Workplace violence in a sanctuary of healing

The unfortunate but extraordinarily serious problem.

The emotions that are heightened during health care encounters and the
number of patients with behavioral issues make healthcare workers at a significantly increased risk for workplace violence. In fact, the Occupational Safety and Health Administration (OSHA) reported from 2002 to 2013 that serious workplace violence resulting in an injured worker requiring days off to recuperate were four times more common in healthcare than in private industry.

This is an incredibly difficult paradox that those who work closest to heal and care are at the greatest risk to suffer. And suffer not just from physical violence but also the verbal abuse that can lead to stress and emotional trauma.

As one nurse told me, “It is hard to care for a patient when you are constantly looking at your back.”

Healthcare workers often accept this as part of the profession. Many will put their own safety at risk trying to do the right things for patients and recognizing that the violence propagated by patients is often unintentional or even unavoidable.

It is vital for all of us to recognize the issue and take the necessary steps to minimize the risks to our employees, our patients, their families and visitors. Training, de-escalation strategies, protective procedures and prevention all play a role.

During my first month as CEO six years ago, an incredibly perceptive security officer recognized an individual standing in our lobby as someone who intended to do harm to someone else. That someone else was a nurse who had stopped her relationship with this person. Recognition, quick response and action to secure safety averted what could have been a tragedy.

Shortly thereafter a second incident occurred when a patient with medical and behavioral problems injured one of our nurses. When we looked into the circumstances, we found several things we could have done to have prevented this.

When asked the usually mundane question of CEOs, “What keeps you up at night?” I could honestly say, violence within our sanctuary of healing.

We created an ongoing workplace violence task force, reinforced education and recognition, created a swat team to de-escalate and contain, and minimize risks in our environment.

And to those who believe this only occurs in busy urban environments, understand that this phenomenon of healthcare-related violence can and does occur in all parts of our country, and throughout the social strata of our population.

Our Safety Huddles have been a good addition in bringing related issues to the front, but I want to ask each of you to think about this issue and speak up.

Do you feel safe, and, if not, why?

What would make you feel safer?

What more can we do to ensure, as much as possible, a safe environment to let you do your primary job, that is, return patients to health and wellness?

The issue is complex and solutions have to be measured and well thought out. But the issue is critical for us to protect our most important asset: all of you.

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14 thoughts on “Workplace violence in a sanctuary of healing

  1. I’m at OFP and recently attended the Active Shooter presentation. I called my daughter at Main to share the EXCELLENT information and she said they had the module as part of their mandatory education every year since she hired in 11 years ago. I suggest that it be mandatory at ALL of locations throughout the system. This information is too good and too vital to not have all of us prepared.

  2. Please assign security officers to sit in the MICU waiting rooms or come and close them down at 8pm EVERY Night. Every week there’s some type of problem with visitors during visiting hours or asking them to transition downstairs after visiting hours. It’s a constant battle and we DONT feel safe. It feels and seems our concerns about this issue has falling on deaf ears! Every time something happens there’s nothing done about it. If security would do walking rounds every other hour inside the waiting room, or stay in the waiting area, or even assist every night closing down these areas, I would feel a lot safer and happy about coming to work!

  3. I feel the employees are at risk for injury or worse. Why? visitors or anyone walking off the street can come in without being checked. Visitors come up on the floors without a pass and ask for a patients room but I send them to the front desk because I do not know the situation or who they are. Why can’t the front desk be set up for people to pass them before going in the elevators. The front desk by the main entrance face the opposite way. People walk in get on the elevator and can go anywhere in the hospital.

  4. I work in the visitor’s lounge on WC5 MICU, as a Unit Secretary/Conceirge. I feel unsafe at times, because there’s no security posted on the floor, and there’s no regular or consistent rounding of security throughout my shift. 10am to 8pm. I’ve had past incidents of families fighting and visitors becoming irate. Security is called, but by the time they arrive, the damage is done. It would be a safer environment if there was a security presence throughout the day, and especially when the lounge is closing at 8pm.

  5. Good morning. As the times are changing, we have to be aware we are in a different day than we were 5,10,years ago. In trying to do our best with care, there are some challenges with safety. I work the frontline for Radiology. So no issue sitting at the desk, but I am wide open with one way in and one way out. A lot of times we can be too comfortable assuming things won’t happen. Pray it doesn’t but honestly if someone wanted to come in and do harm to me, nothings blocks them. I can try to call security if able. I look at our main doors and west entrance doors. I sit outside often during lunch, etc. There is a lack of security presence. So much so, that the patients or family can easily light up a cigarette right near someone in wheelchair, or another patient who can not have the fumes. I have spoken up sometimes. I am disregarded most of the time because not security. So, my point is if they can’t monitor smoking, how can you protect us is there is a greater need?

  6. Thanks for addressing this topic. I am a nurse at HFH and we deal with patients of all walks of life. As a nurse I am use to patients being admitted and diagnosed with an illness, and all the comorbidities that may exist, but there is one thing that goes unnoticed. Patients expectations of the staff. This makes for a very tough environment to work in because the acquity of care just went from 2 to 10 coupled with the fact that we were within grid for staffing, but because of the high demands of patients we just went from having enough staff to being short staff. Now tensions may run high on both sides the patients if their not getting their needs met, and with staff who is trying so very hard to keep up with everyone, and everything.

  7. I want to thank all who have been responding to this blog post. We are taking all of the comments very seriously and will be considering each one in collaboration with leadership from the hospital, HR, and the Workplace Violence Committee.

  8. Janis and the MICU Staff, thank you for sharing your concerns. Our HFH Security staff rounds the entire hospital at closing. If you are uncomfortable at any time, please call Security Dispatch at (313) 916-1122 and an officer will respond immediately. We want you to know that all calls are recorded and all non-patient areas are on monitored by an officer on camera, including the MICU waiting room, entrances and hallways. A supervisor is present 24/7 should there be any concerns about response times. The safety of all of our staff – and our patients – is our highest priority and we will continue to make improvements so that you feel your surroundings are safe no matter what shift you work on or where your unit is located.

  9. Thanks, Janet. We’ve had a number of improvements implemented to develop more friendly processes for visitation for patients and their families. We want to remind you that if you or any of your coworkers are uncomfortable at any time to please call the Security Dispatcher at (313) 916-1122 and an officer will response immediately. Duress alarms are also available which alert Security as well as our house managers, who are also very experienced in defusing situations.

  10. Esther, thank you for your comment. We take safety very seriously. We want to ensure our staff is equipped with as much knowledge as possible to address potential situations. We will pass your feedback to HR, the Workplace Violence Committee and HFHS University for consideration in the required education for all employees.

  11. Thanks, Charmaine. We appreciate you bringing this not only to our attention, but for taking action on behalf of our patients and coworkers. Our Security staff enforces the smoking ban when they see someone smoking. However, they are not able to be in all places at once. If you see someone smoking on campus, please contact the Security Dispatcher at (313) 916-1122 and our staff will respond.

  12. Barbara, we understand your concerns about carrying concealed weapons. Our challenge at HFH is that we have both a hospital and clinic space in the same building. The current State of Michigan law prohibits concealed weapons in a hospital, but a visitor may openly carry a firearm in a clinic. Our Security does monitor visitors to the Emergency Department. We also prosecute those who illegally carry weapons.

  13. Lisa, thank you for all you do for our patients each day. We recognize that our staff goes above and beyond when the acuity of care is high. This is when proactive communication with patients and their families can help. It won’t solve every challenge, but it will alleviate some of the pressure by ensuring our patients have clear expectations of what is possible.

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