By Violence Betrayed: OSHA Mulls Regs, Healthcare Workers Face Attacks

January 20th, 2017

By Gary Evans, Medical Writer

The Occupational Safety and Health Administration has formally opened rule-making for a regulation to protect healthcare workers from rampant violence perpetuated by patients and visitors. In the current political environment any new regulation could face resistance, but this is not a matter for pros and cons and academic discussion. This is an outrage.

Consider one story, that of Gena Deck, MSN, RN, assistant professor of nursing at the University of Alaska in Anchorage.

“The patient was known to the department and hospital, although I had never tended to him in terms of nursing care. I was new to the hospital within the previous few months,” she says. “It was an emergency room environment. The patient was brought in by EMS for altered mental status secondary to diabetes. The patient has many medical and psychosocial issues -- which I now know. He was placed in a trauma bay, in view of the healthcare provider’s station. He was calm and cooperative while receiving services for about 4 hours. Because he had a history of not wanting to leave the hospital at discharge, security was called to the bedside to assist. I did not know this information prior to this event.

“The patient presented many obstacles as to why he could not be discharged, including having no transportation, no place to go and threatening to harm himself if we discharged him," she continues. "The physician evaluated the patient and stated he was still to be discharged. He was offered a ride to a shelter, which had already agreed to accept him. The patient then stated he had no appropriate foot wear. The security guard stated he would grab some temporary footwear from the storage closet. In a flash, as soon as the guard was gone, the patient stood, grabbing the cording from the overhead Phillips monitor -- wrapping all three cords around my neck shouting “Here bitch, you try it” in reference to his saying earlier he would hurt himself. In the next 10 seconds, hearing the screams and commotion, the guard and physician who had been assessing him returned to the room, freeing me from the situation.”

From there ensues a complex and frustrating saga as Deck pursued legal action, which many healthcare workers decide against due to a variety of reasons that include fear of retaliation. As violent attacks and verbal assaults reach epidemic proportions in healthcare, Deck is another scarred survivor who lives with troubling thoughts and disturbed sleep.

“This has left me changed as a nurse and as a person,” she says. “I believed that I would die. I physically had bruising, sore throat and scratches, all of which healed in a few days. The psychological impact was, and is, significant. I have sleeping difficulty, occasionally having nightmares that awaken my spouse who then wakes me to calm me. I have anxiety when approaching some patients who are large or loud. It changes who you are as a nurse. We are geared to go toward chaos and violence, not away from it.”

For more on this story see the March 2017 issue of Hospital Employee Health.

Gary Evans has written about infectious diseases, occupational health, medical ethics and a variety of other healthcare issues for more than 25 years. His writing has been honored with five awards for interpretative and analytical reporting by the National Press Club in Washington, DC.