Dr. Jeff Kane: Unrest in the healthcare workplace
Emotions run high in medical settings — and higher in some places and times than others. When I was working in a county hospital decades ago, the sheriff found it necessary to maintain a substation in the ER. The first day I worked there, a martial arts instructor addled by a horse tranquilizer kicked me across the room.
During this current pandemic of both virus and misinformation, emotions are especially high. According to the Occupational Safety and Health Administration (OSHA), healthcare workers comprise 13% of the workforce but suffer 60% of all workplace violence incidents. They suffer injuries that require sick time at quadruple the rate of workers in other industries, and it’s estimated that healthcare workers under-report violence by 50%.
Causative factors include high levels of stress and anxiety in the working environment (especially the ER, operating room, and ICU), feelings of loss of control by patients and their families, inadequate hospital staffing, and patients with pre-existing mental health and dementia disorders.
The COVID pandemic multiplies the troubles. People out of work, and so in financial straits, arrive at the medical setting already anxious and fearful. COVID deniers come anger-primed. Patients in isolation are deprived of contact with friends and relatives, even when they’re dying. And overworked physicians, nurses, and other staff are stressed to their edge.
Few healthcare organizations have effective response programs. That leaves workers feeling isolated or fearful of retribution should they report violence or take action to protect themselves. A further complication is our cultural notion of framing the medical mission as self-sacrifice: as I’ve written here before, one result of medical training is proficiency in absorbing punishment.
The first step in solving any problem is recognition of the issue. Medical administrators who sense their staff’s dented morale, hopefully soon, will devise corrective policies and programs. Healthcare workers who acknowledge that some of their stress is less about burnout than abuse will develop self-protective strategies. And it’s up to us, the public, to recognize that our medical heroes are being tortured. Let’s find ways to be kinder to them.
Jeff Kane is a physician and writer in Nevada City.
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“The recommendation for everyone to resume masking indoors and to get tested after an exposure is a prudent measure to slow the spread of the Delta variant,” said Nevada County Health Officer Dr. Scott Kellermann.