I never thought I’d be in a position where I would feel scared at work, but then — it happened. I started writing this piece a long time ago, far before Utah nurse, Alex Wubbels, was assaulted on camera by a police officer. It certainly reminded me to work on this again.
A few years ago when I was very green, I was working in inpatient on a hospital service. A particular patient assigned to our service became a very memorable one: a still teenage aged young woman named Ellie with a severe form of heart failure that required her to be on a life-saving IV medication 24/7. Overlooking Ellie’s chart, I became wary as I read a nurse’s account of the patient’s boyfriend known to be physically abusing her. Several calls from her parents imploring for help to various physicians and nurses had been cataloged. It was also clear by her vitals and labs alone that she was fairly critically ill. Additionally, Ellie showed a poor understanding of her illness and was rebelling against her parents. In normal circumstances, this was annoying, but in a critically ill patient — it was very alarming.
Nevertheless, I walked into the hospital room with a will to project certainty and authority. When I emphasized to Ellie that she will need to eventually bring her not-on-our-formulary medication (a bit sternly mind you, as I felt she didn’t understand this was keeping her alive), her boyfriend began to speak up. Her boyfriend offered pointedly that there was no one who could get this medicine — that he would not be able to afford the drive.
Out of concern, I asked the boyfriend what they usually do for money, whereby he became extraordinarily abusive. Complete confusion skyrockets on my part. Obviously, I will not specify what was explicitly said to me, but let’s just say every expletive you know of was immediately hurled in my direction with snarling contempt at my person, my profession and my very presence in the room. He now stood up, and I realized he was quite tall. Though he was young and lanky, I immediately calculated that he would be able to hurt me, a petite thin woman, very easily. I remember my heart pounding, the skin on my cheeks getting red, all my senses heightened — all the catecholamine to the localized threat. And things got a little fuzzy in the whirlpool of alarm. I remember asking him to leave, whereby he snapped back that he will do whatever he wants. I remember poor Ellie sobbing hysterically and begging her boyfriend to stop — and me getting paged about her tachycardia into the 160s (hugely concerning in this patient who was septic and at risk of fatal arrhythmias due to her heart condition.)
I walked out to collect myself. Two police officers were called to the floor.
After an explanation of the situation (with clarification that this was suspected domestic abuse), they went to see the patient and boyfriend. I waited expectantly for their return, hoping to be vindicated. Upon their return, I was told by one officer that having patients (or visitors) “cuss” at me is really “just part of the job.” He also stated that perhaps using excessive expletives is just how the patient’s boyfriend “talks.” I, in disbelief, stated that I am not sure if being called derogatory names is something I should expect during my work hours, and truthfully I doubt I am supposed to feel physically unsafe while I work. It’s also unclear why it is necessary to defend a visitor who is not a family member or spouse but rather someone the patient is dating for the moment who has prompted concerns from others for domestic violence against the patient.
Additionally, any visitor who acted similarly would have been removed or asked to leave in any other setting — a baseball game, a restaurant, an amusement park, a courthouse, etc. One could also argue that if a visitor were to speak to a police officer this way, they would promptly be arrested. It’s unclear why this is something I feel the general public feels healthcare providers should just “tolerate,” whether it is from a family member, friend or patient themselves.
Just to be clear — I understand a frustrated family member or friend. I understand the anger in trying to process critical illness and chronic illness- the unfairness and difficulty, the plain misfortune of it all. Plus, it is enormously painful to see a loved one suffering and incapacitated. I understand throwing out an expletive or two in the disappointment of one’s circumstances. As well, the threats of a known domestic abuser really aren’t surprising (and nothing I have experienced in the workplace can compare to the reality of someone suffering from domestic violence.) The real eye-opener was the mishandling by security personnel of the situation. Should my institution be stressing that their workers should be treated with civility no matter the circumstances? Is there any sort of formal training for police officers regarding interactions with health care workers? What is the thought process of the police in instances like this? Is my offense justified? Or are my nurses and I on our own here?
Honestly, I am unsure who to place responsibility on for how these situations of aggression or indifference thereof develop. Perhaps, in general, we all share a little blame; medical staff and hospital workers who simply accept being mistreated as part of the job and those in the public who feel we should readily take out their frustrations on them without consequence. Though this situation was in the context of someone who was a known domestic abuser, my coworkers and I are regularly cursed at, threatened, have had objects thrown in our direction by patients and so on.
And the literature shows that we are not alone.
Alex Carvson is a physician assistant.
Image credit: Shutterstock.com
