Hospital Health Hazard; Attacks on Workers Redefine 'Emergency Room'

Article excerpt

Byline: August Gribbin, The Washington Times

Hospitals can be scary places for patients, but for doctors, nurses and others who work there they can be downright dangerous.

"Every emotion is expressed in the emergency room every day. Emotions are raw, and there's always a risk. Abusive patients and the families of patients can become violent as the result of stress," says Dr. Thomas Arnold.

Dr. Arnold, a professor of medicine and acting chairman of the emergency medicine department at Louisiana State University's Health Sciences Center, adds:

"Things [such as patient care] can never go fast enough for patients' relatives. Sometimes they object violently when other, more urgent patients are treated before their relatives. Then, too, people sometimes turn on doctors when, unfortunately, we must inform them their relative has died."

Consider what happened to Dr. Paul Matera, emergency room physician at the District's Providence Hospital.

"It was about 2 a.m. I was working on a trauma patient with numerous, serious chest and abdomen stab wounds. He was 19 or 20 years old, and very large, weighing about 250 pounds. I had been talking to him, telling him what I was doing while trying to stabilize him and keep him alive," he said.

"Suddenly he sat up and spun me around. He hit me in the back of the neck with his fist, rupturing a number of discs."

Despite the pain, Dr. Matera continued to treat his patient. He made little of the assault then or later, although it nearly crippled him.

Subsequently Dr. Matera has had three surgeries to repair the damage to his back. He says the latest surgery performed this summer has finally eased the persistent pain. Two years ago the American Medical Association awarded him its rarely presented Medal of Valor for "courage under extraordinary circumstances in non-wartime situations."

Dr. Matera's story and similar tales are being repeated these days partly as a result of the September 11 attacks. They have caused hospital administrators and medical association officials to examine whether medical facilities are equipped to cope with the consequences of other terrorist acts. In the process, they have found that many lack the ability to protect their workers even in normal times - much less in periods of chaos.

Patient violence

One survey released in December asked emergency room managers and other representatives from 50 hospitals about worker safety at a national conference. It found that: "Despite the increase in concerns about bioterrorist threats, respondents cited patient violence as the number one threat to emergency department personnel."

The finding coincides with larger studies by the 154,229-member American Nurses Association. For instance, in a national, on-line survey of 4,826 nurses conducted in November, fewer than 20 percent said they felt safe in their "current working environment."

Seventeen percent of the nurses reported they had been physically assaulted in the past year. More than half said they were threatened or verbally abused.

The introduction to the Occupational Safety and Health Administration's largely ignored, voluntary Guidelines for Preventing Workplace Violence for Health Care Workers states: "More assaults occur in the health care and social services industries than in any other."

The document points out that the incidence of violence is increasing and also notes that "between 1980 and 1990, 106 occupational violence-related deaths occurred among the following health care workers: 27 pharmacists, 26 physicians, 18 registered nurses, 17 nurses's aides, and 18 health care workers in other occupational categories.

"The nursing staff at a psychiatric hospital sustained 16 assaults per 100 employees per year. This rate compares with 8.3 injuries of all types per 100 full-time workers in all industries and 14. …