Another Life Lost; Enough

Beijing Dr Wen YANG’s death is another reminder of the healthcare violence global epidemic. Going forward, we ought to take action.

Guest post by Dr. Li Li, MD, MBA

Global Medical Lead, Cardiovascular, Bayer AG, Berlin, Germany

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Dr. Wen YANG was a 51-year-old ER physician, a mother, a wife, a daughter, working in Beijing Civil Aviation Hospital. On 24th, December 2019, Tuesday, one week earlier, she lost her life. That day was Christmas Eve. 

Dr. Yang was stabbed by a patient’s relative at her night shift, suffered from serious wounds to her neck, no breaths or heartbeats at the scene. The tragedy was recorded by the surveillance camera, a few seconds of murder was terribly brutal and cruel.

As a human, I was shocked by what I saw from the footage, just as most of us were. Dr. Yang was a caring, young woman, she had the nerve to apply her 27 years’ medicine knowledge to patients. Her death is another tragic reminder that there have been increasing reports, yet still underreported, of verbal, physical and psychological violence happening in the past years, not just in China, but worldwide.

The doctors, nurses and the staff work in health care are trained to take care of the ill, the injured and the people who come for help...the health care workers do not agree to be attacked, insulted, or murdered. 

Working in the health care profession is not easy; to treat and to care for patients is very challenging, it takes a life-long commitment. The medicine does not always work, some diseases so far are still not curable, a group of patients sadly has to face death no matter how hard they have fought. 

We all know the reasons causing healthcare violence epidemic are not straightforward, combating the violence goes a long way ahead, same in America. One piece of advice shared by Sheila Wilson, President of Stop-Healthcare-Violence in one of her publications, “combating Healthcare workplace violence,” she wrote, “it is my belief that underreporting is due to healthcare worker misconception of workplace violence.” (1)

Some healthcare workers get used to the verbal abuse or mild physical attacks, seeing them as part of their daily work, they felt upset or angry when the attacks happened. But the victims did not deem it necessary or important to file an incident report, or perhaps no one or no channel in the workplaces available was to assist those victims. On the other hand, the phenomenon of healthcare violence epidemic, if released to the general public, seems to undermine the image of the hospitals. (2) 

Sheila suggested, “With an advocate in place, there would be a non-administrative point-person designated to check in with the victim frequently, communicate with staff, conduct ongoing education and outreach, and foster a sense of security and right to safety for healthcare workers.” Then the first fundamental step is to ensure healthcare workers clearly being aware of the process of the incidence reporting, and the risk management system should be in place.

The doctors, nurses and the staff work in health care are trained to take care of the ill, the injured and the people who come for help. Sometimes they enjoy the extraordinary, wonderful moments when they witness their patients getting recovered. They are proud of themselves and their endeavors. The public media also extolls the pleasures of the medical achievement and disease cure by humans.

However not always it is perfect, and very uncommon for the general public to listen to health care workers complaining, about their frustration, tiredness, depression. Remember please, the health care workers do not agree to be attacked, insulted, or murdered. 

Another life was lost when she was taking care of others. Violence again wins. 

Enough.

References

1. Wilson S. Combating Healthcare Workplace Violence. 
Available from bestnursingdegree.com 

2. Arnetz JE, Hamblin L, Ager J, et al. Work, 2015, 51(1): 51-9. 
Available from ncbi.nlm.nih.gov

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About the Author

Dr Li Li graduated from Peking University with MD degree in 2004, worked in Peking University Third Hospital, Beijing, China as a licensed Gynaecologist for 6 years.  Then she received MBA degree from the Chinese University of Hong Kong. Since 2012, she has been working in the global headquarter of Bayer AG. She has published about 10 papers in the scientific journals and several posters in the international congresses.

Dr Li Li has an interest in enhancing the medical communication & education across countries, and a passion of supporting the activities to improve people’s health & wellbeing worldwide.

Dr. Li Li may be reached by email at li.li9@bayer.com or wannalof@gmail.com.

Again I am writing " Implementing lasting deterrents to Healthcare violence" There is a total of 17 deterrents to this.
There are a few that could cost the hospital a few dollars but not much.
Working with an emergency physician that knows what truly happens in the emergency room and will cover our backs as nurses, medical assistants, x-ray techs etc. is great,
Thank You DR. Charles Anderson for your help.

# 11 No Healthcare worker may be penalized for coming to the aid of another healthcare worker who           is being assaulted or abused.This would require a level of immunity.

# 12 Any healthcare worker who fears for the safety of another healthcare worker, a patient or a                  visitor may dial 911 at any time without fear of being disciplined by the hospital they work in.

 # 13 Any person that is deemed to be drug seeking by a physician may not be a candidate for a                   patient satisfaction survey,nor can a physician's decision not to prescribe                                               sedatives,tranquilizers.antibiotics or tests be used against him/her by hospitals.
         Physicians are  being forced to please drug seekers in the name of pleasing customers. A                     disproportionate number of violent people are under the influence of drugs or are drug seeking.
         High Press -Ganey scores mean that ED Physicians have given up doing the right thing. They             are ordering tests ,giving antibiotics ,and giving narcotics to get high scores.

# 14  An emergency physician may request the application of four point restraints by security of any            belligerent patient without the fear of retribution by administration. There would be guidelines.

#  15 The emergency physician may request that security personnel remain at the bedside of any                    patient the physician deems to be a threat.

# 16  All in-patient hospital and ED treatment area must wear identification badges.

# 17  An Emergency physician may request that security remove any relative,friend or visitor from               the premises of the hospital should the physician deem this person to be a threat of violence.

Speaking with Dr, Anderson was so refreshing! He knows what goes on because he worked it! Only a couple of these suggestions would cost the hospital money. However if it saves a healthcare worker it really wouldn't cost anything!



#7.  Uniformed,armed security personnel must be allowed to use non-lethal deterrents without fear of prosecution ( pepper spray, Mace and taser),

#8  Hospitals must be required to provide legal support for healthcare workers who sustain significant injury, or at the request of the employee.

#9  No Healthcare worker may be penalized for reporting an assault or abuse.

# 10 All verbal and physical assaults must be reported, including those by family, friends and visitor.


To be continued!

                                       Implementing lasting Deterrents to healthcare violence


                     I am continuing with my interview with Dr. Anderson, we are on #3,#4 #5 and six.

#3 Signage : Prominent signs using the word "NO" must be displayed throughout every hospital describing behavior that is not tolerated.
    How many of you have this type of sign??????

#4 Every type of assault or abuse must have a measured response from the hospital.

#5 Every hospital must be required to supply uniformed  armed security in the ED at all times. The first principle of crowd control is a show of force. The uniform and the weapon are powerful deterrents necessary to do this job whether you like guns or not.

# 6 Uniformed ,armed security personnel be authorized to restrain any person they deem to be out of control or a danger to healthcare workers or patients.including the use of hand cuffs, of course there would be guidelines. of course ,a certain level of immunity from prosecution would be necessary in order to insure that security personnel are hands on  My point is that non ED dedicated non uniformed, unarmed security personnel who are fearful of touching anybody is the norm at this time.

How are we doing so far? Any comments would be appreciated . Thank You
                                                     

                               Implementing Lasting Deterrents to Healthcare Violence




A while back I had an interview with DR. Charles Anderson on PWRN internet radio. We were discussing the violence in healthcare and what could we do about.I am writing the second of our list in Implementing lasting deterrents to healthcare violence.



Please give me your comments. 






#2 Rejection of the customer model of healthcare. This model has caused so many problems that it should be rejected by nurses and physicians. Patients are only customers in the eyes of ignorant marketers and greedy corporations. Medical decisions,the dispensing of controlled substances, the use of antibiotics,and the use of expensive and potentially harmful imaging procedures, should no longer be the prerogative of patients or customers.That is what Doctors are for.

Implementing lasting deterrents to healthcare violence

A while back I had an interview with DR. Charles Anderson on PWRN internet radio. We were discussing the violence in healthcare and what could we do about.I am writing the first of our list in Implementing lasting deterrents to healthcare violence.

                                                       What do you think?
Re- education of nurses. In some cultures, suffering in silence is traditional. In some cultures self-flogging is a virtue. Nurses need to agree on a ZERO Tolerance Policy for verbal and physical violence. No amount of pain,or delirium,or intoxication,or organic brain disease should excuse a patient from responsibility for his actions,or from being reported as an offender.We cannot dismiss aggressive behavior because it was unintended or because no bones were broken or eyes clawed out.
All assaults must be reported so that perpetrators can have their charts flagged. When a perpetrator registers the next time,hospital employers will know immediately if there is a history of aggressive behavior. Without 100 percent reporting, future injuries cannot be prevented. Being assaulted is never a part of a healthcare worker's job. A nurse who doesn't report verbal pr physical abuse is making it easier for a co-worker to get hurt later

Sheila Wilson MPH BSN R.N.

Is it Their Fault?

Whether or Not to Prosecute Someone with a Mental Illness

Guest post by Marie Miguel, writing and research expert with BetterHelp.com

Mental illness affects one in five people in the United States and one in 25 of them are serious mental illnesses. With so many that have mental health conditions, we need even more health care workers to take care of them. We need those nurses, doctors, and other healthcare professionals to care for those who cannot take care of themselves. Many of these people do not have anyone who can take care of them at home, or they are just too sick to be cared for by a layperson, no matter how much they want to be there for them. That’s why it is on healthcare professionals to do this important work.

You Just Want to Help People

Maybe you grew up always wanting to be a healthcare professional in order to help people and take care of them. You spend all those years working toward schooling and certifications to become the best you can be, and take your licensure tests and pass them with flying colors. Now, you’ve finally made it and are taking care of people like you have wanted to do since you can remember. Then you realize that even though you are supposed to take care of these patients, there may not be as much support to back you up if you get hurt – not in a workplace accident, but instead, by one of your patients.

Like a War Zone

Some days are better than others, and there are those days when you question your career path or even fear for your life. You may get slapped, punched, verbally abused, and / or threatened with death threats. It may feel like you are more of a police officer or soldier at war, but you are simply trying to help people as a healthcare professional. Whether you work in a nursing home, emergency room, or psychiatric ward with mentally-ill patients, there are going to be times that they act unpredictably, and you can get hurt. But what are the laws to protect you in these different cases of on-the-job abuse? When do they apply? Are you protected only if you have serious bodily harm? What if you are providing medical care outside of a medical facility? These different scenarios can be confusing.

Protecting Those Who Protect Others

Most patients do not intend to hurt you. They may be in a lot of pain, or have a mental condition that confuses them and makes them unable to regulate their emotions, actions, or both. That’s not to say that there aren’t those who really do want to hurt you, but they are few and far between, luckily. Whether your patients intend to do it or not, what are your protections from getting hurt on the job by your patients?

Is it Their Fault?

Less than 30% of medical personnel who are abused by their patients ever report their abuse, but the number of reports is still alarmingly high, as 75 of every 25,000 assaults in the workplace are medical professionals. Every year, more than two million people with serious mental illnesses are put in jail. As a healthcare professional, how can you know whether the patient is capable of being held responsible for their actions and able to be prosecuted? Most times, unless you are a psychologist or psychiatrist, you are not really able to make that decision. That is when it is time to call in a mental health care expert. Even the patient who seems quite docile and “normal” can have a mental illness without you knowing about it. This is especially true if this is a patient that is new to you.

Checking Their Records

A patient who is abusive or violent toward you is likely to have a record of being abusive or violent in the past. Getting their records and talking to people that have provided care for them in the past can often help you to determine whether they need mental health treatment or a police escort. Patients who seem quite “normal” one moment and then harm someone for seemingly no reason is usually suffering from some type of mental health disorder.

Symptoms of Different Mental Illnesses

An example of a common mental health diagnosis for patients that may be more likely to cause harm to others around them is bipolar disorder, and there are several types. Those that are diagnosed as having Bipolar I Disorder have at least a week of manic symptoms, alternating with at least two weeks of depressive episodes. Those with Bipolar II also have the depressive symptoms, but not as marked or intense manic episodes as those with Bipolar I.


If you have a patient who has a history of being full of energy and feeling like they’re on top of the world one day, and then has periods of sadness and not wanting to get out of bed on other days, you may need to have them evaluated by a mental health care professional, if they haven’t been previously.

Talk to a Professional

Many medical professionals and lawmakers are trying to pass laws to make it a felony for patients to harm those who are trying to take care of them, although these may not cover those who have mental illnesses. If you have a mental disability, you need medical treatment, not jail time, in most cases. But sometimes that is not possible.


If you are a caregiver who is in need of mental health support for yourself due to what you have been facing in your workplace, or have other personal issues where you could benefit from a mental health care professional’s expert opinion, consider contacting www.betterhelp.com for help today. You don’t need an appointment. In fact, you don’t even have to leave your home.

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About the Author 


Marie Miguel has been a writing and research expert for nearly a decade, covering a variety of health- related topics. Currently, she is contributing to the expansion and growth of a free online mental health resource with BetterHelp.com. With an interest and dedication to addressing stigmas associated with mental health, she continues to specifically target subjects related to anxiety and depression.

It isn't easy trying to get information and actually believing what I do get. A simple question can lead to some serious discussion and all I want is a simple answer,
So here goes!
1. What is the difference between contract guards and guards that are employed by the facility.

2, Who is responsible for the contract guards ? the facility? or where they are contracted from?

3.What is the level of training if they are contracted?

4.How do we as healthcare workers know what they can do and not do? Our lives depend on that!

5. How many guards are assigned to the facility? is it the same for contract ?

6.Who gives this information to the charge nurse of supervisor?

7.What if they are short staffed? Does that make it more dangerous for us?

8.How do we know if they are hands on or hands off?

9.Do any guards carry weapons? Tasers,pepper spray,mace How do we learn that?

 I am just curious if things have changed! I think it is important that we know what everyone is doing in this time of  this violence  epidemic against healthcare workers!

I was listening to a colleague as she was speaking to a group of nurses at a conference. She said a quote from this person that made me think! How true this is.


The expectation that we can be immersed in suffering and loss daily and not be touched by it is as unrealistic as expecting to walk though water without getting wet!
Rachel Remen
As nurses we see, hear ,touch, and feel so many things that this quote seems so perfect!

The violence has been out there and in our hospitals way too long. Many nurses lives have changed because of this violence.
Help us change the laws in MA. 

Bill # 795 a bill that could change the MA. Law to a felony instead of a misdemeanor didn't get passed! This bill could give healthcare workers more protection. 34 other states have a felony law for protecting their healthcare workers so why is it so hard for MA. to do the same.?????

I was reading an article titled The Traumatized Nurse.
In this article ,there are many writings on the violence other nurses have had, nurses leaving the job because they feel unsafe, Stories like :
I was threatened and will never be right again, .I have been threatened by family members , abused many times by patients, I was stabbed in the chest, I have been out of work due to the injuries I sustained by a patient. The response goes on and on. Maybe this isn't bad enough for some people ,Do they get assaulted on the job? How would they react if they got assaulted?
 Sheila Wilson MPH BSN R.N.