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MGH

Published On January 21, 2019

POLICY

Silent No More

Peter L. Slavin and Timothy G. Ferris discuss the need to end workplace violence in health care.

On the afternoon of November 19, shots rang out in the emergency room of Chicago’s Mercy Hospital & Medical Center. Four people died, including a first-year pharmacy resident and an emergency room physician. The outpouring of grief and outrage from the medical community was swift, less because the attack came as a surprise than the fact that, by now, such an incident feels inevitable.

Those who practice medicine are no strangers to violence. Clinicians treat people in their most vulnerable moments, and many patients have been underserved by mental health care and social services. But violence in hospitals is on the rise, as “When Healers Get Hurt” relates. And when violence happens, clinicians too often feel pressure to brush it off and assume it’s part of the job. They are trained to think of patients’ needs first, and so a culture of tolerance for such incidents has been building, not for years, but decades.

Silence is not the answer, however, and neither is complaisance. At Massachusetts General Hospital, we have built a series of protocols to be prepared for any situation. The Center for Disaster Medicine has worked through active shooter scenarios and taken the entire hospital through a drill that included Boston Police and Boston EMS. We have equipped work stations with panic buttons. We have invested in strategies that help us spot troubled people before they cause harm.

Above all, we have become students of how to de-escalate tense situations. Behavioral psychologists have made strides in establishing techniques that can manage aggressive behavior. Staff members can take part in seminars to learn how to respond. We are committed to doing everything we can to help keep patients from hurting themselves and others.

A recent conversation about this topic has trended on Twitter under the hashtag #silentnomore. It is indeed time to break the silence. It is our job as a profession to listen to one another and make sure that hospitals remain a safe place for patients and their healers.

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