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When the security guard at the San Antonio Methodist Hospital met the visitor at the door of the children’s emergency room on a Saturday afternoon in early August, the officer’s request was simple: the man had to undergo a temperature check to make sure it didn’t show any early signs. of COVID-19 before entering the hospital.
The man refused, became agitated and began to scream angrily, pulling out his camera to register the guard and hospital staff.
The scene got so tense that the San Antonio Police were called, but the man – whose identity and reason for wanting to enter the hospital was not included in the police account of the incident – Left in anger before the officer could arrive.
It was, relatively speaking, a small explosion, but Texas hospital workers and health officials say incidents like this have increased both in number and intensity this summer as tensions boil over the course of the summer. of the fourth wave of hospitalizations for COVID-19 fueled by the delta.
“Our staff have been cursed at, yelled at, threatened with bodily harm and even had knives pulled at them,” Jane McCurley, director of nursing for the Methodist Healthcare System, said at a press conference five days later. the incident in the children’s emergency room. . “It’s intensifying. … It’s just a handful in each establishment that has been extremely violent. But there are certainly an increasing number of events every day.
Nurses and hospital staff are historically vulnerable to workplace violence due to the nature of their work, where they deal with people who react badly to street drugs or to mental breakdowns and often have to deliver bad news. to patients or their family members already in pain or emotional distress.
Half of Texas nurses reported verbal and physical abuse on the job in 2016 – last year, Texas health officials asked them about it.
But the pandemic has exacerbated stress which can escalate into threats and violence as people now grapple with not only the virus but also job loss and other stresses, said Karen Garvey, vice president. of patient safety and clinical risk management at Parkland Health & Hospital System in Dallas.
Garvey said the confrontations at Parkland this year alone included “people being punched in the chest, urine being thrown at them, and inappropriate sexual innuendo or behavior in front of staff. Verbal abuse, name calling, racial slurs… we had broken bones, broken noses.
Visitors and patients assaulting hospital staff “were an epidemic before the pandemic – it was just silent for the public,” she added. “Healthcare workers have faced this for years, and it has become more pronounced with the COVID pandemic.”
The rise in tensions linked to the pandemic in the United States is not unique to the hospital sector. Airlines are reporting an increase in aggressive passengers as flight attendants take self-defense courses. Police report an increase in violent crime and incidents of road rage.
A similar phenomenon emerged last year when retailers and grocers became frontline agents of mask warrants and limits on gatherings and indoor activities. And it resurfaced last month when parents aggressively confronted school teachers about the often-changing mask rules.
But unlike airlines, which can ban passengers permanently, hospitals are more limited in how they can respond or prevent these cases.
A 2013 Texas law made it a felony to assault an emergency room nurse, but legislation that would have expanded that to include nurses in other areas of a hospital died in the Texas Senate earlier this year. A bill dealing with the issue is currently being considered in Washington by the US Congress.
As hospitals report historic nursing shortages as the pandemic continues, fear is that the “alarming rate” of escalation will be the last straw for nurses who are physically exhausted after battling a pandemic for 18 months, slim on compassion for people who need care after choosing not to be vaccinated and fearing for their own personal safety, said Houston pediatrician Dr Giancarlos Toledanes.
“With the escalation of this violence against healthcare workers, we will lose the workers who are deemed essential,” Toledanes said. “If the problem continues to worsen, I think it will make it much more difficult to staff these hospitals. “
“Temperaments are high”
The Texas Department of State Health Services does not track incidents of assault on hospital staff outside of its regular investigations, the next of which will be carried out next year, a spokesperson said.
But as Texas health officials watch hospital intensive care units and pediatric units overflow with record numbers of mostly unvaccinated people, they say the upsurge in assaults on healthcare workers is obvious.
Many of the issues reported in recent months include disagreements over masking and testing protocols that people don’t have to follow elsewhere, especially after most mandatory protocols have been banned in recent months by Gov. Greg Abbott, officials said.
Clashes are sometimes caused by hours or days of waiting in emergency rooms that are so full of COVID-19 patients that there is no room for anyone else, health workers said .
“Moods are high,” said Carrie Kroll, director of advocacy for the Texas Hospital Association. “To the point where some systems put a security guard on check-in because family members get so abusive about masking and some of the other control things they have to do.”
Families are often upset when they can’t visit someone due to COVID-19 rules that limit the number of people who can be at the bedside or even enter the hospital, Serena said. Bumpus, practice director at the Texas Nurses Association.
“When our family members are sick, we want to be there by their side, and it is not so easy to be by the side of our loved ones anymore because of this increase in the number of COVID patients in our establishments,” he said. she declared.
At the Katy campus of Texas Children’s Hospital in west Houston, Toledanes said some parents were verbally abusive because of rules that require them to wait for COVID-19 test results before more than one parent is cleared. to enter a room with a sick child.
“With their child in the hospital and they are the only ones dealing with everything, it obviously becomes stressful,” he said. “It has intensified a lot more, especially now that we have become a little stricter with our policies” because of the surge.
Health workers face online harassment
The threats also follow healthcare workers online and often have to do with philosophical differences over what have become political hot spots such as masking and vaccinations, Toledanes wrote in a recent column for the online medical magazine. MedScape.
“Online, healthcare workers, who advocate masking or vaccination, are often subjected to death threats, threats against family members and verbal abuse on social media,” he said. writing. “Veiled threats of” we know who you are “and” we will find you “follow doctors who advocate masking in schools.”
In Parkland, some of the administration’s actions to protect workers include a staff of six mental health peace officers – known as environmental / patient safety law enforcement response personnel. – who are specially trained to respond to high-risk incidents, Garvey said. Administrators have developed a patient chart flagging system that identifies patients who have been identified as known risks to staff, she said.
Some hospitals have hung signs in the hallways reminding families to be courteous and patient with overworked staff.
In mid-August, escalating reports prompted the Texas Hospital Association to use social media with an image of the face of an exhausted nurse, a mask pulled under her chin.
“Don’t forget the person behind the mask,” the image reads.
McCurley said the growing violence this year is made worse by the contrast in attitudes workers see now compared to a year ago, when the public seemed to understand nurses and hospital staff stood between themselves and the pandemic. deadly.
“We were considered health heroes and our community responded with love and support, food and gifts, car parades, buses, motorcycles and airplanes, and we felt so much love and Support. It gave us the courage to come in and face our own fears of the unknown early on, ”McCurley said at the August press conference. “Today, these healthcare workers are subjected to abusive behavior from the families of patients. It is unfathomable that this is happening, and it must stop.
Disclosure: The Texas Children’s Hospital and the Texas Hospital Association have financially supported The Texas Tribune, a nonprofit, non-partisan news organization funded in part by donations from members, foundations and corporate sponsors. Financial support plays no role in the journalism of the Tribune. Find a full list of them here.
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