Violence Toward E.R. Nurses and Doctors Is the ‘Dirty Little Secret' of Health Care

When it comes to risky jobs, one would expect that construction work or the mining industry would be among the most dangerous jobs in the United States. But according to Bureau of Labor Statistics analyzed by NBC New York, health care providers in hospitals are significantly more at risk.

BLS data reveals the intentional injury rate by another person for employees working at private hospitals in 2017 was five times the national rate of all other private industries. The rate was seven times the national rate in New Jersey, and eight times in New York. The national rate was roughly two injuries per 10,000 full-time workers for all private industries.

In New Jersey, state law requires that people assaulting health care providers be charged with the same offense as someone that assaults a law enforcement officer. According to New Jersey State Courts, there were 67 charges of third-degree or second-degree aggravated assault on a healthcare workers issued between Jan. 1, 2019 and Dec. 31, 2019.

Multiple emergency responders that spoke with NBC New York about workplace violence in the emergency room say the numbers reflect a very real problem in the healthcare industry.

They said some of the patients that assault staff do suffer from mental illness, are often under the influence or stressed from the emergency they experienced.

But the medical providers said it’s difficult to find an E.R. nurse who hasn’t witnessed or been a victim of an assault by a patient.

“The patient yanked my head backwards,” said Shoshana Weiner, an E.R. nurse in the Bronx. She said one patient became upset after Weiner recommended a psych evaluation. 

“She grabs my hair all the way backwards and continued punching me in my face and to my head, which caused the chair to fall over,” said Weiner.

Weiner says she underwent physical therapy for weeks and missed several days of work. 

“I have a C-6 herniation. It’s a neck injury. It’s gonna be there,” said Weiner.

Benny Matthew is also a Bronx nurse. He too survived a similar attack.

“I was entering his information into the monitor,” Mathew said.  “The guy grabbed my scrubs and started punching me all over my head, my face, and the security was in the vicinity.  They did a great job within a few seconds.”

A 2018 survey by the American College of Emergency Physicians found that out of more than 3,500 E.R. doctors, 47 percent of them had been assaulted. Additionally, 97 percent of the time, the assailant was a patient.

“The violence that occurs on a daily basis, it's known as the dirty little secret in health care,” said Edward VanWagner, a registered nurse, paramedic and firefighter.  He’s also an instructor for DT4EMS, a company that train defensive tactics to emergency responders.

“The vast majority of assaults that occur in the health care setting are non-lethal in nature. But you don't have to be killed to be changed forever,” said VanWagner.

The DT4EMS course requires students to escape a real choke-hold to the neck, among other escapes.

“We do everything we can to create the realism in this course so that when they face it in the field, they're familiar with it and they know how to respond in a reasonable manner,” said VanWagner.

Connecticut Congressman Joe Courtney sponsored H.R. 1309, a House bill that, should it become federal law, would require hospitals to create workplace prevention plans, collect data reflecting workplace violence and mandate the Occupational Safety and Health Administration to collect that data.

“If you slip and fall as an employee in a hospital, that’s reported. There’s data collected on it, “ said Rep. Courtney. “But if somebody punches you out in a hospital, that data is not collected by the OSHA system.”

H.R. 1309 received bipartisan support in the House of Representatives and is now S-851. Rep. Courtney expects the same bipartisan support from the Senate.

As for the nurses that spoke with NBC New York, they said change can’t arrive soon enough — as the help they need is an emergency, because all too often it’s them who are becoming the patients.

“It‘s not only a physical violation to you, but it's also … you’re being attacked by a person who you're caring for,” Said Mathew.

Weiner added that the normalcy of the assaults has caused her colleagues to have a false sense of acceptance.

“Medical providers all feel that, 'OK, the patient didn't know what they were doing. It's okay for them to do it.' It's not.”

NBC New York reached out to the Greater New York Hospital Association for official comment on behalf of its members. 

The association said, “Hospitals are constantly reviewing and improving their strategies to address workplace violence, including in the emergency department, with a focus on best practices for prevention and mitigation. Common themes include coupling a robust incident reporting system with an environment that facilitates and encourages reporting; prioritizing areas or units for intervention based on information from reporting systems and incident reports; emphasizing employee health and safety via leadership communication and action; and empowering frontline workers to participate in developing and implementing mitigation strategies.”