I use to work inpt acute mental health and we had multiple staff injured by patients. What can be difficult when dealing with mental health patients is that there doesn't even have to be a build up or any escalation. They can be standing there looking calm as can be and all the sudden throw a punch. We had one guy who was sitting in a chair calmly and the provider walked by and he suddenly grabbed her by the stethoscope (yes, we told her many times not to wear it around her neck, but she thought she knew better) and wouldn't let go. He was calm during the entire interaction but he wouldn't let go. We had to cut it off her neck. Another incident, I was calmly talking to a patient who was just having her morning coffee and we were having a pleasant conversation. She then just threw her hot coffee at my face. Good thing my tech was standing right by me and was able to block it with a clip board. Rarely did our staff get hurt because of an escalating situation which makes it even more difficult to prevent. When interviewing these patients afterward, one stated he thought the woman was the devil and the woman stated she just felt like it and wanted to see what would happen. How do we get told to prevent these incidents in the future by administration? Be better at de-escalation. That's kind of hard to do when there was no escalation. It was always our fault, even though we actually had some pretty stellar staff that were pros at listening to the patients and de-escalating. We also had no security staff (this was a big mental health hospital) because admin felt it wouldn't be therapeutic but seemed to be okay with staff getting injured. We had one nurse get PTSD from a patient slamming her against the wall while 7 months pregnant. She asked to work on a lower acuity unit until he was gone because she was understandably afraid of him and he had injured multiple staff and destroyed property. She was met with literal eye rolls from our supervisors and was forced to work the unit even though multiple staff were willing to transfer for her. She said she kept having nightmares and they did not care. She had worked there for 8 years. She was fired soon after for advocating for safer units. They lost a great nurse. Administration does not care.

My daughter gave up being a CNA and even giving a chance of becoming a nurse (despite so many nurses telling her that she REALLY should study nursing)...she has no desire to become a nurse. She’s now an MA for derm while she is going to school. The biggest reason is because, although she was really good at her previous job and so much encouragement from other nurses, she has no desire to stay in healthcare. As her mom, a nurse, the fact that she came home from “sitting” with a demented patient with bruises and scratches. She got those things while trying to keep a patient safe. That is not healthcare 3.0

I think anyone in the medical community who has been assaulted by a patient needs to press charges and follow through with pursuing those charges criminally and civily. As well. If a nurse or doctor is assaulted by a patient they should have the right to refuse to continue treatment of the patient. The only way to stop the abuse of healthcare workers is for the healthcare worker to follow through with pressing charges and demanding that they be backed by the administration.

You are dead on with people treating us like a commodity. We had a saying (what’s said in the med room stays in the med room!) that was “Welcome to Hotel [insert hospital name here]”. It’s sad. And wrong. #LevelUp

I was doing a written piece about violence in healthcare, a lot of takeaway points from this thank you!

One major issue that needs to be addressed is a setting of expectations all-around. Patients and families aren't upset because they aren't getting care. It's because what they are getting doesn't match with their expectations. This is true whether their expectations are correct or not. Some of this boils down to portrayals in media - there's always provider/patient interaction because showing someone waiting in an ER bed for 6 hours makes for terrible television. Likewise for system status. The fact that there were only 2 patients waiting to be seen when you came in doesn't mean that a plane full of nuns didn't just crash into a bus full of children. But we have no way of providing context to people. It's the down side of medical privacy regulations.

ICU Nurse for 23 years and have been hit, kicked, spit on, and evem sexually assaultef by patients going through DTs or drug withdrawal (tweaking). I feel so very tired. I do love bedside but am getting so very burnt out. I do stand up for my patients and their families though, it’s my duty. I usually have very good relationships with patients families.

I worked in militarily hospital, we just put them in 4 point restraints.

I'm on 18 months of probation for putting a male RN In a choke hold, and punched another. Security got there and they beat me and beat me to the ground. I have schizoaffective disorder, bipolar type. I had just been put on different meds which put me into psychosis, which is why I was acting that way. I remember pulling my IV out. That's it. I read the detectives report given to me in jail, that's where most of my info comes from. I'm not the type of man to hit hospital staff. However having schizoaffective, during bad times I end up in the ER often. I was hard to deal with some of the time. But I did have a bad taste in my mouth about how I was treated by RN'S and Doctors. There were some shining stars that treated me so professionally and with a little empathy. But I've been violently thrown on a psych bed and forcibly restrained. A couple of times. That was incredibly shitty to me. I'm already got PTSD from being a prison guard back in my 20's. Getting strapped to that bed was worse then anything that happened in my corrections years. And I worked in the worst prison in New Mexico. So when these security guards and male RN tried to restrain me, pop blacked out and did some awful things I wish I could take back. Just wanted to put my story up to see if it helps the dialogue.

I do not have either the patience nor the tolerance for any family/friends escalating in my ER. If anyone is interfering with my ability to provide good care for a patient, I will very calmly but efficiently escort said persons to the waiting room or have security do so if needed. The rights of any persons other than the patient to be in the assigned patient's space during the course of our care is a privilege that I can and will revoke at any point along the continuum of care. #justtrymetoo

As someone who graduated med school nearly 30 years ago, I have seen the deterioration of health care relationships. It has nothing to do with the ACA or EHR. It has everything to do with the decades long trend of public distrust with “the elite”. I recommend 2 books, Twilight of the Elites by Christopher Hayes and any of the Generation series by Howe and Strauss. We are in a Crisis era, according to Howe and Strauss.

What about the residents that hit the aide trying to help them out.

Good discussion. I live in Canada and although we have a single payer system there is still a violence issue, though probably not anywhere near as bad as in the US. What I wonder is what is one's definition of violence. From the patient and family perspective, the system is committing a significant amount of violence. Inflated costs that leave them financially struggling is one form of that. The insensitivity, lack of cultural competencies, etc within the system are also felt as violent. Examples: the common belief among health care workers that Black folks don't feel pain to the degree white folks do. The systemic sexist biases that make women's healthcare inaccessible and substandard. Both of these well-documented among health care workers. Forms of violence. If you want to end the violence there's plenty of action to be taken w/i the system.

One more thing, empathy is often a gift to others and ourselves when the answer is no. We are dating with empathy that we hear the patient/family but unfortunately the answer is still “no” now, but “yes” we can refer them. Also administrators that insist on Customer satisfaction need to show up and participate in these conflict. They isolate themselves and are armchair/ Monday morning quarterbacks.

Brilliant conversation; thank you.

Its not acceptable to hit anyone!

Here in Louisville a nurse recently 12 days ago got thrown a plate glass window by a patient that only been out of prison for 2 weeks the girls in the hospital for 2 days they took him and got him a shot of Ativan and brought him back. What gets me is if you pull that stunt on me and I had to put him in the hospital I'd have been the one fighting. scumbags think that because they go into a nursing home you have to put up with what they want you to do to them.

When I worked in the hospital, I used to say that I was going to drape a towel over my arm and introduce myself as the patients' maitre de. That's how I felt we were treated as nurses.

So, my dad had alpha-1 antitrypsin deficiency and emphysema, so he was in and out of the hospital for about 16 years up until his death, and my stepmother was very ill, and very disabled, as well, so she was in and out of hospitals, alot, as well. I've seen the full spectrum of care from "holy shit, how has nobody sued you assholes for malpractice?!", like when paramedics, and then the ER, were refusing to give my father (who, I remind you, had about 20-25% lung function, at the time) fucking OXYGEN because he was drunk, until I managed to get there and talk some sense into the doctor, while they were treating him after a freaking fire, to the amazing care my father got at the very same hospital's ER in the week before he died. And everything in between. It seems to me that medical practitioners have a tendency to treat patients who they feel "did this to themselves" with much less respect and dignity, almost as if they're beneath them. And as far as mental health is concerned, holy fuck. Like, we talk about bad treatment in understaffed ERs that aren't equipped to handle psych cases, but what about the places that are? I had a physician's assistant, in a crisis center, while I was on a 5150 over an attempted suicide (I'm severely bipolar, btw, and was at the time unmedicated, and withdrawing from nicotine because on top of everything, I'm also a goddamned moron who started smoking even though I knew what it did to my dad), tell me I was faking it for attention. Now credit where credit is due, the other workers were pretty quick to action in preventing me from completely caving in my own skull immediately after, got me cleaned up, stapled up, and even helped me file a complaint, because I apparently wasn't the first person she'd done that to, I was just the first to react that badly. I also had a clinician yell at me. But it was one of those moments of, like, "No, you need to get this through that thick skull, right now: If you don't get your temper in check, you'll die. Your heart will end up almost literally exploding," so... I figure that's pretty acceptable. Actually was something I needed to hear. So, yeah, I guess I'm just saying that, maybe medical folk can remember that we're all people, even the dumb ones who fuck themselves up? Tell a drunk in no uncertain terms that he's an asshole, sure, but if he tells you he has emphysema, especially if he name drops something as rare as AAT, give him the goddamned oxygen! Like, my dad deserved to be called an asshole that night (to my knowledge, I'm the only person who called him an asshole at that hospital). He didn't deserve to be deprived of oxygen for nearly an hour after coming out of a house fire.

Love your candor ZDogg

in corporal punishment discusion: there are two groups of people. those who are using a low force, non-traumatic representation that is intended to teach the child that for adverse actions, that there will be a consequence. the other group associates this concept incorrectly. they feel the level of punishment must equal the adverse action performed or must quantify to a certain level (e.g. x amount of spankings). this group sometimes fits the same group which authoritative parents follow. this borders or as a growing trend - abuse. pain is torture. so why would any parent want their kids in pain whether an injury is caused or not? abuse. the concept is that the child retains repect for their parent and the most devastating effect is the fact that the parent that they love and trust, has become disappointed. positive reinforcement works well, but if it is about sugar coating these consequences, this translates to the wrong perception of society. this causes other inappropriate responses (e.g. assaulting healthcare providers). the fact that the hospital must be a positive experience. the medicine must be pleasant. punishment/discipline must be pleasant. in the real world, life is just simply, real life. medicine was not intended to be pleasant. it was to treat or cure an ailment. the hospital is a place to receive said medicinal therapies. it is about health and wellness. sometimes there will not be good outcomes. there is never an okay circumstance to intentionally abuse another person. there should be consequences for their actions whether in the healthcare environment, or the parental environment, or whatever.

If you made a graph plotting hospitals' increased use of hospitalists and the rise in hospital violence over time, what would it look like? Is forcing patients to submit to a system driven by hospital-loyal medical management lackeys while diminishing the authority of the individual patient-loyal GP a petri dish for rage?

I as a police officer have heard judges and magistrates say "getting hit is part of your job".

No Shade but you went live at the worst time at least for us Chicago peeps. The Verdict of a very high profile case was being read. Watching hours after the face. Love you guys

I believe health care institutions and teams should communicate up front more --even prior to making an appointment or in an ER waiting room. Communications up front should include how waiting times work (based on urgency), if narcotics are not prescribed out of your clinic and New opioid prescribing laws (if to avoid drug seekers or doctor shopping ) , antibiotic stewardship (not giving them unless indicated). Look at usual suspects in areas of conflict where the public needs education. Also I see many hc workers escalate conflict. Talking louder, standing closer, becoming sarcastic. Need training and others on team to step in when needed. Also report bad patients in an official way. Glad you addressed this. Thanks

Until Healthcare is no longer a business that drives nurse-to-patient ratios, hospitalist ratios we're not going to be able to stop violence in the workplace

I'm somewhat new to this channel. What video should I watch that talks about what health point three is ?

Beautiful!

This is messed up. How can I help fix this?

Keep up the awesome videos

I disagree. As a hospital worker, i do not keep a grudge due to past patients. It suprises me to hear a dr say he feels most employees do. I agree with Tom. The medical system has gone down the tubes since ACA. No hope left. It’s already too far gone. Sad for me to witness daily because some of us still care and dont hate people.

Ive said it before and Ill say it again. The mantra of "Healthcare is a right" devalues our work and worth to the level that the patient perceives it to be worth. Since it is a "right" and should be "free" that worth is zero. We are no longer trusted professionals to be treated as such, we are just goons delivering the "free" stuff to people who do not appreciate it and have no incentive to. In the battle between real value and perceived value unfortunately perceived value often is more powerful in dealing with the public. When we tell people they have the "right" to our labor for free, they can and are treating us as such.

I lightly tap my 2 year old's butt when she's being insane. I've always been anti-spanking, however, in some moments I do feel like I'm out of options for discipline and lightly spanking her feels like my only option. I'm usually racked with guilt even though I do it consciously as opposed to anger. This video has helped me reassert my anti-spanking policy. Thank you. #levelup #ashamed

None of my hospital experiences have been positive. It's extremely expensive for not much care

Well the vulgar language sure helps! Right? Makes you feel authentic, huh? I've been an ICU nurse for 27 years and have seen the management trends come and go. Nothing ever really changes. Just new expressions for the same crap. And yes, with Gov funded health care the patient is ALWAYS right.

Timely discussion as my ER is currently buzzing from the most recent extreme example. We are assaulted verbally every shift and/or we have ATTEMPTS at physical assault that are "taken down" or deescalated every shift. It is a sad statement that I have to refer to the case of one of my ED attendings being punched repeatedly by an ETOH pt as "an extreme example" , the attending can recall 6 solid hits that connected with her, so punched 6 times. (see facebook and latest posts by Maureen Suchenski for her comments). So our hospital is being "partnered with" i.e. has been bought by the wealthy gangsters "Neighborhood" which is resulting in a lot of changes. One of these changes is new policy for Kent to be a "no restraint" facility. As you might imagine that places an extremely difficult challenge for us in the ER and as such the ER has been granted this sort of bizzarre legalese workaround policy that allows for restraints, but then imposes near impossible feats of order sets, assessment, documentation---such that the EHR becomes more of a concern than the actual restrained patient. We have come to a slightly more realistic middle-ground after a few disastrous weeks and months of practitioners being too afraid to order restraints --resulting in much needed staff and time/resources being spent on "restraint alternatives" and "agitation reduction techniques". What I do know after a decade of witnessing the issues of violence in the workplace and restraint policies is this. We, the healthcare practitioners, are expendable. Ancillary staff such as security are especially expendable--as evidenced by several security being injured to the point of now being on disability for life. Those cases are , I am assuming by way of action taken/not taken by administration---more affordable than safer policies and resources/facilities.

When you look at the combination of personal responsibility in conjunction with system/social responsibility you have to make sure the system rewards acts of personal responsibility. Right now that is pretty irregular and sometimes the systems punish personal responsible behavior. Example, someone I know is taking generic adderall, I was price shopping between pharmacies for the best price, personal responsibility and advocacy right? In one case I was told that a pharmacy couldn't give me a price without an active rx, but before I tell the provider where the rx should be sent I need to know the price...system punishes responsible behavior.

I had vomit 🤮 thrown in my face.... sucked big time. During residency, inpatient, no support from hospital.

3:02 I've never physically caused harm to a medical professional on purpose, but the motivations for verbally nasty behaviour are not necessary due to being "objectified" or lack of humanity it's more to do with deeply attitudes by medics that ignore the harm they are causing me, or lying to me for their benefit.

Yes verbal assault/threats as well as physical

I hope the patient likes time out for their arms if they think they can hit people trying to help them

I’m a supporter. But I still watch you on KZfaq. FB is irritating me right now. I do and have always preferred the distillation of the KZfaq medium.

A nursing staff member on another unit in my hospital got bitten on their back last week. We have a lot of psych sitter patients on that unit right now. Eek.

Can you review the Dr Death podcast if you haven’t already. Very interesting.

Actually, i think the rise of health care violence has a lot to do with health care persons abusing their patients and violating their rights as human beings needing to be treated with dignity. Anytime you have a group of people [lie health care providers] who think they are above the law, of course they aren't going to be treated very well. Much like the police are also looked down upon! If they are nice caring persons as nurses, doctors and police officers who are doing their jobs accordingly, they would most certainly be met with open arms and respect but their is extra funding and a lot of playing the victim card going on here when they know damn well they aren't treating their patients and citizens right.

Corporal spanking... yep, there's gonna be fanfic XD

I feel out of place here sometimes because I’m not a doctor. I’m in mental health. We set boundaries between client and therapist. It should be no different between doctor and patient.

What hospital is Tom going to? Jeez. My unit has a good team of people who take good care of patients. Our particularly angry patients are outliers.

Like

How about nurses that hit paitents and family members? And threten and attack them at sloan. This is obviously more common in nursing home but i have experienced this as a caregiver in hospitals by the cna's and nurses. And sadly they dont get fired. Ive reported them.

Violence towards anyone, especially a healthcare worker who is trying their best to make you well, is unacceptable in a civilized society. With that said here is my most recent story where someone should have been beaten :-P and yes it is the bean counters fault. My step dad was in the hospital for a lithotripsy, he has a pretty nasty stuck kidney stone. They schedule the procedure and he's chilling in his room. My mom already got confirmation from insurance it's all covered get it done. The nurses say hey you have to go to the case managers to confirm insurance. She goes there "nope we don't deal with insurance talk to these people". So she's getting the standard run-around. Because this is all happening now his procedure gets pushed back because they didn't confirm insurance. Now it's infected, because it was delayed, because nobody there knew how their systems work. Admitting didn't know, the case managers didn't know, nursing didn't know. "Oh I guess we can't have the surgery today". I can see why someone would throw hands at that. Ultimately we demanded to speak to the unit manager who knew exactly what to do without issue. We don't know how our systems work so you get to have an extremely painful infection and delayed treatment, that's just how it goes here. The staff are great and definitely know how to do their job from a medical perspective. From a billing/technology/process perspective they weren't trained but as a patient my step dad got to suffer because of that. I work at a hospital where I am and I think someone there needed a kick in the head.

I have to disagree on the violence. The world is an angry, dangerous, violent place, and violence does solve many many issues. Not hospital workers though. If you can't teach your child when to be violent and when not to be. They'll have a hard time learning when violent words are appropriate and physical violence

I really want to subscribe but I hate Facebook

Universal healthcare gets rid of this problem. 😂😂 Imagine u charging me quarter of a million dollars 😂. And I'm walking out happy lol. 😂😂 You see universal healthcare places getting beat up 😂. Healthcare workers blame yourselves lol. For profit model

Lol at Tom. Going through the stages of grief on camera. Anger is one of them... wanna know who to blame? Your telomeres. Not the doctor/nurse xD

Testosterone is low becuz of the statin. Too young for that.

Are YOU the model? Or is it 3.0 healthcare? Keel politics and apparently parenting stlyes out of it . What are your priority? Pick! We change healthcare OR you get your ego stroked. Hummm... Stay out out of POLITICS!

Spanking is good. You are wrong. Is this where you want to go with Heath care?