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Elaine Thompson / AP
Jeaux Rinehart, president of the Washington State Emergency Nurses Association, said he's not surprised by a new survey that shows violence in the ER remains high, with more than half of nurses reporting verbal assaults and more than 1 in 10 experiencing physical attacks.
Rinehart was beaten in the head by a patient in 2007.
Tammy Mathews was working a late-night Sunday shift in an Alabama emergency department when a patient, drunk and high on drugs, grabbed her around the neck, choked her until she couldn’t breathe -- and then spat in her face.
Jeaux Rinehart was staffing a Seattle emergency room when a patient in a triage room, upset that he couldn’t get methadone, pulled a billy club out of a backpack and beat Rinehart in the back of the head and across the face, breaking his cheekbone.
So neither Mathews nor Rinehart was surprised to learn that an ongoing poll of nearly 7,200 emergency nurses finds that violence in the ER remains high, despite increased attention to a problem that leaves some health workers worried about danger every day.
“It’s so global,” said Rinehart, 51, president of the Washington State Emergency Nurses Association. “It’s actually getting worse.”
According to latest figures from the national Emergency Nurses Association, between January 2010 and January 2011, more than half of nurses in the ER -- 53.4 percent -- reported experiencing verbal abuse and about 13 percent said they had encountered physical violence at work in the previous week.
Being grabbed or pulled was the most common physical assault, while yelling and swearing were the most common kinds of verbal attack.
That’s about the same rate previously detected by the ongoing survey conducted by the ENA starting in May 2009. The Des Plaines, Ill., association surveys nurses at three-month intervals, partly to determine if the problem is getting any better, said AnnMarie Papa, the group’s president.
Frustrated, she admitted that it isn't.
“It’s upsetting to me that we can’t change the culture,” Papa said. “What is this with society that says it’s OK to do this to people who are trying to help them?”
Nurses on the front lines, like Mathews, 49, of Auburn, Ala., say that long waits, crowded conditions and growing numbers of mentally disturbed patients all exacerbate the stress of emergency department visits.
“Tempers kind of flare up and it just happens,” said Mathews, who was assaulted in 2005.
Both Mathews and Rinehart have worked in emergency departments for decades and they say they’ve come to expect vile treatment by patients and their families.
“I’ve been called things that, honestly, I have never even thought about putting those words together,” said Rinehart, who was attacked with the club in 2007.
The problem has received serious attention in recent years. At least 25 states have strengthened penalties for attacking health care workers and a growing number of hospitals have bolstered both physical security measures and staff training, according to the American Hospital Association.
At Virginia Mason Medical Center in Seattle, the hospital where Rinehart works, a new emergency department opened just last week with greatly enhanced security features, among other amenities, according to spokesman John Gillespie.
But that progress hasn’t curbed the crisis, said Papa, who advocates a zero-tolerance policy to stop ER violence. Only about a third of nurses actually submit formal reports about physical violence and less than 15 percent report verbal assaults, the survey found. That might be because in almost half of cases of physical violence -- 46.7 percent -- no action was taken against the perpetrators. In nearly three-quarters of cases -- 71.8 percent -- nurses received no response from hospital officials about the assaults.
In Mathews’ case, she said the hospital wanted her to drop assault charges against her attacker, and that officials fired her when she refused. She works in the emergency department of a different hospital now and she says she's still wary of erratic patients. Rinehart said he has transferred out of the emergency department to focus instead on patient safety.
“I miss it, but I don’t miss being called every name in the book," said Rinehart, who worked in ERs for 32 years. "I miss it, but I’m not going back.”
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That nose! That nose! How many rum and cokes does this guy suck down before going on duty. That nose! Left hook. Splat!
A really drunk man who had been in a motor vehicle accident reached up from the ER gurney while I was checking his pupils and grabbed both my breasts REALLY roughly. I had trouble releasing him and he left bruises. What I found interesting was that he was convicted of drunk driving, but I, as a medical worker, could not get a charge of assault made. I think basically sane people under the influence need to be held accountable for their actions no matter where they are. It is sad he has an addiction, and I can feel compassion and act compassionately, but anyone who abuses me should be held responsible for his actions.
Did you continue to work at the facility that wouldn't let you press charges?
Or was it someone else, like the prosecutor who wouldn't let you press charges?What excuse did they give?
Yeah, it's a whole different ballpark for us female techs/female nurses. Not only is there the verbal (which I can deal with), the physical, but there's the sexual violence and sexual harrassment.
People make arguments about how being hurt and scared turns them into @!$%#s, but how does being hurt make you grab my ass and say incredibly lewd thing about "i wanna **** your **** and **** your **** baby"?
Reinhart would be perfect for the W.C. Fields part in a remake of "The Bank Dick." Reinhart's nose is a clone of W.C. Fields' nose. Combination. kapow! Kabaam, Kaboom.
His face ould make a good target for the baseball pitching booth over a water tank in Coney Island.
There should be video and sound recording everywhere in the emergency department. It should be a felony and not within the influence of the administrators who only care about profits. Any falsification by the administrators should also be a felony. Ultimately, the greed of the jerks in control is the real source of the problem.
Don't u just wanna smack the crap outta the minions of the Medical Industrial Complex. Occupy , Roosevelt, New York Downtown, harlem, Bellvue and Mount Sinai Hospitals and kick the crap outta the running dogs of the medical Industrial Complex. LOL
The Khmer Rouge mhad it right. Send all the Doctors, Drug Company Salesmen and executives, researchers and their lawyers to the countryside to pick lettuce. Power to the people. Occupy Mount Sinai Hospital.
Sounds like you been drinking some of Tom Cruise's Kool-aide.
They're watching you, aren't they? Is this 'medical industrial complex' you speak of monitoring your posts, trying firgure out how to detain you again so they can keep getting Gov't reimbursement for the meds they 'force you' to take?
Maybe. Is Pfizer, Abbott labs, Purdue Pharma and Endo watching u?
I think one of them supplies the med he's not taking, LOL!
62 deleted, Johnny N. derailing about how 'minorities have no self control'. Keep the racism to yourself, post on-topic. You're suspended for a day for violating #5 of the Code of Honor.
leftsux suspended for a week for violating #4 and #5 of the Code of Honor with really obvious off-topic trolling. Don't do this again.
No. They're just flooding the country with xanax, Bextra, oxycontin, percocet, vicodin, lorazapan, acetaminophen and semi synthethic opioid mixtures and this week alone killed 2 20 something year olds at the Vancouver OWS demonstration and a rock muscician who was found dead on his tour bus. Michael Jackson's so-called Dr. convicted of involuntary manslaughter. The CEO bundler for Pfizer handed Obama's reelection campaign $500,000. 400,000 American deaths since 1995 due to accidental rx drug poisoning deahs and countless others maimed and addicted. Your profession is starting to surpass auto mechanics, lawyers and politicians in the public disdain sweepstakes.
And I suppose they forced those people to take those meds, too, huh. Every acetaminophen bottle I've ever seen warns against the dangers of overdosing. Every prescription bottle says not to exceed the prescribed dosage. Can they not read either?
I thought OSHA was supposed to have regulations to protect the worker. Has anyone looked into its coverage for healthcare workers?
I did once as a home health nurse, when my employer was trying to force me to travel alone into an extremely dangerous high crime area and even make night visits there alone.This was after they had lied about where I would be working prior to hiring me.
I was terminated for contacting OSHA.
I thought OSHA was designed to provide a safe working place. Has anyone looked into its regulations for healthcare workers?
I agree, all I can say is it dosen't have to happen. I'm aware of the post that states "no person may be turned away" (wich drains our system due to the influx of illegal aliens useing our system, the drug heads and the gangsta' gun shot retards wich should kill each other in a far away location and free us of haveing to look at them and their goofy clothes-not refering to inocent bystanders just shopping or whattknott) but you are right. Their are laws even at the Hospital level that can be enforced to stop this.
If you are white and defend yourself however it is a hate crime if the attacker is not white also.
So nurses who are trying to save lives are being attacked for their dedication. No good deed goes unpunished.
This is sad but true. I was formerly the safety committee lead at the hospital where I worked. We had many ER nurses hurt their backs dealing with combative patients. However, we had much more severe injuries - broken noses, broken ribs, facial scratches and lacerations, etc. All of these became more and more common as time went by.
We tried to adopt a zero tolerance policy in which the nurses were required to report any assault to the police. We were advertising the policy so patients would know that violence was absolutely not acceptable. Unfortunately, we could never fully implement the policy because of pushback from the nurses and resistance by the nursing union.
The nurses continually made excuses for the violence, such as "the patient was on narcotics so didn't understand what he/she was doing." We tried to make it clear that the police were the ones who would decide the person's mental state. We just could not get buy in on an individual basis.
The union was fully against such a policy because they felt it would place too much reporting responsibility on the nurses. I really don't understand that point of view. I thought unions were designed to protect their members.
I truly believe that we need new laws and a whole new mindset about violence against healthcare workers. Maybe this survey is a good first step!
Not that many hospitals actually have unions for nurses. In some states its illegal for RN's to unionize entirely. Nurses have a higher tendency for co dependence than average, we are very protective of patients even when its not in our best interest. Not a great excuse but trying to explain.
My experience as an ER and ICU nurse included some of the same abuse. Being big and male may have prevented more, but so did an ability to establish rapport and open communication. Unfortunately, no therapeutic communication technique is going to work with somebody on a bad trip, an advanced disease related state of agitation, or who's just plain dangerous with or without drugs.
Sadly, when bedside caregivers get hurt by patients, they are often victimized again by their employers "risk-management" policies, short staffing, and pressure to get back to work before they are ready.
No one said a word about the rest of the staff that takes c*** off patients. We all do, not just nurses. Some nurses are just as whacko as the whacko patients!
I didn't read every post above but I saw so many that said we need more laws and tougher prosecution. BS
We already have laws about physical abuse and battery.
What we lack are judges that will put these pieces of crap in jail and jails big enough to leave them there. They don't need to get out nor should it be extremely expensive to keep them in jail.
No coddling them, no AC in the summer, 60 degrees in the winter, no TV. You can have all the yard time you want to be free.
There is no doubt that these offendors are sick, but it is more digusting that our court and prison systems let them out to do it again.
I can't really blame the offendors but if we locked them up and did not let them loose again to hurt others yet again and to spawn more of them we could end this cycle.
But no, we spend money to make them "better" people and let them hurt others again and again and again..
People in the ER are there for a reason, they're scared, on their death bed, wigged out on alcohol and drugs, you name it. You can't expect people in that situation to be calm and serene. There should be policeman or security guards or something in the ER to protect everyone from the crazies.
Maybe there should be but Administration doesn't want to spend that kind of money. Therefore, there aren't police or security present. So now what's your solution to those scared, dying, wigged out patients who want to injure staff members?
They usually end up strapped to a bed that can be pushed into a looney wagon so they are pawned off to the poor mental ward staff. However if they are walking around town in their underware here it's ok. A police man said It's not a crime to be crazy, I'd love a T-Shirt with the Heath Joker saying that. so I guess it only aplies if someone is attacked. Oh I was still refering to the ones doing it on purpose but sadly I think the same thing happens even when they can't really help it. If they can't afford the mental health care I think things get even worse. But not makeing fun of the real thing I never know what side to take on the whole insurance bit. Some of it seems socailist but then it's better then dieing on the street insane.
What a country. So much shame! What scum we raise.
Although I am not familiar with the law and Mathews' abuse incident, she should have persued a "wrongful termination suit" against the hospital.
Here is a true report of how one physician doing an residency at a Kaiser (sp?) Hospital in Los Angeles or the San Diago area ( I forget which one it was) dealt with one out of control emergency room patient. True story. It was a weekend night, late and "Dr. L." was on night duty in the E.R., when who should be brought in so drunk he could barely walk but Silver Screen Legend, Micky Rooney. He had either fallen or been in fight and had facial injuries requiring attention. Rooney was an angry drunk, beligerent and uncooperative, cursing and generally being a soused ass. Any way, the staff tried to settle him in a treatment alcove, and an E. R. Nurse entered and began to examine and clean his wounds. At that point Rooney hauled off and spat in her face. Blinded with odious spittle, the Nurse nearly fell backward. Dr. L. had entered the alcove just in time to catch Rooney's performance. Dr. L, about 6'3", All American La cross, walked over to Rooney, grabbed him by the scruff of his neck, pulled him off the examining table, marched him out of the treatment area, through the E.R. Intake area, calling to the hangers on who had brought Rooney to the Hospital, told them to follow him, and reaching the entrance doors to the Hospital's E.R., push them open and all but tossed Rooney out through them, telling him and his entourage to not ever come back to Kaiser E.R. Now that took place about 50 years ago and people were generally more civil then unless they were celebrities who thought they ruled the world. Well. Rooney learned he didn't that night. It's a shame my physician friend passed away a few months ago, because his no nonsense chivalry and professional standards of conduct he would not accept in the E. R. on his watch, are sorely needed today. Perhaps it's time that the hospital E.R. Staffs, Nurses and Physicians, take a stand as my friend did half a century ago and defend themselves. forcibly expelling any individual regardless of his or her need of treatment, who assaults or attacks the staff or other patients. Let an ambulance or their friends or family take them to another hospital. I guarantee they will behave better at the second hospital having been tosses out of the first one. If their condition worsens during their journey between hospitals, that is a risk they brought on themselves when their hostility made it impossible for them to receive the treatment they needed at the first hospital. Sure they will try to sue the Hospital and staff which expelled them, But they won't prevail once the details of their disruptive, violent or abusive behavior is testified to. Hospital managements need to develop some backbone as well as another helpful, male anatomical feature, and stop this hooligan nonsense in their E.R.s now before some staff member is killed. Now that's a law suit that would stand a chance of going all the way to the jury. And we all know how generous Juries like to be when those in positions of power and authority who could have stopped or corrected a dangerous situation, but didn't, and someone in their employ is seriously harmed as a consequence.
The medical profession is not the only one that gets verbal abuse from people. The law profession is as bad - just not the physical abuse. Clients all think they are the only clients we have, and that anyone who answers the phone must know who they are and all about their case. Being in a large law firm with 15 attorneys and 20 employees, and many areas of law practiced, that is impossible, but try to explain that to the client! They can really get verbally abusive and then if you try to calm them down, they want your name and the senior partners name so they can report that you are rude to them!! Why do people have to be so darn RUDE anyway?
Yeah, but lawyers deserve a good beating...
Because you are a lawyer. People don't like them for a reason. They overcharge and run the edge of being a thief.
No sympathy for lawyers. None. The law profession is bad. We have more lawyers per capita than anywhere else in the world.
Used car salesmen used to be on the "top / bottom" of the list but lawyers won that spot hands down about 15 years ago.
Because you are a lawyer. People don't like them for a reason. They overcharge and run the edge of being a thief.
No sympathy for lawyers. None. The law profession is bad. We have more lawyers per capita than anywhere else in the world.
Used car salesmen used to be on the "top / bottom" of the list but lawyers won that spot hands down about 15 years ago.
I, too, am a former emergency room RN and can also relate many many instances of verbal and physical threats and actual assaults against myself and co-workers. And it is not limited to ERs--I have also worked in critical care units and breifly in a clinic/office--the fact that a huge number of the general populace feels that it is okay to act this way towards nurses and other healthcare providers is a very sad commentary on where our culture is heading. Some people don't respect anything or anyone. And the crazies, dirtbags, and druggies care about as much as the hospital adminstration does when it comes to their behavior towards us. Someone mentioned the Press-Ganey scores--you are right on the money, which is the absolute bottom line anymore. Gotta keep things looking rosy and keep the $$$ coming. THAT is all they care about. There absolutely needs to be some legal recourse for healthcare workers when they are assaulted. I left the ER because I wasn't getting paid enough to deal with all the BS and abuse anymore. 12 hour shifts in an understaffed, extremely busy ER--think no meals, no bathroom breaks, hit-the-ground-running, have to take daily and nearly constant abuse from jacka$$es who think that their pink eye warrants treatment before an acute MI or trauma victim, and administration that just plain do not care--no support to be had besides the occasional 20% off coupon to used in the cafeteria or coffee shop within the hospital for their "appreciation for working so hard." Gee, thanks....
If they are violent, let them bleed out.
Any chance we can get a racial profile as to whom is doing the spitting and hitting? When ever I am at the E.R. I usualy see calm woried people, prehaps a drunk or two with a cop escort but I don't see any of the other horse play mentioned or they would get thrown out or sedated. A freind of mine made a joke he would strangle the Dr. cause a shot hurt his mother, he swiftly told him, he knew he was jokeing but the pollicey prevents any talk like that or he would have to leave. So where is this rukus takeing place?
I have worked with all types, bad behavior doesn't know economic, religious or racial barriers. You don't see it because its happening usually while we are caring for patients behind curtains or in rooms.
Tammy, are you serious or just fooling around today?
Serious Curt, at my locale E.R. that dosen't happen or they go to jail. Or have to leave. If they are insane they sedate them and another crew comes pick them up, like the mental hospital.
That's fine but a racial profile?? I've seen plenty of these angry patients and they come from all points of the racial spectrum. No one group is worse than another. You're very lucky to live in such a quiet area!
Why is the race of the people important? You seem to be talking about location. So why even ask about race at all? In my personal experiences, which certainly can't be generalized, the nastiest people were not part of a minority race.
I see it with less educated, lower socioeconomic patients. I don't see one particular race do it any more than another. Trailer park trash, ghetto hoodrats, druggies and gangsters, thats who I see perpetrate the violence the most.
Ive been in the business since 84 as a ski patroller did the emt,medic currently rn thing and Im always on edge..ive seen abuse in the dept forever...then the pt wants the pt. advocate...wheres the nurses advocate...there are some angry peeps out there...15-85,m/f dont matter...and if they dont get what they want as fast as they want it they just snap...verbally,physically,...ive been spit at point blank right in the face...just the other night a pt threw a full blue slurpie at the rn leaving her room...11and a half more hours of her shift and she looks like a smurf.....support from the house....not...what gives...they act out... like they are doing us a favor when all they need is tylenol and they are requesting dilaudid....and of course the co pay we end up paying for...some should have a limit to their state card...well yeah its a little frustrating at times but we eat chocolate and get buy...cuz ya just neva know...and the stories...you just cant make that s--t up...i have compassion but its wearing thin...and my 88 y/o mother who has worked 2 jobs for decades cant afford her meds...where is all the tax $$ she put in over the years gone...she has to much pride to ask for more than she is given...to bad ...what a world...
30 years as an RN has it's good days and it's bad day. Most of my years has been ER night shift. I promised myself if I ever don't see a human when I am taking care of any patient, even one who is trying to verbal abuse me or my family. I will get out. That day has not come, some times I change employment to regain perspective. We have not re3cieved training how to deal with violence. Drugs and restraints are often our only defense. Staffing is short, patient waiting lines are long. Still at the end of the day I try to care for each patient as if it was my family member. Because someday my son or uncle may be in an ER some where and not be in their right mind, or having a very bad day. And I hope some one is their that sees them as a human.