How America can stop violence against health care workers

“The severity seems to keep going up. It doesn’t go down.”

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The young man in Cleveland Clinic Akron General’s behavioral crisis intervention unit hadn’t communicated much during his hospitalization, but he showed no signs of violence until Brian Eckley tried to draw his blood early one morning.

The patient stood up, sat back down, rose again and then punched Eckley, a state-tested nurse aide and senior technician, in the left jaw.

Keeping his cool despite the pain, Eckley dodged more punches as he held the needle and tourniquet out of the patient’s reach, banged on the treatment room windows and called for help.

Attacks on health care workers have reached epidemic levels across the country, exacerbating turnover, turning caregivers into patients and further fraying systems of care already worn thin by COVID-19. The Workplace Violence Prevention for Health Care and Social Service Workers Act, twice passed by the House and just reintroduced in the Senate, would require employers to implement the safeguards needed to help keep Eckley and millions of his peers safe on the job.

The legislation—supported by numerous labor unions, trade groups and other stakeholders—would direct the U.S. Occupational Safety and Health Administration (OSHA) to develop a standard requiring health care providers to implement safety plans for clinics, hospitals, nursing homes, rehabilitation centers and other treatment facilities.

The bill calls for facilities to consider measures such as alarm systems, physical barriers and strategic staffing, including having workers in hazardous situations operate in teams. To ensure the plans are as comprehensive and effective as possible, facilities would have to devise them with the input of workers on the front lines and address the specific hazards in each work area or unit.

“Having a safety officer on the unit 24/7 would be a wonderful first step,” observed Eckley, a member of United Steelworkers (USW) Local 1014L, who had calmed down his combative patient by the time a security guard in another part of the hospital complex arrived at the behavioral health unit.

“They just don’t have what we need to do the job safely,” he said of health care employers around the country. “They do the bare minimum, and it’s more reactive than proactive.”

Even before COVID-19, health care workers faced five times more violence on the job than their counterparts in most other professions. Incidents skyrocketed during the pandemic as the crisis exacted a heavy toll on Americans’ emotional health and patients, relatives and community members grew frustrated with staffing shortages at medical facilities.

The violence is now so pervasive that many health care workers are victimized over and over again. Eckley, for example, has been punched repeatedly, stabbed with a pen, and bitten by an HIV-positive patient who disliked the meal he was served. He’s also witnessed numerous attacks on coworkers and once watched a patient batter a door to get to a jar of candy on the other side.

“This is absolutely unacceptable,” Wisconsin Senator Tammy Baldwin, the legislation’s chief sponsor in the Senate, said of the surging number of assaults. “We know we need to do more to protect these workers.”

Under the legislation, employers would not only have to implement safety plans but also train workers to report assaults, conduct real investigations when incidents occur, keep records of injuries and ensure workers get immediate treatment when harmed.

Right now, as Jackie Anklam, president of USW Local 9899, knows all too well, many facilities across the country minimize incidents, dismiss assaults as part of the job, or try to pin the blame on the victims.

Anklam recalled getting a frantic phone call late one night from an emergency department technician at Ascension St. Mary’s Hospital in Saginaw, Michigan, who was pushed and threatened by about 20 highly emotional family members who gathered at the facility after a loved one arrived there with a fatal gunshot wound.

The victim’s relatives somehow managed to enter a locked treatment area off the waiting room, and Anklam said the technician was roughed up while following a doctor’s orders to usher them out. Anklam said she expected a robust investigation given the family members’ dangerous breach of a secure area.

Instead, she said, “we reported it, and their investigation was, ‘they don’t know who pushed the button and let them in.’ I think it was downplayed and swept under the rug.”

Amid tireless advocacy by health care workers and their unions, the Democratic-controlled House first passed the violence prevention bill in 2019. But the Senate, then controlled by Republicans, refused even to bring it to a vote.

Under the leadership of Connecticut Representative Joe Courtney, the House passed it again last year with bipartisan support. Now, it’s more crucial than ever that the Senate swiftly take up the bill and pass it.

Some states have attempted to address the crisis by considering or passing laws imposing stiffer penalties on people who assault health care workers. But Eckley and his coworkers know it’s even more essential to prevent violence in the first place.

“As time goes on, it will grow,” Eckley warned, noting attacks are becoming not only more numerous but also more brutal. “The severity seems to keep going up. It doesn’t go down.”

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