Children’s Hospitals Report Rise in Attacks on Workers

Arkansas Children's (Provided)

In addition to facing staffing shortages, higher labor costs and low reimbursement rates, Arkansas Children’s faces a new threat: a rise in workplace violence.

In December and January, Arkansas Children’s experienced nine events “that we would label as patient behavioral events, meaning aggressive, violent-type patients,” Arkansas Children’s President and CEO Marcy Doderer told a group gathered for the 2024 Children’s Forum: Influences on Children’s Health. The event was held Feb. 22 at the Central Arkansas Library System’s Ron Robinson Theater.

She said that 18 employees reported being injured and five required medical attention during the two-month period.

“I have experienced a personal threat, deemed credible by the FBI, that warranted extra security at my home and in my office,” Doderer said. She said the threat came from a former employee.

But the state’s only pediatric hospital organization isn’t alone. Children’s hospitals across the country are also dealing with a rise in workplace violence. A recent survey of hundreds of nurses conducted by Children’s Hospitals’ Solutions for Patient Safety of Ohio found that 82% of those surveyed had experienced at least one episode of workplace violence in the last year, Dr. Anne Lyren, clinical director for the organization, told the audience. In 2019, 69% of nurses reported experiencing workplace violence.

The organization is a network of 150 children’s hospitals in the U.S. and Canada that works to improve pediatric patient and employee safety.

“The COVID-19 pandemic certainly had a profound impact on this,” Lyren said. “It was highly stressful for all of us.”

Hospitals restricted visiting hours during the pandemic, “which is extremely stressful when there’s a child in the hospital and there not are not unlimited visitation policies for families,” she said.

And there are a number of patients with mental health issues who don’t have access to psychiatric services. “Children’s hospitals are, and will always be, a safety net in those situations,” Lyren said. “But that … has left us vulnerable.”

A study of psychiatric nurses who had been assaulted showed that a year after the attack, 75% of them had a diagnosis of depression, she said.

“Burnout and post-traumatic stress is a really big part of the impact that comes afterwards and is often uncounted and underappreciated at a system level,” Lyren said.

The use of defensive medicine, with an estimated cost of more than $100 billion a year, has also increased, with providers ordering tests to calm down patients or family members or to avoid upsetting them.

“You can see that this is really counterproductive to the health care industry as a whole,” Lyren said. “Thirty-seven percent of nurses have reported that the risk of workplace violence is making them actively consider leaving the profession altogether, which is really heartbreaking.”

Legislation might help. A bipartisan bill pending in Congress, the Safety from Violence for Healthcare Employees Act, would provide federal protections for health care workers who are assaulted at work.

In 2023, the Arkansas General Assembly passed a law requiring hospitals and clinics to post signs saying that attacking a health care worker is a felony.

Doderer said that Arkansas Children’s has added a psychological assessment for employees when they report an injury at the hands of a patient or a visitor. The assessment will determine if the employee is thriving, surviving, anxious or in a crisis.

“We’re starting to collect that data so we can really assess the mental state of our team as they report it to occupational health,” she said.