Five Tips from Law Enforcement to Combat Healthcare Violence
If you’ve read social media lately, there is a frenzy of discussion around violence in healthcare. Recent events include an ED nurse being raped and held hostage in Illinois, an ED nurse being stabbed in Massachusetts, a legal case in New York where a pregnant nurse was punched in the stomach, causing her to lose the baby and an unjust arrest of a nurse for refusing to draw a patient's blood without a legit legal reason in Utah. It’s been on people’s minds for a while, but now it has been pushed to the forefront. There are many accounts of healthcare workers responding to social media posts, citing their own experiences of being a victim of violence at work and even the lack of support from hospital administration. Included in these posts, not surprisingly, are healthcare workers lashing out at each other and placing blame on the victim.
Our healthcare culture hasn’t dealt well with violence. And it makes sense. Most, if not all, go into healthcare to help people and receive training as such. We do not receive extensive training in de-escalation and self-defense. Some might argue though, that they took a violence prevention class, so they received adequate training in self-defense. However, not all violence prevention classes teach self-defense. Compared to the years of medical/nursing training, we must call those few hours of violence prevention training woefully inadequate. It’s hard for healthcare to switch our mindset to a place where we might run the risk of hurting someone, even if it is necessary to save ourselves or someone else.
After these recent events, I discussed healthcare violence with a law enforcement friend of mine and his wife, who is a nurse. The following is from our conversation.
The bigger the agency, the less they support you – Our employers are running a business, and to them, it would be just as easy to hire another person as it was to hire us. When we retire or resign, they will replace us and the healthcare machine will march on without hesitation. Don’t love an agency that can’t, or won’t, love you back.
We’ve heard the stories of hospitals not supporting their employees that are victims of violence. It is the easy way out. It is very easy to let someone talk us out of calling the police to report the crime (yes, intentional violence in the hospital is a crime). It is very easy to talk ourselves out of it with thoughts of, “the department is busy, I don’t have time”, “I don’t want to seen as a weakling”, “it’s a part of the job, I should just get used to it”, “I’ll probably get fired if I report it”, “I don’t want to miss work,” “the hospital won’t pay me to attend trial” or “I don’t want to make the hospital look bad”. We could go on with the excuses, but you get the picture.
Since healthcare hasn’t trained itself to address violence head-on, it’s no wonder that support for the victim is lacking. We just don’t know how to deal with it. We have plenty of evidence staring us straight in the face that it is a rising problem. And yet we remain fairly passive and our training, policies and action remain anemic. OSHA is considering a standard that would mandate all healthcare and social assistance to provide violence prevention education to their employees. If we don’t do right by our people, we will be regulated to do so. Congrats healthcare, we are at that point.
What if leadership/management discourages you from reporting violence or pressing charges? You, the victim, have the right to press charges. Management/leadership does not get to make that decision for you. It is not the hospital’s responsibility (unless it is written in policy). You have to be willing to be the victim. And unless the hospital specifically says that you cannot report the crime or press charges, there might be a case for a civil suit. Remember, you do have the right to a safe work environment. You may have started a career in healthcare to help people, but that is near impossible if we do not take care of ourselves and our safety, first. By prosecuting violent people, we help ourselves recover and find closure from an incident. We hold the assailant accountable so they don’t do it again to someone else. And by prosecuting, we might be helping that person get back on the right track. Sometimes we’ll never know.
What if law enforcement discourages you from reporting violence or pressing charges? Follow the chain of command. It might start with the shift supervisor, then to lieutenant and maybe all the way up to the chief (or sheriff). If you are worried about HIPAA, you can disclose some information since your attacker committed a crime. Read here to put your mind at ease. If anything we know, nurses are persistent. Don’t give up on this.
What if you had to defend yourself? Expect to be questioned by law enforcement. Expect to be grilled by your leadership/management. If done correctly, law enforcement should have your injury documented and photographed, and the same done a couple days later. If you caused your attacker injury, it is suggested to hire legal counsel. It’s recommended that you don’t give details without first seeking legal counsel. It may be advisable to consult as well with your union rep, but they should not take the place of a good lawyer. Realize that your recall of the event might improve over the next couple of days. Your self-defense should be judged from your point of view, not based on witness accounts. You might even have to appear in court. Since violence is so prevalent, an insurance policy might be helpful. NSO offers coverage for personal injury (that you might cause) and assault coverage (I am not paid by NSO).
What is your advice for healthcare workers from a law enforcement perspective?
1. Change your mindset. Even though you help people, change your mindset. What is the most important thing in your job? You; followed by your coworkers, followed by the public, followed by your employer. If you don’t prioritize your safety above all others, you may become a victim. Wrap your mind around the fact that you might have to do something you’re uncomfortable with in order to protect your safety and those around you. We have to take care of ourselves before we take care of others.
2. Do enough to escape and get away. The intent is not to turn medical/nursing staff in to black belt cage fighters. We are talking about self-defense. Develop the skill set to do what is necessary so that you can get away and home to your family uninjured.
3. If it’s a fair fight, change tactics. Think dirty. Cheat. Your goal is to do number 2 above. Remember, this person tried to hurt you. You did not ask for this confrontation, and it was most likely forced on you.
4. Know how to observe, be aware and be proactive. Training for the worst situation can often help you avoid it. Sometimes it is simply teaching people how to identify a bad situation so they can step back before it gets out of control.
5. Realize when we are stressed, we do not always rise to the occasion. We fall to our lowest level of training. Don’t fall into the trap “this won’t happen to me.” You won’t be prepared when a volatile situation rears its ugly head.
This is not, nor should be considered, legal advice. Nor does this advice supersede your institution's policies or procedures.