Managing violent patients — just another thing healthcare workers have to do

Just as healthcare workers are frustrated and burned out, so are patients who often have to wait for long periods of time for care in overcrowded waiting rooms or in patient rooms when clinicians are busy tending to other people or necessary administrative work. 

Regardless, there's never an excuse for violence anywhere — but especially not in a hospital where the focus is on providing the most skilled, timely care.

Unfortunately, violence against healthcare workers by patients and their families is on the rise,and hospitals are taking precautions by educating their workforces about how to handle unruly situations if and when they occur.

Further, many hospitals aren't taking any chances, including the Geisinger Health System, based in Danville, Pa. Reacting to a Jan. 26 report from the American Medical Association which revealed nonfatal workplace violence against workers in healthcare systems is on the rise, Chief Medical Officer Narayana Murali, MD, told Becker's earlier this year that Geisinger is prioritizing efforts to protect physicians and nurses against patient violence. Efforts include hiring more security, making investments in technology and installing medical detectors.

As part of an initiative to give hospital leaders a platform to share opinions and advice on a variety of topics, Becker's asked three executives about strategies being employed at their hospitals to combat violence by patients and their family members against healthcare employees. 

(If you would like to be featured in this Q&A series, please send an email to

Editor's note: Responses have been lightly edited for brevity and clarity.

Megan Bussard, PharmD. System Vice President of Quality and Safety at Penn Highlands Healthcare (DuBois, Pa.): Penn Highlands Healthcare created a code response to be activated when patients appear to display signs of agitation. This is utilized throughout the system and, when activated via overhead paging, an influx of personnel responds to the situation to help de-escalate the patient/visitor/staff member.  

We also partner with our local police for quick response times and have included them in mock drills, such as active shooter drills. 

As part of our Workplace Violence Committee, we conduct site-specific education to departments based on the type of patients they typically encounter. We also conduct comprehensive crisis management training to help empower our employees to verbally de-escalate patients to help prevent a violent incident occurrence.

Tina Santos, MSN, Assistant Vice President at Orlando (Fla.) Health and Chief Nursing Officer at Orlando Health Orlando Regional Medical Center: This is a topic that we have been reviewing in our workplace violence prevention committees. We are committed to the safety of all of our team members, our patients and our visitors. We are working to truly adopt and educate all within our healthcare system about what is acceptable and not acceptable behavior [and] provide excellent training programs to our team members on how to de-escalate these types of situations. And, if or when there is an incident, we want to be sure to provide the physical and emotional support to our team members. 

Suzi Talarico, MSN, RN. Chief Nursing Officer of Providence Clinical Network. (Renton, Wash.): As an organization, we use our EMR to flag patients at any risk of violence to inform staff prior to and during the patient's visit. We've also employed workplace violence training in most of our regions; these include de-escalation training programs for our employees. In our larger areas, we've engaged with our security teams to maintain a presence. 

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