Violence in Hospitals

We had an incident the other night in the hospital where a patient with known psychiatric problems became violent after an anticipated medical procedure was canceled. The patient’s family also became agitated and made verbal threats to staff.

In my discussions with other physicians and CEOs throughout the country, it appears patient violence issues, such as this one, are increasing.

 It’s happening in both urban and suburban hospital environments – most recently at Johns Hopkins.

 I believe that there are many causes for the increase in hospital violence:

  • The woefully inadequate inpatient and outpatient psychiatric facilities for those with long-standing behavioral problems;
  • Drug and alcohol dependency;
  • Stress related to finances;
  • And the stress a patient and his family experience during an acute illness.

A hospital needs to be a haven of safety in order to be an oasis of healing. 

That’s why the responses to violence in health care institutions need to include a more multi-faceted approach to manage these issues.

It’s vital to have early recognition of patients with behavioral problems – be pre-emptive, before the act of violence occurs. 

We respond to critically ill patients with multidisciplinary rapid response teams.  Similar response teams need to be deployed to address deteriorating behavioral situations.

There can be little tolerance for violent or threatening behavior in the health care setting. 

Professionals have a larger responsibility than patients to deal with the dynamics of illness, injury, and death as well as the emotional responses which patients and families have in those circumstances. 

We need to ensure that, just as in the courtroom or the sanctuary of a church, certain behavior is not tolerated in a hospital. 

We also need to establish firmer ways to deal with patients and families who are threatening violence – in any way – in the health care setting. 

Health care providers need to concentrate on their vital roles – not worry about their backs.

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2 thoughts on “Violence in Hospitals

  1. I agree that the healthcare professionals who are trying to minister to the physical problems of patients need to feel safe as they do their vital work. I really like the idea of rapid response teams, and as a mental health professional can see the value of having such a team available within the hospital structure at all times (24 hours). The healthcare staff would simply need to be trained to detect behavioral warning signs and when they reach a certain level of psychological intensity or danger (as identified in the training) they can then activate the behavioral healthcare team to assist. I am presently dealing with all of the emotions related to my father undergoing critical, emergency, lifesaving surgery and the aftermath. While in the critical care wating room, I witnessed familes who were struggling with each other, and I realized that these situations place great stress on the patient and family members ,who are suddenly face-to-face with each other under very intense circumstances and that can aggravate any type of pre-existing negative family dynamics. Families tend to be reluctant (or don’t know they can) ask for social work assistance, so if a behavioral healthcare provider initiated approaching the family they might be relieved and appreciative.

  2. Dr Popovich:

    First of all, congratulations to you on your new position. The fact that you have already provided direct connection to you for all of HFHS employees indicate your future success in this role. You are not an invisible “armchair warrior” who never interacts with us.

    This blog regarding violence in healthcare settings is so very important. As a RN who has worked at HFH for 18 years, I am very sensitive to this issue. Our first priority to our patients is their physical safety and health needs. We have all been exposed to the patient and family members who are unable to cope with the stress. Many of us have been placed in harms way while trying to take care of the situation. The idea of having a response team available 24 hours a day is strongly needed. Thank you for supporting your employees on the front line. Please consider making this available asap.

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