Violence in the Emergency Department: Reflections During COVID-19
In March 2020, the initial response to the COVID-19 crisis included a worldwide celebration of healthcare workers.
Would it surprise you to know that some of those same healthcare providers were the victims of violence in American emergency departments just months earlier?
Photo by M. Gisondi
The first reported case of SARS-CoV-2 in the United States was identified in Snohomish County, Washington on January 19, 2020. Less than 4 months later, the numbers of affected individuals are staggering. As of May 2, 2020, according to the Johns Hopkins Coronavirus Resource Center, 1,115,848 Americans tested positive for the virus and over 59,500 died from complications of COVID-19 disease. Many more symptomatic individuals were never tested.
Among the various national responses to coronavirus, perhaps the most uplifting are the celebrations of healthcare providers and other individuals working to keep essential businesses open. Though proud to be an emergency physician, I have very mixed emotions right now.
The cheers and thanks for healthcare workers continue in most communities, but not everywhere. Shelter-in-place restrictions are conflated with scientific conspiracies by small groups of protesters. National news outlets highlighted these individuals yelling at nurses who staged peaceful, counter-protests. My ‘non-medical’ friends were shocked by those responses; however, none of this should be surprising.
Emergency departments frequently manage violent outbursts by patients and visitors, often resulting in physical injuries to staff. In a 2009 study, 25% of emergency nurses were the victims of physical violence in a 36-month period. I contributed to a 2016 study of workplace violence experienced by emergency medicine residents in New York City, which found an even higher prevalence. During their training, 96% of emergency medicine residents experienced verbal harassment and 65% were the victims of physical violence.
I’m reminded of that study today, as the nation celebrates emergency providers caring for the sick in New York, who dutifully go to work despite risks associated with inadequate personal protective equipment and poor facilities. Remember, that is the same city in which emergency physicians cared for those injured on 9/11, then continued to be harassed in their workplaces months later.
Nurses are the most trusted professionals in the United States, with physicians ranked right behind them. Yet, these respected individuals have been the victims of harassment and physical violence in emergency departments for years, a story under-reported by the national media. I hope that changes after COVID-19.
I placed the blue awareness ribbon pictured above on the tree in front of my home, in honor of the heroic staff members that I proudly work with every day in the emergency department.
May 2, 2020
Co-authors of the 2016 original article: Benjamin H. Schnapp, MD, MEd – University of Wisconsin, Benjamin H. Slovis, MD – Thomas Jefferson University, Anar D. Shah, MD, MBA – Morristown Medical Center, Abra L. Fant, MD, MS – Northwestern University, Michael A. Gisondi, MD – Stanford University, Kaushal H. Shah, MD – Weill Cornell Medicine, Christie A. Lech MD – NYU Langone Health.