A man in the center of the room is bleeding from an open wound. The woman in the corner is wide-eyed and muttering to herself. A child in the seat next to you is crying and holding a clearly broken arm.
Any of these situations would constitute a serious red flag in the workplace. But you know this is a typical “Monday at the office” in your hospital’s ER. For most emergency rooms, it might even be a best-case scenario.
However, unnecessary danger is added to chaos when emergency room staff are faced with irrational patients, unwelcome visitors, or threats of aggression. Violence in healthcare not only threatens the well-being of your hospital staff but everyone within your ER.
Is your hospital equipped to mitigate the danger despite the chaos?
Increased Danger in the ER
Violence in healthcare has been on the rise since the COVID-19 pandemic. An emergency room, by definition, is the kind of chaotic environment that can serve as a breeding ground for violence. Still, hospitals can mitigate violence with good process planning and a focus on safety in healthcare.
Two 2022 studies published in JAMA by Yale researchers discovered “a widespread and increasing level of overcrowding in America’s emergency departments (EDs), a crisis that puts patient safety and access to care at risk.”
In hospitals plagued by staffing woes, patients in the ER may wait up to a day to get a bed in a hospital’s general or specialized units. Those long wait times can cause patients with medical emergencies to wait two hours to see a doctor. And in many cases, medical providers are treating patients in the hallway due to overcrowding.
Patients experiencing a medical emergency in a relatively public hallway are particularly vulnerable, especially when you consider the rising trend of violence in American hospitals and, more specifically, emergency departments.
Even before the uptick in violence, emergency medicine doctors and nurses had high-stress, life-or-death jobs with evolving responsibilities.
American College of Emergency Physicians President Dr. Aisha Terry, in a New York Times opinion piece, explained why emergency medicine practitioners are especially vulnerable to this violence in healthcare settings:
“People, appropriately so, feel that the safety net should always be there, no matter what, and should serve its purpose of not letting people fall through the cracks. Whether intentionally or unintentionally, those factors have resulted in us becoming more vulnerable to violence.”
In the same article, an emergency medicine physician recounted a story of a patient complaining on the phone about his long wait time and delayed treatment. She then turned to see him shout a racial slur and hurl a computer at nearby doctors.
Hospital emergency departments strive to be accessible to the most vulnerable in our societies. However, ER patients face emotional and sometimes life-threatening situations that can alter their normal behavior. Poor health, long wait times, and likely some amount of financial or insurance stress are all factors that take a toll on patients already experiencing pain, shock, and disruption to normality. It’s a pressure cooker for violence.
Most of Your Providers Have Been Assaulted
The results of a 2022 American College of Emergency Physicians survey (ACEP) are shocking, revealing that 55% of ER doctors report having been assaulted, and 85% credibly threatened. One-third of respondents reported being assaulted more than once. Most of those assaults were from patients, and about one-third resulted in injuries.
For nurses, the 2022 data is staggering. Nearly three-quarters (70%) of nurses reported being physically assaulted at work. Even more respondents to the survey reported witnessing an assault at work, with only 6% reporting no experience with assault in the emergency department. Shockingly, most of these incidents didn’t end in an arrest or charges but rather a note in the patient’s chart.
Unfortunately, these numbers are only rising. According to an article released in early 2024 by National Nurses United, 81.6% of nurses reported experiencing at least one type of workplace violence in 2023 and 45.5% agree that workplace violence in healthcare increased in the past year.
Aside from the trauma of the assault, more than 80% of care providers reported the assaults led to:
- Loss of productivity from emergency physicians and staff
- Increased staff anxiety
- Increased wait times
- Reduced focus from physicians and staff
Further exacerbating the problem, a majority of respondents reported those incidents resulted in the violent party not receiving the care they need.
The ACEP survey included suggestions for improvements, with the top responses being:
- Layered safety plans that include security guards, cameras, and visitor screening
- Clearer policies
- Better police reporting
- Increased emergency department staff
Keep Your Staff, Your Patients, and Your Money with a Focus on Safety in Healthcare Workplaces
Only 15% of surveyed nurses said they plan to be in the same position in one year. More than twice as many nurses said they were considering leaving the profession entirely. McKinsey and Company predicted that the United States would see a shortfall of up to 450,000 RNs by 2025.
According to the same article, emergency department physicians are experiencing a 65% burnout rate. When experienced doctors and nurses leave the profession, they leave an even more significant burden for their former colleagues, creating a negative staffing cycle and a considerable decrease in patient health outcomes.
How Healthcare Violence Impacts Nurses
According to Nursing World, “This under-reported epidemic has devastating results on the healthcare industry. Studies show that WPV [workplace violence] can affect the quality of care and care outcomes, contribute to the development of psychological conditions, and reduce the RN’s level of job satisfaction and organizational commitment.”
The organization reports that nearly 15% of all nurses’ missed workdays are due to workplace violence.
The Centers for Disease Control and Prevention report that incidents of violence in healthcare workplaces can lead to low morale, low productivity, a lack of trust in management, reduced team cohesiveness, and a more hostile work environment, ultimately resulting in “increased stress, absenteeism, family turmoil, and worker turnover.”
Those consequences have real dollars tied to them before lawsuits and settlements ever enter the picture. Recruiting and sustaining a vibrant staff is one of the most considerable challenges hospital administrators have in the current industry landscape.
The CDC article also points out that coworkers who witness these incidents are often left experiencing the same adverse side effects.
A focus on safety in healthcare can improve emergency staff productivity, resulting in better patient outcomes.
Violence in Healthcare Workplaces Is Expensive
The American Hospital Association estimates hospitals spent nearly $1.3 billion on reactive workplace violence response efforts in 2016, before the national increase in violence in healthcare. The Occupational Safety and Health Administration (OSHA) warns that treating employee injuries and reimbursing lost wages can become astronomical, especially for large healthcare organizations that self-insure.
But the costs of replacing a nurse are equally high, which can quickly top $100,000 when considering recruiting, hiring, orientation, and training. The costs of replacing emergency physicians can be more than double that. Plus, hospital administrators must deal with increased overtime or PRN expenses required while the new provider is being recruited and trained.
Patients’ Lives Are at Stake
Emergency departments see their fair share of sprains, cuts, and low-stakes injuries. Still, the majority of ER patients have experienced significant trauma and are at some increased risk of long-term injury or death. They are in pain when they walk through the emergency department doors.
The violent actions of one patient should not affect the care of others, but in reality, it can. In fact, about 80 percent of ER physicians agree that violence harms overall patient care. However, a focus on safety in healthcare can increase patient outcomes.
When a patient or visitor attacks hospital staff, those staff members are prevented from caring for their patients, creating a bottleneck. At the same time, the other doctors, nurses, and staff members will either help the victim and restore order or, at the very least, be distracted and concerned. These delays worsen already crowded emergency departments.
At the same time, violent outbursts can directly harm any patients in the way of the attack, not to mention the emotional distress that is caused by witnessing violence in an already vulnerable situation.
Take Control of Your Emergency Room | Focus on Safety in Healthcare
Every second matters when responding to a violent situation in your emergency department.
CENTEGIX works with hospitals to provide the added layers of security and safety in healthcare that doctors and nurses already demand.
The CENTEGIX Safety Platform helps hospital emergency departments plan for emergency situations, screen every visitor, and maintain room-level visibility of the facility.
The Safety Platform takes a multifaceted approach to full-campus safety coverage.
CrisisAlert™ empowers all staff members to signal an alert from their wearable staff duress button. The badge can immediately and discreetly request help when and where it’s needed.
Safety Blueprint™ gives administrators the tools they need to create interactive safety planning maps of their entire campus with precision. Add safety assets and other valuable information to maps of your campus and monitor alerts in real-time with floor- and room-level accuracy.
Visitor Management gives your team peace of mind, knowing that everyone who walks through your hospital doors has been screened through state and proprietary databases.
Combined with the Safety Blueprint and CrisisAlert technology, Enhanced Visitor Management allows administrators to see how long visitors and vendors spend in the facility and can control entry to sensitive areas.
Control What You Can with Increased Safety Measures
You can mitigate the risk of violence in your healthcare workplace with a robust and multi-layered approach to safety. CENTIGIX can be your partner in creating a culture of safety.
See how CENTEGIX works with healthcare organizations and then schedule a demo to see it in action.