LITTLE ROCK, Ark. — The emergency room is a place where people go in their moments of greatest need. As doctors, nurses, and other healthcare providers work to help ER patients, they face a growing problem of their own – workplace violence.
An average of 165 to 170 patients seek treatment in the UAMS emergency department (ED) on any given day, and that number is on the rise.
Melissa Easdon, director of the UAMS Emergency Department and Clinical Decision Unit, says patient volume has created challenges for hospitals nationwide.
“There’s not enough primary care physicians in the country,” Easdon said. “Even for people who have primary care doctors, it can be difficult for them to get transportation to the doctor or find time in their busy schedule, which means people come to the ED for all sorts of problems – not just those life-threatening injuries you think about being treated in the ED. That turns into longer wait times, and people get very frustrated.”
Easdon said those frustrations can sometimes turn violent.
“Most people have an image of nursing as being a very calm and comforting and caring profession, and we do try to do that as much as we can, but we face a lot of violence from our patients,” Easdon said.
In a nationwide survey of more 7,000 emergency nurses, 54.5% said they experienced physical or verbal abuse during a seven-day period. Meanwhile, nearly 70% of emergency physicians who responded to a 2018 survey said emergency department violence is increasing.
"We have a triage acuity level, and sicker people get seen faster," Charity Strahs, a registered nurse in the UAMS Emergency Department, said. "It makes people very unhappy, and we would more than like to take care of people's issues as fast as we can, but unfortunately we don't always have the resources to make that happen."
Strahs has dealt with workplace violence throughout her 10-year nursing career and witnessed its impact on her colleagues.
“It's almost a daily verbal assault,” Strahs said of her own experience. “I have been physically assaulted. A few months ago, I was attacked and had to press charges against someone for battery. It’s not the physical that happens all the time, but it will mess with your head and it makes it a lot more difficult to come in and want to do your job because you don’t know who’s going to attack you.”
UAMS has a number of measures in place aimed at creating a safer environment for patients and employees. That includes a Workplace Violence Task Force that reviews every reported instance of violence, analyzes trends and proposes solutions.
A sign posted behind the emergency department reception desk outlines the hospital's expectations. It reads in part: "This hospital has Zero Tolerance for abusive or violent behaviors toward staff, patients or guests." It says violation could result in removal from the area and/or legal action.
In addition to a security guard staffing the entrance, UAMS has its own police department with officers on-site at all times. Patients and guests entering the ER waiting room go through a screening process that includes walking through a metal detector.
"We have panic buttons throughout the department, so if anyone is attempting to assault a healthcare worker we can push that button," Easdon said. "And that immediately summons a police professional and we have the rest of the staff that jumps in to help their coworker."
Strahs says safety training, tools and support of UAMS leadership provides a level of comfort.
"We're trying the very best we can," Strahs said. "It's not that your needs don't matter they really do we want to resolve them and we're doing the best we can with the resources we have available."