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.