A physician from the Houston area taught me a new phrase: “Code Silver.” Dr. Stella Fitzgibbons had an op-ed in the Austin American-Statesman yesterday about assaults and other violence in US hospitals to healthcare workers. She begins:
“You’ve been waiting in your hospital bed for pain medicine or some ice water, and are starting to get cranky about the nurse’s delay. Then you find out that it happened because another patient tried to strangle her with her stethoscope. Or you hear ‘Code Silver’ on the overhead speakers, and a nursing assistant comes in, wedges the door shut, and helps you get out of your bed and hide behind it. …Hours later, you find out that ‘Code Silver’ means ‘active shooter on hospital property’ and that an intensive-care patient’s relative pulled a gun on the staff.”
Dr. Fitzgibbons goes on:
“Healthcare facilities deal regularly with drug users demanding narcotics and with criminals who need little reason to become violent. …While we doctors are only rarely targeted…we and our patients depend heavily on the people who keep healthcare running: nurses, therapists, X-ray techs, and the little-noticed people who keep the place clean.”
With her op-ed fresh in my mind, a news report from St. Peter, Minnesota popped up in my email yesterday:
“A 16-year-old patient at the Minnesota Security Hospital in St. Peter, Minn. violently assaulted a female staff member… The male patient bashed her head into a brick wall, then kicked her repeatedly. The woman reportedly began suffering seizures…”
I suspect the image most people have about hospitals are white coats, clean floors and the smell of antiseptics—not nurses aides getting beat up.
An article some months back in Scientific American showed the hodge-podge of requirements and prevention measures across the States to protect healthcare workers. Few states require healthcare employers–or any employers for that matter–to have violence prevention programs. (About half the states, however, focus after the fact with special penalties for offenders who assault nurses and other care providers.)
Fitzgibbons argues that the accrediting body–the Joint Commission –and OSHA should do more to sanction hospitals that fail to protect their employees from workplace violence. OSHA doesn’t have a regulation to address violence. The agency has used its “general duty clause” to cite healthcare employers–with willful violations (e.g., here, here)–for failing to protect its workforce from assaults and other acts of violence. The State of California is considering a regulation specifically on violence against healthcare workers, which would be enforced by Cal/OSHA.
Worker safety and health are rarely the topic for op-eds. That’s probably the reason that Fitzgibbons’ piece caught my attention. Here’s to her for bringing “Code Silver” to our attention.