Frontline health workers face increased violence, harassment — mostly from patients

LILO H. STAINTON, HEALTH CARE WRITER | JUNE 27, 2022 

NJ Spotlight News

Most violence against NJ hospital workers in 2021 was by patients.

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Hailed as heroes two years ago, frontline health care workers in New Jersey are now facing growing levels of verbal threats, harassment and workplace violence — most of it from patients under their care.

New Jersey hospitals reported nearly 10,000 violent incidents involving their staff during 2021 alone and a nearly 15% increase in these attacks over the past three years, according to data released Thursday by the New Jersey Hospital Association.

Half the cases involved physical abuse, the hospital association found in the recent survey, with 84% perpetrated by patients — including the South Jersey patient who hit an emergency room nurse in the head with a wooden board, putting her out of work for weeks.

“The terrible irony is that those who dedicate their lives to healing others are the targets of increasing violence and aggression,” said NJHA president and CEO Cathy Bennett. More than two dozen incidents are reported daily in hospitals here, and the vast majority occur in emergency rooms, NJHA found.

“We can only speculate on why these incidents are rising and the degree to which the tensions of the pandemic and our polarized society are part of it,” Bennett said. “Our goal with this report is to provide reliable data on the depth of the problem and prompt a much-needed public dialogue on our collective responsibilities to keep New Jersey healthcare workers safe.”

But the problem is not new

While hospital-based workplace violence is on the rise, the problem is not new. Even before the pandemic, health care providers were five times more likely to experience violence on the job than other workers, and their injuries accounted for nearly three out of four incidents reported, according to federal data from 2018. A survey conducted by the state’s largest nursing union in 2005 found three in 10 workers had experienced violence within the past five years.

The federal Department of Labor in 2010 reported a 13% increase nationwide in health care-related violent incidents over the previous year yet said the workplace violence is significantly underreported. Federal officials urged hospitals to take steps to reduce the risk of violence, which beyond the physical and emotional harm can depress overall morale and productivity.

Dennis W. Pullin, president and CEO of Virtua Health, which runs several hospitals in South Jersey, said the hospital association’s data is distressing, especially since many violent incidents go unreported.

“I’ve spoken with several frontline workers who have come to think that encountering this sort of bad behavior is simply ‘part of the job,’ and that is entirely unacceptable,” he said. “We are a community and we must support one another as a community.”

Health care advocates agreed the data is an undercount and said employers have a critical role to play in reducing risk. Debbie White, president of Health Professionals and Allied Employees, or HPAE, which represents about 14,000 frontline workers in New Jersey, said the trend reflects problems outside hospital walls. “The pandemic itself probably escalated a lot of anger within society itself,” she said, “and of course the uptick in mental health” challenges.

White said the problem is also exacerbated by ongoing staffing shortages, which can make hospitals less safe for staff and patients alike. “I am glad (the NJHA) finally acknowledges this is a huge problem,” she said. “But they’ve played a role in this. (Hospitals) are always staffing as lean as possible to maximize profit margins.”

Doug Placa, executive director of JNESO, whose members include 5,000 health care workers here and in Pennsylvania, agreed hospital operators needed to do more to promote safety. JNESO workers recently settled a 31-day strike with St. Michael’s Medical Center in Newark and Placa said safety — both in the hospital and around the staff parking lot — were important negotiation points. “The last couple of years (workers) have made safety a priority,” he said. “COVID really opened a lot of eyes.”

“Nurses (and nursing assistants) don’t need to be looking over their shoulder for someone swinging a big piece of wood at them,” Placa said. “Management has got to be held accountable.”

Criminal charges

Then-Gov. Jon S. Corzine signed a law in early 2008 designed to reduce health care workplace violence. It requires hospitals, nursing homes and other health care facilities to establish committees to identify risks in the layout and design of buildings, considering security and staffing levels, and patient population to create a violence-reduction plan. It also requires facilities to post these policies clearly.

New Jersey lawmakers are now advancing legislation that would enable the state to criminally charge people who are violent with health care workers and allow courts to consider the victim’s employment as a factor in sentencing. The measure — the Health Care Heroes Violence Prevention Act (A-3199/S-2008), backed by Assemblyman Louis Greenwald (D-Camden) and Sen. Troy Singleton (D-Burlington) — has passed the Assembly with unanimous support and awaits a hearing in the Senate budget committee.

“We could have not gone through the last two years without the dedication of our frontline healthcare workers. They are truly heroes in this pandemic,” Greenwald said after the Assembly vote in mid-June. “These repeated acts of violence against our health care heroes are simply just unacceptable.”

Pullin, with Virtua, said he was part of a group of hospital CEOs who joined forces to advocate for the legislation to increase penalties for violence against health care workers and lobbied to be sure it included all staff, not just physicians and other clinicians. He published an op-ed in the business magazine ROI New Jersey in February, arguing for a return to civility in health care, and collaborated with fellow hospital leaders on an opinion piece on gun violence that ran recently on NJ.com.

“I invite everyone to consider the emotional safety and wellbeing of the people we turn to when we need care,” Pullin said. “These folks have never wavered from their commitment to us — despite all the challenges and unknowns of the past two years. Let’s show them respect and kindness in return.”

Placa and White said they appreciate these efforts, but sentencing changes don’t go far enough to improve safety. “Employers have got to recognize they played a role in this uptick” of violence, White said.

Some hospitals take steps

Some hospitals are taking real steps to address this problem, labor leaders said. White praised initiatives at Bergen New Bridge Medical Center — the state’s largest hospital, in Paramus, which treats many patients with psychiatric needs and substance use disorders — and Inspira Health, which runs several hospitals in South Jersey.

AtlantiCare, with a hospital system based in the Atlantic City area, has also taken steps to reduce workplace violence, according to NJHA. With the hospital association’s support, AtlantiCare created a one-minute YouTube video that acknowledged the hardships and violence hospital workers faced recently and praised their commitment, especially during the pandemic.

“I propose that we consider kindness as another social determinant of health,” nurse Lori Herndon, president and CEO of AtlantiCare and NJHA board chair, said in the video. “It is a fundamental human trait that connects us all and it may be the glue that we all need in this trying time.”

At Virtua, Pullin has instituted anti-violence workplace policies and made sure signs promoting tolerance are clearly posted at all the system’s facilities. He has also made templates available to other health care providers, Virtua said.

“Emotions inherently run high in health care settings, but that does not excuse rudeness or abuse, especially toward people who have proven their selflessness and commitment to serving others,” he said. “The frontline workers I speak with don’t want to be treated as heroes. They simply want to be treated with dignity and respect.”

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published this page in News and Politics 2022-06-27 02:40:47 -0700