The recent shooting of a Johns Hopkins physician by a distraught family member focused media attention in Baltimore and Maryland on the issue of safety in hospitals. While the public obsessed about metal detectors and guns, local occupational health and safety researchers took the opportunity to frame this shooting as the worker safety that it is. Section members Jane Lipscomb, Jonathan Rosen, Matt London, and myself have a 10-year history of working together on the issue of workplace violence. Jonathan Rosen, Evie Bain, Harriet Rubenstein, Barbara Silverstein, Karen Worthington, and Jordan Barab are additional Section members who are active on the regulatory aspects of workplace violence. Jane and I worked with our university media folks to craft an op ed to the Baltimore Sun and responded to calls from the media. Below are excerpts from our op ed. The complexities of this issue cannot be fully explored in the typical op ed, but the following excerpts demonstrate one approach to bringing attention to this worker safety epidemic:
Excerpts from the Baltimore Sun, Sept. 22, 2010
“The public was stunned to learn of the shooting of a physician by a patient's family member at Johns Hopkins Hospital last Thursday, but what many people don't know is that violence in hospitals has become an everyday occurrence. Health care workers are four times as likely as the average American worker to face assault on the job, according to a federal labor report. For those working in psychiatric units and emergency departments, the risk is considerably higher. Fortunately, most of the assaults - unlike the Hopkins incident - do not involve handguns and near-fatal injuries, but many of them are life-altering, careering-ending injuries.”
“Most of the discussion following last week's events focused on metal detectors, but metal detectors don't prevent violence toward staff by individuals who push, scratch, choke, and punch, which is far more common”…..”Transparency on the part of management and being immediately responsive to staff concerns also contribute to building a culture of safety. But the components of such a culture are rare, based on our research and our ordinary encounters with health care workers in our roles as researchers at the Work and Health Research Center at the University of Maryland School of Nursing. Earlier this year, for example, a nurse at a hospital elsewhere in Maryland made a point to let the center know that she had been physically assaulted by a patient but received no support from her institution. She said she took several weeks of personal leave to recover.”
“Workplace violence is an invisible but deadly epidemic for health care workers around the world. Depending on the type of patient and the type of unit, estimates of hospital staff experiencing verbal and physical violence each year range from 30 percent to 100 percent. In the case of any other epidemic (salmonella or H1N1, for example), these statistics would generate alarm. But violence toward health care workers remains largely invisible to the public, remaining the purview of a few active unions, nursing associations, and researchers….”
“Patient safety and staff safety are linked. If your nurse, physician, or patient care technician is not safe, neither are you or your loved ones. As such, the public would be wise to recognize and demand improved working conditions and safety of health care workers. Health care organizations must demonstrate that staff safety is as high a priority as patient safety and that they will work with clinicians to improve security while not compromising the quality of care for which institutions such as Johns Hopkins are world renowned.”
“The dangerous jobs of the past, such as Baltimore's famed steelmaking and shipbuilding, were made safer over time by strong workplace regulations and strict enforcement. With manufacturing in decline, the "new economy" is the service sector where different--but still dangerous--working conditions exist, whether the public realizes it or not. In the past, the Maryland Occupational Safety and Health Administration (MOSH) made manufacturing jobs safer. It's time to regulate workplace safety in our hospitals to reduce the daily risk of violence faced by the health care workforce. Other states have done so, including California, Washington, New York and New Jersey.”
“Regulations that protect health care workers from violence on the job will not turn hospitals into fortresses. Instead, regulations require clear policies, a thorough risk assessment, adequate staffing and security resources, employee training, and ongoing recordkeeping and monitoring. Last week's tragic incident of workplace violence should prompt us to call for new and stronger MOSH regulations to keep health care workers, patients, and visitors safe in Maryland's health care facilities.”
Kathleen M. McPhaul is an assistant professor and director of the Community/Public Health Program, Work and Health Research Center, University of Maryland School of Nursing.
Jane Lipscomb is a professor and director or the Work and Health Research Center.