by Michael Del Trecco, President & CEO, Vermont Assocation of Hospitals & Health Systems It’s long past time to stop the scourge of workplace violence in our community hospitals and health care settings. These are places for health and healing, peace and recovery. They are staffed and run by the most talented, caring and loyal group of providers and staff anywhere in the world. Violence within their doors is a rampant and unrelenting problem, and we need to address it.
In this week’s VAHHS update (see related stories below), you’ll read two commentaries from providers in our emergency departments about the increased violence they are experiencing, and you’ll read a heartbreaking story about an individual known to cause harm and upheaval in at least three of our southern Vermont hospitals. If you’re a regular reader, these stories are all too familiar to you.
In a meeting just this week with our staff, we heard from providers who shared stories of incidences that resulted in hearing loss, traumatic brain injury (TBI) and ripped tendons. I have heard providers who have weathered serving in the military, responding to the Sandy Hook shooting or delivering care at Ground Zero on 9/11 say that their subsequent experiences of workplace violence in health care settings have resulted in PTSD for them.
One provider had a family member of a patient threaten to harm him and his children. I could fill multiple columns with stories of horrific, terrifying and completely unacceptable acts of violence. And that’s not all—nearly every single provider and hospital staff member is subject to regular verbal assault. For many, the verbal abuse, threats and hateful, racial and discriminatory slurs leave gaping but invisible wounds.
I do not share these examples lightly or without the consent of those involved. I’m sharing in hopes that airing them will lead to change. Our health care providers desperately need this dynamic to improve. The impact on staff is low morale, workplace fear, disruptions in career development, burnout and turnover. For patients, it means their care is interrupted and they can be victims themselves. It causes some to fear being in a health care setting like an emergency department, which is already very scary for many.
Workplace violence and threatening behavior have to stop if we expect to make any progress toward population health, a strong and stable health care workforce and hospital financial and operational sustainability.
Hospitals are making significant investments to hire more security, install new monitoring systems and cameras, pay for sitters for violent or potentially violent patients and fund capital projects that retrofit space to keep patients and staff safer. In budget hearings this past year, many, if not all, of our hospitals identified both security and capital construction investments as meaningful areas of increased costs.
This is all necessary and important, but it cannot be the answer. We cannot ask our doctors, nurses, staff and leaders to continually build, buy and borrow their way to health care settings that better protect providers and patients.
That is why VAHHS and health care leaders from across the state are working with our federal delegation and local lawmakers on legislation aimed at reducing workplace violence. Here in Vermont, a bill will be introduced this session that would allow law enforcement to immediately remove perpetrators who threaten or commit violence that interferes with providing care.
Additionally, we have to invest in more long-term care and inpatient mental health beds to reduce wait times and overcrowding and get patients the right care in the right care settings. This not a nice-to-have; it’s a must do. If we don’t act, we will see the problems in our emergency departments and on our floors worsen despite all of the measures mentioned above.
We did not get to this unfortunate reality overnight. Violence in health care settings was a major issue before COVID. Like so many challenges, the pandemic has made it far worse. It will take time to stop this downward spiral happening in our society and spilling over into our emergency departments. None of us is to blame for the suffering and instability that is causing this violence to occur, but we all have a role to play in making it stop. So, we must act now, and we must work together.
You can learn more about work place violence in health care and access our toolkit here.
And one more thing: if you see doctors, nurses or other hospital staff members in your
travels, you might take a minute to smile their way or say thank you for continuing to show up to work and endure the fear and violence to care for us when we and our loved ones need them. They continue to show courage and compassion in these really challenging times.
Legislative Update, by Devon Green, VAHHS VP of Government Relations
Part of my job is looking at each issue from every angle—what will the state say, what will this stakeholder say, where is this legislator coming from? For years, I’ve looked at workplace violence from every angle. It’s an extremely difficult conversation. How do you protect health care providers from getting injured while they are caring for hurt people? How do you ensure that the conversation does not break down into an us-against-them mentality and alienate patients? How can you get more resources to address this issue when you’re in a workforce shortage?
We worked on this issue from all the angles. We had a multidisciplinary task force and developed a toolkit. We tried a public service campaign. However, after the health care provider stories piled up and health care providers themselves despaired that nothing would happen until someone was killed, I can only look at the issue from one angle—we need to do something now. We will not be able care for Vermonters if health care providers are going to work worried about getting assaulted or subjected to hateful threats. We have asked too much of our health care workers. They need immediate relief.
VAHHS is proposing that workplace violence, and the threat of workplace violence, against health care workers result in immediate removal of the perpetrator from the facility by law enforcement. What we need now is help in removing individuals who are violent from hospitals so that trauma to health care providers and patients is mitigated as much as possible. This provision will not solve workplace violence. It will not apply to individuals who need emergency care for stabilization. Law enforcement doesn’t have the resources to carry out this directive every time. And, the question of where those individuals go remains up in the air. But, the issue is clear—we need help caring for those who provide care. And, we need it now.
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