Violence in the workplace is a rising concern among healthcare professionals. In the Clinical Congress session, Surgeon Safety: When a Patient Becomes a Threat, panelists described the surging violence and offered ways surgeons can keep themselves safer. Amy E. Liepert, MD, FACS, from the University of Missouri in Columbia, and M. Timothy Nelson, MD, FACS, from Oklahoma University Health Physicians in Tulsa, co-moderated the session.
Multiple panelists cited the same stark statistics: 73% of nonfatal workplace injuries occur in healthcare, workers in healthcare are five times more likely to experience violence than in any other profession,1 and approximately 50% of healthcare workers report verbal and/or physical abuse.2
Three panelists then shared information about personal experiences with violence. Dr. Liepert read a victim impact statement she had presented at the sentencing of a former patient convicted of stalking her. The statement made clear the profound difficulties the situation caused for her life and career.
Jay J. Doucet, MD, FACS, from the University of California San Diego, connected workplace violence with the work of military surgeons. Through six tours in Bosnia, Afghanistan, and Iraq, he provided surgical care while experiencing the risk of harm to himself and other substantial risk factors for post-traumatic stress disorder (PTSD). He emphasized that civilian medical staff are subjected to many of the same risks through workplace violence and that appropriate violence prevention, plus support and accommodation of affected employees, are important to preventing PTSD. A colleague of Dr. Liepert’s at the time of her stalking, Dr. Doucet also noted that institutional failures had exacerbated risks to her.
Nathan J. Powell, DO, from the St. Francis Health System in Tulsa, Oklahoma, shared his experience with a mass shooting on June 1, 2021, during which four people died, including orthopaedic surgeon Preston J. Phillips, MD. After walking through the events of the day, Dr. Powell noted that eight shooting incidents that had occurred in healthcare facilities in 2023 alone.
“There are many, many challenges that come about because they’re in a hospital,” Dr. Powell said of such incidents, including facilities’ innate openness to thousands of people per day and the complexities of aiding seriously ill patients amid violence.
He noted that active shooter response training can be helpful. At his hospital, one training occurred 6 weeks before the June 1 shooting: “That may have saved lives that day.”
Carter K. Lebares, MD, FACS, from the University of California San Francisco (UCSF), directs the UCSF Center for Mindfulness in Surgery. She said, “Nothing can take the place of institutional resources that protect people,” including metal detectors and security guards.
But she also shared that mindfulness training, a type of meditation, is now part of military preparedness to strengthen service members’ well-being and proactively mitigate mental trauma. She cited the Center’s Enhanced Stress Resilience Training for Residents, a program that modifies a mindfulness-based stress reduction curriculum for resident physicians.
Finally, Joseph Dalu, a former law enforcement officer now affiliated with a security corporation in Mission Viejo, California, shared tips for threat assessment and mitigation, including walking in groups to vehicles, maintaining adequate lighting, and using legal and digital protections to limit public access to one’s name, address, and other vital data.
Dr. Liepert added recommendations for preventing workplace violence, including management heeding concerning behaviors, zero tolerance for bullying, adequate security measures and procedures, fair and consistent disciplinary procedures, and a trained threat management team. She further suggested supporting HR 2584, a federal bill to protect hospital personnel from violence.
“There is nothing more important to ensuring excellent patient care than ensuring our own health and safety,” she commented in an interview.
“Don’t lose the caring nature that brought you into this field,” Dalu added at the end of his talk, a comment many speakers echoed.
References
- US Bureau of Labor Statistics. Injuries, Illnesses, and Fatalities: Fact Sheet, Workplace Violence in Healthcare, 2018. Published April 2020. Accessed October 27, 2023. https://www.bls.gov/iif/factsheets/workplace-violence-healthcare-2018.htm
- Turner PL. How the ACS Can Help Surgeons Address Workplace Violence. Published September 11, 2023. Accessed October 27, 2023. https://www.facs.org/for-medical-professionals/news-publications/news-and-articles/bulletin/2023/september-2023-volume-108-issue-9/how-the-acs-can-help-surgeons-address-workplace-violence/
