Understaffed ERs Lead to Abuse?

Seven Mondays in a Week: The Consequences of Society’s Decline in Civility Part 1

Would you look forward to work each day if you knew there was a possibility you would be verbally or physically abused?

Emergency departments are experiencing an increase in use by the public. Hospitals are unable to keep up. An analysis of this use points to one unintended consequence of a non universal private health care system. The emergency department of a hospital is the only location in an overburdened health care system where any patient who shows up must be treated regardless of ability to pay. With state facilities and programs for mentally ill citizens, and those suffering drug addiction being eliminated these patients often end up in emergency wards. Visits to emergency departments(ED) for alcohol or drug related incidents are on the rise.

Emergency departments are often overcrowded. Overcrowding is defined as all beds in use and the waiting room full for more than 6 hours a day, patients placed in halls, and seriously ill patients having to wait more than 1 hour to see a doctor. (1)
Long waits are more then rule than the exception. Add sickness, trauma, mental illness and drug use to the lack of privacy, and a less than ideal situation is created for patients to appropriately cope with stress.

Nurses who execute care and spend the most time in triage and treatment suffer the brunt of patient and family frustration. They are subject to verbal and physical abuse at unacceptable rates. Studies have shown that health care workers are the most likely to suffer workplace violence after prison guards and police officers. In a profession where healing and mercy are requirements it is disturbing that nurses are subject to these assaults.

Nurses are abused verbally by been sworn or yelled at, or called names. Physical violence includes being spat upon, scratched, hit, slapped, kicked, or stabbed. Injuries can range from the not visible to months taken off work for severe injuries.

The Emergency Nurses Association believes that violent incidents are underreported according to a recent survey. Nurses often don’t report incidents. They fear it will reflect badly on them as being less than competent. Or they believe that the administration will not take them seriously or be indifferent. They do have some basis to believe that as up to 75% of medical centers do not respond to reported workplace violence. Also many institutions do not have workplace violence policies or prevention programs. Nurses also believe that abuse by patients and families are part of the job. In some cases they can empathize with the scenario that created the violence. Often they believe if they press charges that the perpetrator will escape conviction because they were mentally ill or high on drugs.

The conclusion in part two next week.