Ensuring health care worker safety is more complicated than simple security, but physician leadership can help it become reality.
In 2015, there was a murder-suicide inside one of our local hospitals in the Tampa Bay area. The victims were visiting an ill relative and no health care workers were involved. The local media covered the event extensively and questioned all sorts of issues related to security and protection.
Not surprisingly, several of our staff members became quite concerned about how this could happen and why this could even be possible. The event was very real for everyone.
Then the Paris terrorist killings occurred, followed quickly by the San Bernardino rampage. In the background are growing concerns about increasing gun violence and murder rates in our cities, other mass shootings and incidents of police violence against citizens. All of this feeds the political rhetoric that dominates the news media as the next U.S. presidential race heats up.
The United States is not alone in this either — many countries are experiencing similar concerns.
Closer to home, management of our office building mandated that all organizations and companies provide a video review to their staff about a “shooter-on-the-prowl” scenario, encouraging each company to practice their reactions. We complied but did not have full context for why this was necessary. We are safe — right?
For me, this increased awareness of societal violence is an issue I had not recently considered deeply on a personal level. I had become complacent in my view of how much impact these events can create in our everyday worlds. That complacency bothered me.
Coming from an academic clinical background of trauma surgery and surgical critical care, I have been intimately involved with managing critically ill patients, operating on the injured, and watching far too many victims die. Historically, I also participated in a wide range of violence prevention initiatives and continue to follow the medical literature related to violence prevention. There was indeed a time when I cared passionately about these issues and had sought to create change.
I am not the only one who has developed a degree of complacency for societal violence. Acts of violence are increasing and the media coverage is expanding. Gradually, a different norm is being established in terms of how we collectively assimilate acts of violence into our expectations of society. Many of us are now more complacent and inured to the violence happening around us. Our children just view it all as an expected aspect of life – unfortunately.
Sure, we expect our societal values to change with each generation. But this complacency toward violence and purposeful harm toward others is one that broaches unethical behavior. I personally need to rekindle my own awareness of violence and work to prevent it. I believe that, as physician leaders, each of us needs to help provide focus on workplace safety.
I remember all too well the mass casualty drills I participated in as a trauma surgeon. The drills sometimes didn’t go well. But then when significant events did occur, often the various teams pulled together in remarkable ways to provide excellent triage and care. This is a phenomenon termed “swarm intelligence” by two of our faculty, Len Marcus and Barry Dorn, who helped analyze responses to the Boston Marathon bombing.
Relying on swarm intelligence is not enough, however. At the very least, we, as leaders in our profession, should look critically at our workplace environments to re-evaluate the safety and efficacy of our violence prevention programs. Consider how to prevent a violent act from occurring and how to safely manage an event if one occurs. These safety efforts often start with a strong Failure Modes and Effects Analysis. If you have not done one, it’s worth considering.
But as physician leaders, our vigilance should potentially extend beyond our workplaces to our communities. Medical professionals are considered leaders in society. When bad events happen in a community, there is an unspoken expectation the physicians and other medical professionals will mobilize and support the community.
Is there something you can do to help prevent violence in your community? Creating large-scale change in public health requires commitment, resources and a great amount of time. Our anti-smoking efforts and motor vehicle safety initiatives took decades to reach their current levels of improvement. Other public health initiatives are only in their infancy and struggle along. Violence prevention is lagging, unfortunately.
Teams of professionals dedicated to public health certainly deserve credit and reward for their long-term vision and perseverance as they work to create societal change. Physician leaders can learn a lot from them. Highly motivated individuals also can generate energy toward creating large-scale change. If you have the opportunity, it is always enlightening to spend time with a highly motivated individual and take a lesson from his or her playbook for how to create societal change.
Physician leadership is critical to curbing violence in health systems and the greater community. When bad events happen in a community, there is an unspoken expectation the physicians and other medical professionals will mobilize and support the community.
Join me in losing complacency toward violence. Embrace the necessity for change as our societal norms shift and assume the leadership role you have the privilege of holding in our society as a physician. All of our patients and their families will be safer, as will our fellow health care workers.
All physicians can be considered leaders. So get more engaged, stay engaged and help others to become engaged. Creating a broader level of positive change in health care — and society — is within your reach.