Lona DeNisco has lost track of the violent incidents that have taken place in the 20-odd years she’s worked as an emergency room nurse in Buffalo, New York. “There’s not one shift that goes by that a nurse doesn’t get punched, kicked, slapped, hair pulled. That happens every day,” she says. “I’ve been punched, taken to the ground.” She is also certain that the growing violence in the Buffalo community is spilling into her hospital, Erie County Medical Center. Recent shootings—most recently the mass shootings in which 10 people were killed at a local Buffalo supermarket on May 14, and at a Tulsa, Okla., medical facility on June 1, in which four people were shot to death including two doctors and a receptionist—are painful reminders that at any moment, violence could threaten her life, or the life of her patients, and that it seems to be up to her to keep things safe.
“We do train for mass casualties, we train for active shooters, but none of that really prepares you,” says DeNisco. “We could do drills all day long, right? That doesn’t mean [much] when I have a gun in my face.”
Tulsa’s shooting is a stark example of this growing trend. Violence against nurses and doctors. According to Bureau of Labor Statistics data, health care and social service workers are five times as likely to be injured from violence in their workplace than other workers, and the number of such injuries has risen dramatically over the last decade—from 6.4 incidents per 10,000 workers annually in 2011, to 10.3 per 10,000 in 2020. Healthcare workers say the situation has become even worse during the COVID-19 pandemic; in September, nearly a third of respondents to a National Nurses United survey said they’d experienced an increase in workplace violence.
This is partly due to the fact that people are less able to communicate politely because of the pandemic. No matter what party they are, tensions run high due to the incessant partisan back-and forth about COVID-19. Gordon Gillespie is a registered nurse, who studies violence against health care workers at the University of Cincinnati. Many health care workers are exhausted by endless worrying—about personal protective equipment, the risk of getting sick, or having to pick up the slack for ill coworkers. “Everyone is just tired, and their resilience is down. And so when you have things happen, you’re more likely to escalate even faster,” says Gillespie.
Many of the problems leading to violence have been exacerbated by the pandemic, which has revealed deep gaps in America’s social safety nets and healthcare system. And even more so than before the pandemic, doctors and nurses—and emergency room workers, in particular—must deal with the consequences. Many people experienced mental distress, many of which were untreated before the crisis. The change is visible to Murnita Bennett, a psychiatric nurse and DeNisco’s colleague, who says that some of the increase in violence she’s witnessed has been the result of patients not getting the care that they need.
“These patients who are violent, are put back right in the community. We’re keeping violent offenders in the hospital longer, instead of sending them to the state hospital where they could get more help. It’s appalling,” says Bennett. “I’m talking to the patients constantly, and their families, but I’m always [thinking], where’s my escape route? What’s my body language—[making sure] that I’m not showing any aggressiveness…. When you see what’s happened in Tulsa, it’s a reality for us to know that at any moment, someone could come in to harm us.”
Bennett says the hospital is experiencing an increase in tension because of racism that was visible most clearly in the attack on the supermarket. In which a gunman targeted Blacks and killed 10 people, Bennett said. In the decades she’s worked as a nurse, she says, there have been many times she was the “only Black face in the room” partly due to discriminatory hospital hiring practices. “I don’t think I would have been around this long if I didn’t fight,” says Bennett. “I fought many battles in this hospital.” Bennett says that the supermarket shooting was particularly frightening for her, because her mother lives in the same neighborhood, and in the last few years, she’s felt more nervous out in the community. “I’m always looking at white people, I’m thinking, Who is this guy? I wonder who is driving this truck? I’m looking at people differently,” she says.
Although health care workers have greater challenges due to the pandemics, they are also supported less. In the United States, understaffing is common due to patients being sicker and requiring more attention. As a result, patients don’t always get the care they want as quickly as they expect it, which can result in conflict. Meg Dionne is an emergency room nurse at Maine Medical Center. She says she became more aware of her behavior after she received a punch from a patient in January. This was while she had 26 weeks to go before giving birth. If she hadn’t been so busy, could she have kept him calm? “If you’re being pulled in 40 different directions, you can’t meet the needs of these people who are scared, and hurt, and more prone to escalate towards violence if they’re not properly cared for in a timely manner,” says Dionne.
It is clear that living in a state of high violence and danger for the long-term is not advisable. Gordon argues that it’s key to train health care workers for violence, and to make it more difficult for people with violent intent to get into hospitals—which, he admits, is a challenge, because hospitals are designed to welcome people, not to lock down. Bennett, Dionne and DeNisco say that hospitals are too reactive to violence instead of preventing it. In Dionne’s opinion, the key is new legislation—such as the federal Workplace Violence Prevention for Health Care and Social Service Workers Act, which, among other things, would require facilities to develop violence prevention plans—which she feels would make hospitals more responsive to the safety concerns of nurses. However, Bennett and DeNisco argue that the violence won’t stop spilling into hospitals until it’s limited in their community—which, in part, they say, must include curbing gun violence and promoting gun safety. “Until people start to understand how fragile life is, we’re not going to change this,” says DeNisco.
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