By Dr. Seleem R. Choudhury

Originally published by the Caledonian Record, Apr. 4, 2019

The Dalai Lama once said, “To earn trust, money and power aren’t enough; you have to show some concern for others. You can’t buy trust in the supermarket.”

In January 2019, nurses were again voted the nation’s most trusted profession. For 17 years in a row, nurses have earned their spot at the top of the list by a landslide. In a funny sort of way, when I mention this statistic to people, no one is really surprised. Many people in the Northeast Kingdom tell me about the love and affection they have for their nurses and other health care workers. An important and trusting relationship blooms between health care workers and patients and their family. It is a privilege to be held in high regard and to be so explicitly trusted by a stranger.

In stark contrast, nurses and other health care workers also experience instances of verbal and physical violence. In the United States, the rate of violence against health care workers is 3.8 times higher than any other occupation, excluding law enforcement. There are nearly as many serious injuries as a result of workplace violence in health care than all other industries combined. Perhaps what’s more troubling is that the number of violent incidents involving health care workers is likely higher than reported, and ironically, non-reporting may contribute to an increase of workplace violence.

What causes health care workplace violence? Does the law require health care facility employers to take certain actions to prevent violent acts at work?

I had a colleague who would often motivate her staff by saying, “We should be the best part of someone’s worst day.” She would say that as a reminder that nobody wants to be hospitalized for surgery or medical care, or to seek treatment from an emergency department. Health care workers see individuals and their families during their scariest and most vulnerable moments. Add to that the pain, fear and uncertainty that often accompanies health care visits or procedures; any number of personal, emotional, logistical and financial problems that patients and families may face; and an open-door policy that allows the public to enter freely, and it’s not surprising that emotions can run high and routine interactions can escalate into dangerous confrontations.

In some ways, this creates the “perfect storm” for violence against care providers; however, violence against someone who is trying help you is not ok. In fact, violence against any individual is not acceptable, said Lt. Robert Clark, of the Caledonia County Sheriff’s Office.

“Hospital staff look at all patients as equals and should be able to feel safe while providing that care,” Clark said.

People seeking care for a health-related issue often experience heightened emotions, which they may express through negative behaviors. In health care, these behaviors are sometimes justified as being part of the job even though they are clearly inexcusable. Fear of experiencing verbal or physical violence can have an impact on how well a health care provider is able to do their job.

Several strategies have been adopted and several law changes have been made in recent years to help mitigate and deter violence against health care workers. Certain professions in Vermont are considered “protected,” which means that assaults that are committed against workers engaged in official duties in those professions are punished more severely. Health care is now considered a protected profession. This change has encouraged hospitals in the NEK to shift away from acceptance and non-reporting of workplace violence.

Health care providers and organizations have taken a stance against workplace violence in our community by implementing initiatives such as mandatory reporting to law enforcement, preparedness drills and de-escalation training. It’s believed these strategies will raise awareness and decrease the number of assaults that occur in our hospitals, clinics and community, thereby, enabling nurses and other health care workers to provide the best possible care.