Hospital Impact: We must work together to make hospitals safe places to work, heal

The names of the cities evoke the images: Dallas, five killed, nine wounded; Baton Rouge, three dead, three wounded; Orlando, 50 dead, 53 wounded; San Bernardino, 14 dead, 22 wounded; Newtown, 27 dead; Charleston, nine dead, one wounded; Aurora, 12 dead, 70 wounded.

The numbers are almost too staggering to fathom.

Since 2006, there have been more than 200 mass killings in the United States, according to a comprehensive database from USA Today. This means that, on average, they happen about every two weeks. The death toll for the past 10 years from such attacks is approaching 1,600.

The courageous police response to these tragedies rightfully grabs the headlines, but there are less-heralded heroes who are thrust into this too-frequent maelstrom: the women and men whose job isn’t to protect the public from violence, but rather to save the lives of its victims. The nurses, doctors and other front-line caregivers whose calling is the everyday hospital battle to save lives are the warriors of last resort. It is only after the carnage that their work begins—jump-starting hearts, extracting bullets, repositioning bones, sewing flesh. 

Regular exposure to such trauma can take an emotional and physical toll on hospital workers. Consider the words of Joshua Corsa, a senior surgical resident at the Orlando Regional Medical Center who treated victims of that city’s nightclub shooting and vowed to wear his bloodstained shoes until the final patient from that night is released from the hospital: “This blood, which poured out of those patients and soaked through my scrubs and shoes, will stain me forever. In these Rorschach patterns of red I will forever see their faces and the faces of those that gave everything they had in those dark hours,” he wrote in a Facebook post, as reported by NPR.

Hospital workers talk about developing a sort of psychological shield—a barrier that helps them stay focused but can create an unintentional detachment from their patients as well.

Abstract photo of a crime scene
On average, mass killings happen about every two weeks in the U.S.

Sadly, hospital workers frequently need a physical shield, as well. Far too many of America’s nurses, doctors and other hospital staff end up as patients rather than providers due to a national wave of abuse toward healthcare workers. In 2014, 76% of hospital nurses experienced verbal or physical abuse from patients and visitors, according to a study published in the Journal of Emergency Nursing.

These numbers are cause for alarm—and for action.

Nationally, the American Hospital Association has begun work to address violence that brings patients to the hospital and how that violence affects hospital workers who treat the victims. This effort has three primary goals:

  • Identifying, joining or building coalitions and other types of partnerships that focus on relevant community violence issues
  • Developing tools and resources to highlight and share among AHA members on programs, initiatives and other efforts to help combat violence in their communities and to help their employees
  • Conducting research to quantify the cost of violence to the hospital field

One of the root causes of these problems, which seems to be growing in intensity and frequency, is the ease by which an individual, with whatever motivation, can take lives and inflict grave wounds on others. Whether the tool is a bomb, a firearm or even a rented truck, the ability to inflict mass violence seems ever more possible. Is it becoming easier? Or is previously unthinkable harm no longer so unthinkable for those who have become so isolated, angry and lost in our society? What is driving the isolation and hatred?

Corsa, the surgical resident, said later that his shoes remind him “not of the terrible things that happened, but of the good that came from them, … how the city came together, how the hospital came together,” according to NPR.

The women and men whose life’s work is to undo the damage caused by violence have been left asking if there isn’t more that could be done to prevent such horrors in the first place; our skilled trauma teams are asked to respond to senseless violence on some scale day in and day out.

Their question begs our serious attention. 

AHA’s early work is the seed of what will become a long-term fight to stem the wave of violence in our communities and in our hospitals. And it will take the collective strength of hospital leaders throughout America to turn the tide, so that hospital caregivers can do what they do best without fearing for their own safety.

Carmela Coyle is president and CEO of the Maryland Hospital Association.