In a 2022 American College of Emergency Physicians survey of emergency room doctors, 55 percent said they had been physically assaulted, almost all by patients, with a third of those resulting in injuries. Eighty-five percent had been seriously threatened by patients.
The risks can be even higher for E.R. nurses, with over 70 percent reporting they had sustained physical assaults at work, writes Helen Ouyang, an emergency room physician and Columbia University professor, in the New York Times.
“People, appropriately so, feel that the safety net should always be there, no matter what, and should serve its purpose of not letting people fall through the cracks,” said Dr. Aisha Terry, president of the American College of Emergency Physicians. It is this tenet at the heart of emergency medicine that also allows it to be exploited. “Whether intentionally or unintentionally, those factors have resulted in us becoming more vulnerable to violence.”
In the E.R., there’s a certain level of resignation that violence is part of the job, like getting bloodstains on our shoes, Ouyang writes. She says, "We have come to endure racist, sexist and homophobic slurs, choosing silence over confrontation, to fulfill our duty to care for human life. After all, we pledge to hold our patients’ well-being above all else." Ouyang says violence in the E.R. is stark evidence of society’s broader neglect: a medical system in which mental health beds are scarce, primary care remains elusive and prescription costs soar and a shelter network that’s buckling. She says, "All of this can lead to intolerable overcrowding and interminable waiting in the E.R., which can rupture into frustration, anger and incivility."
The U.S. Bureau of Labor Statistics reports that the rate of injuries from workplace violence against health care workers grew by nearly two-thirds from 2011 to 2018. The pandemic worsened the situation.
During the pandemic, more than 40 percent of adults reported high psychological distress, which may contribute to outbursts. It has also sown profound mistrust between patients and medical professionals.
Only 15 percent of surveyed hospital nurses said they would continue in the same job in one year; a third of nurses said they had considered leaving the profession because of the pandemic. The burnout rate among E.R. doctors climbed to 65 percent, the highest rate among all specialties.