07/19/2023
The Risk is Real: Coping with the Increased Possibility of Violence in Healthcare
Arguably we are dealing with the most stressful time in American history during the past fifty years. That being said, my position is not to minimize the consequences of war, financial uncertainty, or civil unrest; but to draw attention to the fact that stressors affecting our current timeline are global in nature. The wealth of this country has cushioned us from many hardships: And that does not mean that certain individuals don't suffer despite being citizens of the most powerful country in the free world. The following passage is the often-quoted introduction to one of the most popular books ever written. The wonderful thing about timeless literature is that the stories and characters continue to be relatable even in modern times. Take a moment and to read and embrace the essence of the following passage. Notice that the energy of the passage, not only relevant to individuals living in 18th century Western Europe, resonates accurately with the issues that are prevalent and important to us today.
Let us refamiliarize ourselves with the introduction to one of Charles Dickens’ acclaimed works: A Tale of Two Cities.
"It was the best of times, it was the worst of times, it was the age of wisdom, it was the age of foolishness, it was the epoch of belief, it was the epoch of incredulity, it was the season of Light, it was the season of Darkness, it was the spring of hope, it was the winter of despair, we had everything before us, we had nothing before us, we were all going direct to Heaven, we were all going direct the other way--in short, the period was so far like the present period that some of its noisiest authorities insisted on its being received, for good or for evil, in the superlative degree of comparison only."
As human beings, we live in highly complex social systems. Complicated emotions and our perceptions of systems or individuals that are perceived as hostile, whether the transgression is actual or perceived, can lead to aggression or violent responses. And as people encounter and are served by the health care system, the vulnerability associated with relinquishing control to a system that we no longer blindly trust can contribute to heated and/or violent responses. Generally speaking, learned scholars would not argue against the position that stress will increase the likelihood of a violent or aggressive response.
Health care workers now are being asked to “man” the front lines for longer hours with fewer resources and supporting staff. This has the possibility of creating the perfect storm energy which, in theory, puts more emotionally stressed people in conflict with each other as they deal with difficult situations. Those who have committed to adhering to the standards and guidelines associated with evidence-based practice while protecting the health of the public at large now face increasingly unsafe environments. Federal statistics indicate that Health care workers experienced five times more violence on the job in 2018 compared to the general population. Covid-19 and its variable mutated forms have only seemed to increase the amount of violence in health care settings, as noted by an uptick in reports of assaults and verbal abuse toward medical staff. The aforementioned observation takes into consideration several aspects of health care. When mental health care systems are viewed separately, the potential for a health care worker to experience violence increases exponentially.
It is no wonder that these issues contribute to an increase in occupational burnout and compassion fatigue. While healthcare worker burnout can refer to the slow onset of hopelessness and cynicism associated with feeling unable to make a positive impact within the confines of our complicated healthcare system, compassion fatigue refers to the negative emotions that individuals feel from helping others at work. We often underestimate the psychological drain associated with constantly extending emotional support in stressful situations. Severe compassion fatigue may also make it more difficult for health care workers to express non-judgment and empathy towards those they serve.
For those of us on the frontline, it is prudent to note our own feelings regarding our work environment as we attempt to navigate these trying times. The typical signs of stress, irritability, poor sleep, increased used of coping substances, feelings of overwhelming dread associated with the environment should be monitored. When it comes to dealing with frustrated people, it is also prudent to understand that in certain situations, logic and common sense will not guide the conversation. When people are stressed, emotional pain can increase to the point that the person is not capable of processing logically. The most intelligent and learned person in the world digresses to being a “hot-mess” if they lose a small child for more than a minute.
I find that the Serenity Prayer, in its various forms, gives us a template for accepting the discord and inconsistency that are prevalent today. The unanswerable challenge for all of us centers around the appropriate and reasonable action we need to take when faced with threats hostility or misinformation. Take into consideration that some people solve their problems with violence, and we should proceed with caution when situations get heated. People who argue and define themselves via a particular group or position, feel personally attacked when confronted with contradictory information. Simply put, accept that some conversations are counterproductive.
The usual forms of addressing our stress health, e.g., proper sleep, meditation, hobbies, exercise, counseling, spending time with trusted friends and family remain the gold standard for coping with stress. Now more than ever, we must truly take inventory of our feelings and emotions and preemptively address our mental health needs while decreasing the chance of suffering a negative outcome in a hostile situation.
