse told her she had to put on a mask and go to the hospital, “she jumped out of bed, pushed me against the wall, and started biting me. It took everything I had to get her off of me.”

The nurse later said it was not so much that the patient did not want to go to the hospital; the problem was the mask. “She was very big on social media that said, ‘don’t let them tell you what to do.’”

This type of violence is happening all over the country. In this case, the incident occurred in a rural area of South Dakota. However, incidents like this have been reported in New York, Chicago, and San Francisco.

The big concern for the medical industry is that hospital violence is causing many people to leave the profession. The private-practice nurse in the scenario above is a perfect example. She left a job at a medical center to work on her own, believing it would be safer and she would not be subjected to threats or violence. She found, as others just like her, that violence against medical personnel can happen in the hospital or at someone’s home.

According to Dr. Kara Dahl, an emergency room physician at the Sanford Aberdeenhospital violence Medical Center in South Dakota, when hospital staff come to work, “I can almost guarantee that they’re going to be name-called or disrespected in some capacity at least once a week.” Not only is the name-calling and disrespect stressful, but Dahl says, “it pulls us away from more critical situations [when we] have to deal with a behavioral issue. It’s impacting patient care.”

So, what can we do about this hospital violence? Here are some suggestions:

 Dedication. When patients are first admitted to the hospital, advise them that the staff is dedicated to their welfare and the welfare of all patients, doctors, nurses, and staff in the facility. The goal, according to one physician, is “we’re not asking [patients] for devotion or appreciation, just asking for decency.”

Signs of stress. Look for signs of stress among patients and their families. A little extra time discussing their health can help soothe tensions between patients and staff. However, as a safeguard to hospital staff, nurses should note they are concerned about a patient or their family so others are aware of it.

Educate. Doctors and nurses typically are not taught how to manage hospital violence. However, in today’s world, that is an oversight. Some hospitals have now started group sessions in which hospital staff are taught de-escalation techniques; how to react respectfully, safely, but forcefully; who to call if assistance is needed; and how to protect themselves and others in the hospital should things get out of hand.

Messaging. Some hospitals are now placing posters and signs in strategic locations throughout the hospital with the following messages:

  •   Please take responsibility for your energy. If tense, take a deep breath and make sure your energy is in check.
  •   Your words matter, your behaviors matter, our patients and teams matter; please respect everyone in the hospital.

Conduct a Risk Assessment.  A risk assessment helps educate hospital staff on how to handle hospital violencee and work in tense situations and how to de-escalate them. However, they can go much further. They also look for the following:

  • Potential risks and hazards to both patients and staff.
  • Any vulnerabilities to the facility, where, for instance, intruders may enter unnoticed.
  • The possibility or likelihood of an incident or risk occurring.
  • Spots where surveillance cameras should be installed, where heightened security is necessary, or where barriers may be needed.
  • Where additional lighting is needed.

Hospitals have lots of people coming and going on a 24/7 basis. As a result, they usually have many vulnerabilities. A professionally conducted risk assessment identifies these vulnerabilities, reduces risks, can help stem violence, and promotes safety for everyone using the hospital facility.

Johnathan Tal is Chief Executive Officer of TAL Global Corporation, an international investigative and risk-consulting firm. He served as a military field intelligence officer for the Israeli armed forces during the 1970s. Tal has also served as an antiterrorism security specialist. He is a licensed investigator, Certified Private Investigator (CPI), and Certified Fraud Examiner (CFE), and he holds a Bachelor of Science degree. He can be reached through his company website at www.talglobal.com.

Here is more on hospital violence from Frontiers in Public Health

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