"We are desensitized": Violence escalating in struggling emergency departments.

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Authors: Diana Duong and Lauren Vogel
Date: Sept. 12, 2022
From: CMAJ: Canadian Medical Association Journal(Vol. 194, Issue 35)
Publisher: CMA Impact Inc.
Document Type: Article
Length: 1,042 words
Lexile Measure: 1370L

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Content warning: Descriptions of violence.

Samantha Marchand says she and her colleagues in the emergency department at St. Michael's Hospital in Toronto have experienced so much violence at work they have become numb to it.

Marchand, a registered nurse who has worked at St. Michael's for five years, says that incidents of physical and verbal abuse occur every single shift. "It's something that's been normalized, and we are desensitized," she says.

Often, the attacks involve patients throwing "vomit, stool, urine, semen," Marchand says.

"I had someone pull a maggot off them and throw it at me," she recounts. Another patient "pulled off a necrotic digit, a toe, and threw it at staff."

And in one incident that Marchand found particularly disturbing, a patient who was upset about being discharged trashed a room and left a used needle poking up under some sheets, seemingly to cause a needlestick injury.

"There are some very extreme things that have happened," Marchand says. And the violence seems to be escalating as emergency departments are increasingly understaffed and overwhelmed.

More intense, less predictable threats

"It's becoming more problematic in that it's less predictable," says David Kodama, an emergency physician at St. Michael's. "We're starting to see patients who we normally wouldn't think would be overly aggressive becoming both verbally and physically abusive."

High-risk situations requiring police intervention are also "much more common than in the past when we could handle these things more internally," Kodama says. One recent incident involving a patient wielding a small axe led to an arrest.

Before the pandemic, health care...

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Gale Document Number: GALE|A716601215