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Black Hole in Medicine



It was heated argument from the outpatient clinic area within the hospital and soon as expected, code white is called. The male patient was frustrated over hospital staff, and nurses were being first responders in all. He was hurling any bad words available to hospital staff and exhibiting violent behavior. Hospital security intervened; patient was restrained and a push of haloperidol calm him down. Patients often kick, scratch, and grab them; in rare cases even kill them. This is not everyday situation, but this kind of events occurs often than other professions. In maternity floor and trauma units, these situations are a norm. In fact, there are nearly as many violent injuries in the healthcare industry as there are in all other industries combined.

Health care professionals are periodically trained in crisis management and de escalation. Hospitals provide annual crash course on crisis management. It is a part requirement in hospital and patient-care units across north America. The workplace becomes difficult when there is frequent abuse from customer base, in these case patients. Hospital staff have to keep the highest morality, and the best patient-care attitude in the midst of constant verbal or occasionally physical abuse.

In another case, where a mother walked to the clinic with her kid for some health concerns. Her first demand was to see a “white” doctor. The clerk responded politely that it is impossible on that day, and she had to come back another day when a Caucasian physician is working, or she can decide to see any of doctors that day. Even after a polite and professional response from the entire team, the mom escalated situation and eventually local law enforcement had to involve. This situation created enormous stress for the front line staff. Only one situation led us to rethink our response and change in policies. Most of all, this situation created a crack in synchronized fast-paced and harmonic work environment.

The vicious cycle of patient neglect arises from continuous bad behavior. A patient or a family member continuously perceives neglect and reports to healthcare staff. Oftentimes, patient and families’ higher expectation led to bad behavior towards staff, which may lead to failures of healthcare staff to achieve objective standards of care. People really feel like their administrations are to a lesser degree engaged in mitigating violence, when more and more distances from the epicenter of the problem. It makes people less invested in the work that they do because they feel not as much supported. The healthcare delivery cost is attached to every level of workplace violence, and it increases with more malicious behavior.

The struggle to keep balances among moral, work ethics, professionalism vs continuous abuse leads to burn out, symptoms of depression and dysthymia. Escalating anxiety and stress at the workplace in turn leads to increase chances of therapeutic and other mistakes. It is a great learning curve, and every arduous situation teaches something new. At the same time, frequent difficult situations and abusive behavior from patients and relatives create hostile environment, burnout, anxiety, depression and ultimately detrimental effects on workplace morale, personal toll on health and most importantly the patient care.

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