Patient attacks on doctors and nurses are more frequent

With the attention focused, rightly, on patient safety, what about health care workers?

It’s somewhat of a hidden phenomenon, but attacks on doctors and nurses are on the rise.

Rahul Parikh writes about this in a recent Slate piece. He cites data from the Bureau of Labor Statistics, which found “health care workers are twice as likely as those in other fields to experience an injury from a violent act at work, with nurses being the most common victims.”

He goes on to detail an attack on a physician who initially refused to give his patient opioid pain medications:

Mansfield’s attacker wanted pain killers. “I need you to give me more Percocets, given the shape I’m in after what I’ve been through,” the patient said in a soft but gravelly voice. What I’ve been through apparently referred to a grudge he held against an orthopedic surgeon whose rough examination exacerbated his neck pain. Mansfield says, “[H]e tried to reproduce the ‘painful range of motion exam’ on me, such that if I knew how painful it was—I would understand how much he needed the Percocet.”

Much of teaching on how to avoid potentially violent situations are ineffective in the long term. That leads to more extreme solutions — like carrying a gun.

Indeed, according to a survey conducted in 2005, 40 percent of emergency physicians admitted to carrying a gun. That seems like an incredibly high number to me.

Just like we should be concerned about patient safety, the safety of health care workers is no less important. That means doctors and nurses need to tell their stories and bring this issue to light.

And in the case where patients attack doctors or nurses, getting the police involved and pressing charges is an option that needs to be seriously considered.

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  • http://myachillesrupture.com/ Josue Diaz

    Yikes!

    I do agree w/you in the 40% gun-toting docs being high. If in fact, it is close to the actual number, I think it’s a shame more hospital administration are not doing enough to ensure the safety of staff.

    In addition, a down economy tends to breed more short-fuses with patients and the medical professionals are collateral damage to bigger issues.

    Great post on a very serious topic.

  • http://www.drjshousecalls.blogspot.com Dr. Mary Johnson

    It’s only in the last year that I’ve seriously thought about purchasing a handgun for protection – and pursuing a permit to conceal. I blogged about it:

    http://drjshousecalls.blogspot.com/2010/02/surgical-intern-with-steel.html

    Of course my biggest concern right now is not so much my work as it is a cyber-stalker who wants to shut me up and my blog down – this after I answered a journalist’s invitation to the ether five years ago . . . naively looking for help fighting medicolegal corruption in North Carolina.

    People don’t care when doctors take a hit . . we doctors being so “rich” and “greedy”, you see (Pediatiricans do tonsilectomies for the money don’t ya know?). And, of course, there’s alway another one to replace us. We’re a “dime a dozen”.

    But hospitals/hospital executives are world-renowned for not giving a tinker’s damn about the safety of their staff. Open units & ED’s. Un-armed security guards. Many is the hospital ward/stairwell that might as well be a darkened Walmart parking lot.

    Drug-seeking patients are not the only problem – just ask any Pediatrician. Angry and/or warring parents (particularly the “Baby Daddies) can put on quite a show – with healthcare providers often getting caught in the middle.

  • Paul MD

    I must admit that I am shocked on the concealed carry percentage among ER docs. Does this statistic reflect “on the job carrying” or life in general?

    I am licensed to carry and have never done so regarding my work, but then I live in the newly declared “safest state” in the country. Conditions elsewhere must be vastly different. Truth is the police cannot be everywhere and often their involvement is to solve the crime already perpetrated.

  • Bladedeoc

    When seconds count — the police (and hospital security) are only minutes away!

  • Yious

    Dear God, are some of you doctors serious about wanting guns while looking at patients?

    Can you all tell me what hospitals you work at so I go nowhere near you all?

    I understand wanting protection but the thought of my doctor leaning over me with a loaded weapon in their pocket is just downright absurd to me.

  • http://www.pulseuniform.com Penelope

    Men and women in medical scrubs especially the women nurses are the ones’ who are vulnerable to attacks of many patients. I remember last month that there is a case of a nurse who suffered complaint from a patient because she refused to gratify him sexually. The patient assumed that sexual service is a part of nursing care.

    This is a great post and very educational also.

  • http://www.drjshousecalls.blogspot.com Dr. Mary Johnson

    Yious, please. NOBODY here said they WANTED to take a gun to work. In fact, given most institutional policies, if someone did and they were caught (not that there’s a good chance they would be – because most places do not even have metal detectors at the door) they would likely be disciplined or fired.

    But the FACT remains that doctors/nurses/other healthcare are finding themselves targeted for violence BY THE PATIENTS THEY LEAN OVER a whole lot more often these days . . . and (as always) the institutions we work for are lagging behind the times in terms of security and safety in the workplace.

    I’ve done the graveyard shifts in the big city ED’s and I can tell you that sometimes just getting from the parking lot to the door is unnerving.

    It IS a good post. Bladedoc is spot-on.

  • Todd

    The question shouldn’t be “Why do 40% of ED physicians carry guns,” which I agree is very high and unnerving, but instead should be “Why do 40% of ED physicians feel that their work environment is so unsafe that they need to carry a gun for their safety?”

    Somehow, if EDs became a safer place to work (more/armed security guards, well lit and guarded parking areas, less fear of lawsuits for using restraints, etc.) I bet the number of carrying physicians would go down.

  • TrenchDoc

    Like a good Boy Scout always be prepared. My experience a few years ago taught me that. I had done a postop consult and an Orthopedic patient who went into Atrial Fibrillation. After she was successfully converted in the recovery room, I went up to the floor to talk to the husband. He was reasonable at first then a switch went off and he loudly demaned to see his wife immediately because we had obviously done something to her because she had never had any heart trouble. I tried to calm him down but he got more aggitated. I told him I was going to call the Ortho doc to let him know of the husbands concerns. The husband followed me up to the nurses station while I called the attending. While I was talking to the attending the husband screamed at me and climbed over the nurses station and landed on top of me. Fortunately 3 nurses jumped in to pull him off the top of me. Security was called and by the time they got there he was gentle as a lamb and did not understand what we were upset about. Be prepared in our society today where only you are responsible for you own own safety. Next time I won’t need the nurses.

  • TNF

    Hmm…I wonder if tranquilizers would be an option? or stun-guns? Or pepper spray?

  • ER Doc

    I was watching a report on the TSA, and the reporter was quite incredulous that people would swear at them.

    It occurred to me that most people aren’t used to being sworn at on a daily basis. Sadly, it has become life in an ER.

    In the upscale suburban ER where I work, we have had 3 or 4 patient assaults in the last year…..

    It’s everywhere. You just don’t hear about it.

    Thanks for bringing up the topic.

  • John Ryan

    I remember doing a 4th year medical student externship in the ID outpatient clinic at a busy NYC hospital. One of the staff physicians was nicknamed “Dr. Eastwood” (of Dirty Harry movie fame) because he saw patients with a sidearm under his lab coat. He said he began carrying it after a fellow physician was assaulted by a patient dissatisfied with his prescription.

    Also, an orthopedic doctor in my suburban office condo building was shot by an irate patient of his, when giving a deposition after hours. He was lucky. The insurance company’s attorney deposing the patient was shot dead.

    I got a Taser C2 for my office a few years ago after a few aggressive patients frightened my staff. Notifying the occasional threatening loudmouth that we are calling 911 and we can and will use a Taser has been very effective. Although this kind of confrontation is very rare, we all need to realize that you are truly alone when this time of violence erupts.

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