Nurses and other healthcare workers face increased violence on the job

Covid-19 is already responsible for killing some 3,500 healthcare workers across the United States. Now America's nurses say they're being subjected to another chilling aspect of the ongoing pandemic — increasing workplace violence.

The National Nurses United (NNU) surveyed 15,000 of its members last fall. As astounding 20% responded said they have been physically attacked on the job.

Healthcare workers are five times more likely to be victimized on the job than other workers overall, according to the U.S. Bureau of Labor Statistics (BLS). The BLS found that healthcare workers accounted for 73-percent of all nonfatal workplace injuries and illness due to violence in 2018. Nurse labor leaders say the pandemic has made matters worse.

The ongoing coronavirus pandemic is exacerbating violent outbursts from patients.

On February 9, Gregory Patrick Ulrich, a 67-year-old man grappling with opioid addiction, was arrested after he shot up the Allina Clinic Crossroads health clinic in Buffalo, Minn. Lindsay Overbay, a 37-year-old mother of two and medical assistant working at the facility later died. Four others recovered from gunshot wounds.

Ulrich is facing second-degree murder and attempted murder charges, but that's the criminal justice system's swift and clear response. The worker safety side of the equation is entirely different, an underfunded and hobbled system that could protect workers better in many ways, reducing death and misery.

Assaults in ERs, Offices

Assaults in emergency rooms, doctor's offices, and even hospital lobbies all add to the dangers facing nurses in the tense social conditions fostered by the pandemic.

NNU insists that the ongoing coronavirus pandemic is exacerbating violent outbursts from patients and that hospital employers aren't doing enough to protect long-suffering healthcare workers. NNU is the largest union and professional association of registered nurses with 170,000 members.

Allysha Shin, a member of the California Nurses Association and the National Nurses Organizing Committee, is a registered nurse who's still dealing with the trauma of being battered and kicked in the face while attempting to care for a distraught patient at the University of Southern California's Keck Medical Center in Los Angeles.

Shin's entire ordeal, in which hospital security was reportedly slow to respond, lasted what to Shin were 30 very long minutes. The blows the veteran nurse suffered ultimately forced her to miss the next two shifts at work. Shin blames hospital bosses for failing to have adequate safety standards in place. She and other nurses want enforcement of safety standards – and the writing of adequate standards by each employer of nurses.

"They will say it was inevitable," Shin says of her attack in 2016. "But I'm here to tell you, nothing could be further from the truth — the patient's history made this incident predictable."

Underreported Workplace Violence

News about working conditions gets spotty attention in America where labor reporters at major news organizations have gone from few to virtually extinct. So DCReport has been documenting America's weak worker safety enforcement and the unnecessary risks faced by w0orkers because the federal Occupational Health and Safety Administration has far too small a budget to fulfill its duties.

A half-century ago about 190 workers died on the job each week. That number was down to about 100 in 2019, BLS data shows. But that's still a costly toll on society aided by members of Congress who have held down the budget for enforcing job safety laws and imposed rules that weaken enforcement, all in the name of fighting supposed overregulation of business.

Many of the most ardent foes of more effective worker safety enforcement proclaim their devotion to the sanctity of human life yet disregard the safety of workers in occupations from construction and mining to nursing.

Jean Ross, NNU co-president, says that the threat of criminal prosecution alone cannot prevent workplace violence — and that several factors directly associated with the ongoing coronavirus pandemic are, indeed, contributing to an ugly escalation of violent incidences like the kind Shin endured.

Not Enough Workers

A disruption in mental health services is one of the factors. Short staffing — a chronic pre-existing condition at hospitals nationwide — is another.

"If they're not going to supply us with enough staff, this is going to make it 100 times worse," Ross says.

Back in June, when the Covid-19 death toll was around 100,000 people, Michelle Gonzalez, a 31-year-old nurse at Montefiore Medical Center in New York City, described what it was like trying to care for multiple patients in the middle of a pandemic.

"The days that I had up to four [patients], I came home and cried like a baby," Gonzalez said at the time. "Your body cannot physically do that. You can't be at two places at once. So, you just run to room to room to room — neglecting your own body's needs. Not eating, not drinking because you can't take off the mask. Not going to the bathroom for 12 hours."

Tens of Thousands Hospitalized

As of March 1, there were 47,352 Americans hospitalized with Covid-19, according to the COVID Tracking Project. Of that number, 9,802 were in Intensive Care Units struggling for life — 3,245 of them on ventilators, a last-ditch treatment which few survive.

Fear of Covid-19 is also forcing some patients to delay seeking necessary medical attention and that, too, is adding to simmering tensions, according to Ross.

"People aren't coming in early enough" to get vital care at hospitals, Ross says. "Maybe they're in sepsis. That's hard to control. A simple UTI (urinary tract infection), can make people go off the wall."

Sepsis occurs when the body's response to infection goes into overdrive and assaults organs. Unless treated early it can result in death.

Visitor Issues

Visiting family members can be both a hindrance and a help to nurses and other healthcare workers aiding the sick.

"There are more things we have to say no to — [some] people don't respond well (to being told), 'You must wear a mask,'" Ross says. "More patients and their families are acting up. Employers don't want to hear about it and sweep it under the rug."

Reporting violent incidences is voluntary, however. So, the actual number of healthcare workers being attacked on the job is probably a lot higher than statistics show.

Rep. Joe Courtney (D-Conn.) pointed out that nurses are often told to just "shake it off."

Nurses and their allies hope that the change in presidential administrations will put Courtney's 2019 Workplace Violence Prevention for Health Care and Social Service Workers Act on the fast track.

The measure, updated and reintroduced last month, seeks to compel employers to investigate workplace violence incidents, risks, or hazards as soon as practicable. It would also mandate training and education of employees who may be exposed to workplace violence; impose record-keeping requirements; and prohibit discrimination or retaliation against employees for reporting workplace violence incidents, threats, or concerns.

The bill garnered enough votes to pass in the House in the previous Congress but died in the Senate during the Trump administration.

"The Senate was a graveyard for lots of good bills," Rep. Courtney says. "This one failed [when] the Trump administration was doing nothing at the Department of Labor. For four years, he just basically dismissed this as not a priority. I hope [incoming Labor Secretary Marty] Walsh gives this attention."

States Lead

Similar legislation aiming to establish enforceable safety standards and training in deescalating violence has already been adopted in California and Minnesota. But the nurses' union says national standards are necessary because while nurses are taught how to recognize medical needs, they aren't taught criminology.

"I've been a nurse for 40 years — I didn't take violence 101," says Ross.

NNU, along with 44 allied unions and organizations, continues to push the U.S. Centers for Disease Control and Prevention [CDC] to update its Covid-19 safety guidelines to reflect the dangers that aerosols — fine particles emitted when breathing, speaking, coughing, sneezing or singing — pose to healthcare workers.

Nurse Pat Kane, executive director of the New York State Nurses Association, says many of the thousands of healthcare workers killed by the novel coronavirus could have been saved had the CDC recognized the threat of aerosols before the long-predicted pandemic was recognized more than a year ago.

"The healthcare and other essential workforces have been devastated by Covid-19 infection and thousands have died due to their occupational exposure," Kane said in a statement. "Many of those exposures could have been avoided if the CDC had recognized the wealth of data that proves that SARS-CoV-2 is spread through inhalation of airborne virus particulates."

SARS-CoV-2 is the virus that causes Covid-19, its number derived from the year when it was first identified as a novel, or new, coronavirus.

Kane says her 42,000 members and all other healthcare workers "deserve federal guidance that fully recognizes the risk of airborne exposure and recommends controls that effectively limit this exposure."

The American Hospital Association frets the costs of the pandemic. It recently released a report estimating that the pandemic could cost hospitals between $53 and $122 billion in 2021.

Ross noted that the hospital owners have not issued a similar report focused on the lethal risks their nurses and others take every day. Evidently, says Ross,

"Our lives aren't as important as money."