A nurse’s story of health care workplace violence [PODCAST]

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“I can imagine the horror of watching a colleague being attacked. I worry about the coworker who Lynne protected that day, since being a survivor can be so bittersweet. I can feel the shock of how quickly the violence escalated, tasting the bitterness from the desperation of being so alone in the immediate first seconds of the downwardly spiraling situation.”

June Garen is a nurse and author of Hey! I Could Use a Little Help Here! My Story of Healthcare Workplace Violence.

She shares her story and discusses her KevinMD article, “In memory of a nurse who died from injuries sustained during a patient assault.”

This episode is sponsored by Tradeoffs, available on your favorite podcast platform.

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Hosted by Kevin Pho, MD, The Podcast by KevinMD shares the stories of the many who intersect with our health care system but are rarely heard from.

Transcript

Kevin Pho: Hi, and welcome to the show, where we share the stories of the many who intersect with our health care system but are rarely heard from. My name is Kevin Pho, founder and editor of KevinMD. Today on the show we have June Garen. She’s a nurse, and she’s the author of the book Hey! I Could Use a Little Help Here! My Story of Healthcare Workplace Violence. There is an excerpt from that book on KevinMD titled “In memory of a nurse who died from injuries sustained during a patient assault.” June, welcome to the show.

June Garen: Well, thank you so much, and thank you for having me. And to all those who are going to be listening to this, thank you for taking time to spend with us.

Kevin Pho: So we’ll get into your excerpt and book in a little bit, but first off, can you share your story and journey to where you are today?

June Garen: I decided to go to college and become a social worker, and at the point that I got out of school with my social work degree, sadly, there were no social work jobs. We were in a political climate that had eliminated pretty much a lot of programs. So I floundered a bit and went back to school to become a nurse, because I thought, “Well, that’ll be the perfect combination, and maybe I could work in a freestanding hospice.” And I’ve yet to even walk into a freestanding hospice, because I detoured and spent decades working in the operating room, raised a family, took care of my elderly parents, got divorced, always worked at the bedside.

And then when my last child was almost out of college, it was time to revisit: What do you want to do with the legacy years of your career? What do you want to do with what you have left? And so I applied to and was admitted into a psychiatric mental health nurse practitioner program and forged ahead. But somewhere along the way, I got a little edgy and wanted to actually go boots on the ground and work in a psychiatric hospital, because I thought that would be the way to really get a sense of what I was doing, to start at the ground level, as it were. And so that was where my story began for the book.

Kevin Pho: So we’re going to get into your book in a little bit, and I would like you to talk about that excerpt titled “In memory of a nurse who died from injuries sustained during a patient assault.” But before you get to the excerpt, tell me about the genesis of that book.

June Garen: Oh, it’s a tricky one. I think that part of my healing, because I was assaulted. I was the victim of a pretty significant assault: subarachnoid hemorrhage, depressed skull fracture, multiple injuries. I’m a big fixer, maybe partly because of being a nurse and partly because of the social work background. I want to see something good come with something bad. I worked a lot of years in, you know, the organ transplant programs, and something good comes of something bad in those programs. And so I needed to have that, and that was probably the start of the genesis.

I tried to make some headway politically. I tried to raise people’s awareness. I tried to explain that we’re working in unsafe workplaces, and it all fell on deaf ears, and it’s a very political atmosphere. And then I thought, “Wait a second. I’ve got my words, and I’ve got my voice, and I can get the story out, and it might help somebody else.” And I think that that was a big piece of healing for me.

Kevin Pho: So please share your story with my audience, and tell me about some of those headwinds that you encountered after sharing that story.

June Garen: If you wanted to think of what my spirit animal at that point was, it was probably a little lamb, because I just was not getting it, that people who represent me in our state legislature would be interested in supporting nursing. It was a very partisan issue. The health care industry had lobbyists that were invited to the table. Staff nurses weren’t included, and I thought, “Wow, this is crazy.” I thought people loved nurses, you know. I thought they’d want to take care of us and this would be appalling to people. And even neighbors and associates would make comments to me like, “Well, what’d you do to piss him off to make him want to assault you?” And I thought, “I was doing my job, pure and simple. Why am I being blamed?”

And then I started to see a whole evolution, that somehow we’re supposed to be perfect, and we’re supposed to be able to de-escalate anything, and there’s really no guarantee or establishment of a safe workplace for a lot of us. I mean, you work in a practice that can be dangerous. We’ve all seen that. You don’t know who’s coming into that room with you. Are there panic buttons available? Will people respond? Do they know how to respond? Those were all really tangible things that I was asking for, and it just kept falling on deaf ears.

So I decided, “OK, I’ll write a book,” because my words and my story are mine, and I can share them. And by being vulnerable and running the risk of being shamed and blamed some more, I might save somebody from going through what I’m going through. I might throw them a lifeline.

Kevin Pho: So I think that you’re right. The public in general, they’re not aware of the dangers that health care workers across the spectrum face. Now you have a platform here. There are people listening to your podcast. You did write an excerpt on KevinMD. Please share some stories about some of the dangers and patient assaults against health care workers.

June Garen: Well, it’s interesting that you would say that, because I think overall there’s an assumption that assaults follow some sort of algorithm, because we love our algorithms, right? You know, the patient comes in, they’re not happy, and all of a sudden they’re going to say this, you’re going to say that, you’re going to hold this position, you’re going to move here, you’re going to make sure you’re by a door. That’s not how it shakes out. You don’t know who’s coming into your office to assault you. You’re there to take care of them. You’re there to help them, and that may not be, you know, being on the defensive all the time. Well, we have to be. It’s tricky, isn’t it, to always know? Because I’m not a mind reader. I don’t know about you, but most of us aren’t.

And so some of these incidents, like the one that I talked about in the book in the first chapter: Lynne Truxillo was sort of my inspiration to get up off of my backside and say, “I can use my words. I can tell the stories. I can ask other people for their stories.” Because Lynne went to work one day at Baton Rouge General Hospital to take care of patients, and by all accounts, she was a lovely nurse and a great person. And one of the patients came after one of her co-workers, and Lynne stepped in at that point to protect her co-worker and sustained injuries that resulted in her death a week later. Those are the things that happen in the real world. There was no chance to use this fancy algorithm that people or employers or the health care industry think that we could just suddenly move into, because patients didn’t get the algorithm for that. They didn’t get that algorithm.

Kevin Pho: So you did tell the tragic story of Lynne Truxillo. What happened in the immediate aftermath? Did anything change to protect the safety of nurses?

June Garen: No, not that I’m aware of. There was, I think, outrage, and she was quietly buried in New Orleans, and business went on. I’ve often wondered if the people who she worked with were even able to get time off to go to her funeral or the calling hours. And no, nothing that I’m aware of changed. If anything, I believe they continue to have more violence at that facility.

Kevin Pho: Now we are, of course, in the midst of the COVID pandemic, 18-plus months, and you hear in other service industries, tensions are riding pretty high. You hear about altercations in restaurants and on airplanes. Now, have you noticed an increase in health care worker violence during the pandemic?

June Garen: I think what was bubbling under the surface, you know, like when you make a pot with water and it just starts to boil, that’s where we were at before, that little simmer. And now what I see is the rolling boil hitting sometimes. There’s nobody who’s immune anymore. School nurses aren’t immune. We hear about parents being upset about having their kids wearing masks in schools. We hear about teachers and teachers’ aides being assaulted because they’re encouraging kids to follow the rules and wear masks. We hear about school nurses being screamed at because you’re sending a kid out to be tested for COVID.

You know, it’s even reached the areas that we thought were kind of safe from it. And I don’t know what it’s like in the emergency room right now, but I can only imagine how horrific that is, between the critically ill patients showing up, the high emotions around a politicized pandemic, combined with just that whole level of trauma and chaos.

Kevin Pho: Now, after reflecting on your story and, of course, the stories in your book, what are some things that nurses can do to protect themselves?

June Garen: You know, in all fairness, one of the things I refer to in the book periodically is chaos theory. Remember, we all had to learn that at some point, where the butterfly’s wings beat, and it’s just a little breeze, but it turns into a tsunami on the other side of the world. So what can we do? What can we change? What can we do to shift the culture?

So one of the biggest things that I can honestly say we can do is to collect data. We have to collect data. Without data, we can’t establish there’s a problem, right? And the collection of data is next to nil. It’s not usable. It’s not well organized. So we need to collect data. If we’re assaulted in the workplace, or if we’re verbally threatened, it needs to be documented. It needs to be put in one place.

What do we do in the meantime? We start to change our thinking so that we don’t accept that behavior. You don’t write, you know, “disgruntled patient.” You actually draw a line in the sand, and you say, “That’s not a productive situation. I want to help you, but if there’s aggression in the room, I can’t do it adequately.” We need to draw that line in the sand of what we’re going to accept. We need to hold our employers accountable. You need to give us a safe workplace. You get to have a panic button on your badge when you’re in a room with an unstable patient, so if you need help, you can push a button and get help in there. You need to have adequate staffing. We need to demand to have our work environment be one that allows us to be healers, not victims.

Kevin Pho: We’re talking to June Garen. She’s a nurse, and she’s the author of the book Hey! I Could Use a Little Help Here! My Story of Healthcare Workplace Violence. June, what are some of your take-home messages from the book that you want to leave the KevinMD audience with?

June Garen: So I think the most important one I can tell you, and I think we can take it home with us, and the audience can take it home: You are worth so much. What you bring to the table is so important. Everybody has a seat at the health care table, and patients need us, and families need us. You are valuable, and nobody can replace you. So with that said, and really believing that, just know that you deserve a place to be safe and do what you do best, and that’s heal patients.

My book is on Amazon. It’s on a variety of indie book venues. You can look even on IndieBound.org and find it. I’m a big proponent of supporting indie bookstores, but wherever you can find it, I would applaud you for getting it. Or if you have somebody who you love who’s been a victim of violence, get it for them.

Kevin Pho: And since writing the book, tell me some of the responses that you received.

June Garen: It’s been interesting, because I think one of the biggest things is that by me being vulnerable and sharing my experience, it’s allowed other people to open the door and realize that they were victimized not only by the violence that they experienced, but by the actual health care industry pushing them aside and not taking care of them after they were hurt. And I think that that’s been one of the most empowering pieces, to have a community now and not be healing by myself.

Kevin Pho: June, thank you so much for sharing your story, time, and insight, and thanks again for being on the show.

June Garen: Thank you.

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