Connecticut Hospital Association Establishes Patient and Visitor Code of Conduct

There was another tragic mass shooting last week. This time it was in the small town of Lewiston, Maine. Words cannot express how truly sad it was. The occurrence of mass killings in America is just relentless.

The violence seen in our society has increasingly encroached into the hospital workplace. This violence can be verbal, it can be physical, it can be aggressive, and it can be deadly. The escalation and the prevalence of violence in hospitals have had a major impact on employees, patients, and families.

In response, the Connecticut Hospital Association (CHA) issued a “Patient and Family Code of Conduct” on Oct. 20.

Let me just quote from the document: 

“Exceptional patient care requires a safe, supportive, inclusive, equitable, and respectful environment that involves a commitment by patients, hospital staff, families, and visitors to maintain such an environment. Behavior that interferes with the delivery of healthcare or creates an unsafe and disrespectful environment is unacceptable.”

The code identifies aggressive behavior, threats, abusive and discriminatory language, and sexual harassment as examples of unacceptable behavior. Further, possession of weapons of “any kind” will constitute a violation of this policy.

Individuals violating this policy can be asked to leave the facility and may be refused non-emergency services in the future.

The Connecticut Hospital Association’s policy is the first of its kind to address violence against healthcare workers at all state hospitals. The CHA’s action may set an example for other states.

We have all read about the increasing number of alarming incidents over the past few years. 

This past June, a nurse in neighboring Massachusetts was slashed in the throat by a patient when she leaned over to adjust the patient’s oxygen tube.

In August, a visitor shot and killed a hospital security guard when he was trying to escort a man out of the Portland, Oregon hospital’s maternity ward.

But it’s not just these tragic and sensational stories that represent the full picture of violence against hospital workers. Nurses, doctors, and other hospital workers are often punched, slapped, kicked, screamed at, and threatened while on the job. These incidents are seldom reported and rarely make it into the local news.

In hospital emergency departments, these incidents often occur because patients and families do not understand the concept of triaged care – where those who are most in need are treated first. People are most accustomed to a first-come, first-served process. Clinicians know that this does not work in an emergency department, and you would think that more would understand that. I guess that for many, my emergency is the most important emergency.

An emergency room nurse at UConn Health reported that she recently had a full urine bottle thrown at her by a patient because she had spent time in the adjacent care station, treating a critical patient. In a suburban New York hospital where I recently worked, we had a father of a little girl brandish a handgun in the emergency department waiting room because he felt that his daughter was not being seen quickly enough.

According to the CHA announcement, at least five healthcare workers are assaulted daily in the state’s hospitals. It is notable that, according to a recent study by the Centers for Disease Control and Prevention (CDC), American healthcare workers now suffer more nonfatal injuries from workplace violence than workers in any other profession, including law enforcement.

Not only does violence in hospitals create a dangerous environment for hospital employees and patients, at a time when nurses and doctors are feeling burned out and leaving the field for less stressful positions, the headlines and the frequent incidents of violence in our hospitals are only making staffing problems worse.

The announcement of the Patient and Visitor Code of Conduct by the Connecticut Hospital Association will help publicize the issue of violence in hospitals and may take some public-relations pressure off individual hospitals in the state.  Everyone who works in a hospital, or knows someone who works in a hospital, should welcome what is hopefully a trendsetting policy.