It’s been a few days since the video of that Utah nurse being arrested has come out. I’ve been ruminating on it a good deal. I think part of the shock, at least for me, was the physical violence unleashed in a situation that didn’t call for it. The police could’ve pushed past her and found someone else to lead them to the patient. She wasn’t physically barring them from the patient. They could’ve escalated things higher, “ok, you’re not going to help me, where’s your supervisor” kind of thing. When asked why they were taking it out on this nurse, that she was “just the messenger,” the police said, “because she’s the one who has told me no.” So you move on and find someone who will tell you yes. Like a judge. My wife noted that had the police been dealing with a man, things probably would’ve gone down slightly differently. Maybe, although as a former colleague of mine noted on Facebook, if you search for videos between cops and firefighters/paramedics, there are plenty of violent videos between those two groups of mostly men. Anyway, I’m not here to rehash a video, the police are doing their own internal investigation, the nurse may or may not file a lawsuit, from here on out, as far as I’m concerned, this is a legal matter and what’ll happen will happen.
What it does bring up though is the violence healthcare workers face every day. In my career I’ve had a patient try to choke me out; I’ve been spit on, hit, and bitten by multiple patients. I once was attacked by a dog. Patients, family, and bystanders have taunted and insulted me. A patient told me, as I was approaching to assess him, that he had a gun and was going to shoot me. One guy even referred to me as a “Texan,” I think it was supposed to be insulting, honestly I’m not sure. Colleagues of mine have been attacked. A social worker friend reported having been verbally threatened by police in her line of work. Point is, we catch this crap all the time. A depressing statistic I read this weekend was over half of all workplace assaults in the United States occur in the healthcare industry. OSHA reports the “healthcare and social assistance” sector experience workplace violence at a rate 4 times higher than the private sector. And this statistic is probably underreported as it only takes into account days missed from work. Certainly, the patient who tried to choke me out wasn’t reported. Few of the verbal assaults go reported. Which brings us to why these statistics are occurring and why they are underreported, 80% of violence against healthcare workers is perpetrated by patients. Large percentages are psychiatric patients. So we write it off as just, “part of the job.” But of course, it shouldn’t be. Some institutions implement various training to de-escalate, and in worst case scenarios, physically restrain patients or bystanders who are assaulting us. I’ve been through both Management of Aggressive Behavior (M.O.A.B.) and Crisis Prevention Institute (CPI) training. MOAB I went through 10 years ago and CPI probably 7 or 8 years ago. I’ve never practiced those physical skills since, although I try to use the verbal de-escalation tips.
Plenty has been written about dealing with these situations, their causes, and prevention strategies. In EMS were taught about “scene safety,” which is kind of bullshit anyway. The dynamics of a scene can and do change rapidly. This idea that ensuring scene safety is solely our responsibility or that once declared safe, things won’t change is unreasonable. When on scene I’m constantly in a state of threat assessment, and scene safety for me is a sliding scale. I mean just how we get to work is inherently unsafe. That time the dog attacked me? I saw the dog, asked the family to secure the dog (which they did) but then another family member, not realizing what was going on, later released the dog as I was in another room assessing the patient. As I left the house the dog attacked. I left unscathed, although my pants and wallet weren’t so lucky. We were so busy I never had time to change; I spent the rest of my shift with polka dot boxers hanging out of my torn pants.
One thing I’m hopeful this video will do is to bring to light the violence faced by the industry as a whole and promote proactive conversations about safety. Healthcare workers, police officers, fire fighters and EMS all face dangers just by showing up to work. The least we can do, instead of adding to the danger we each face, is to help one another go home safe and sound at the end of our shift.