Happy new year?

The good news is according to the CDC life expectancy has hit a new high of 78.8 years. Women live an average of 81.2 years and men 76.4. The top ten causes of death in 2012 are the same as 2011. In order of decreasing frequency they are: heart disease, cancer, chronic lower respiratory diseases, stroke, unintentional injuries, Alzheimer’s disease, diabetes, influenza and pneumonia, kidney disease and suicide. Fewer people died from eight out of ten of these causes. The rate of unintentional injury remained the same. Suicide increased.

The October issue of the National Safety Council’s “Safety and Health” magazine noted that law enforcement fatalities were 31% higher in the first half of 2014 than they were in 2013. The same issue noted there were 97 fire fighter deaths in 2013 compared to 64 in 2012. There was no article in that issue that addressed deaths among EMS personnel. Not surprising, because it’s not new, transportation incidents accounted for 40% of all workplace injuries. What is surprising is that one out of 6 fatal workplace injuries was the result of violence, including suicide and homicide.

A recent report from the Bureau of Labor Statistics (BLS) showed that violence related nonfatal occupational injuries and illnesses involving days away from work for healthcare and social assistance workers was 15.1 per 10,000 full time workers in 2012. The overall rate for private industry was 4.0. Patients with a history of violence and alcohol or drug abuse were most often involved. Part of the problem is that some of us view it as “routine and part of the job” to be swung at, pushed or verbally abused. After all, ”he was only drunk or she was only stoned.” Specific training that enforces situational awareness, the recognition of potentially violent situations, de-escalation, escape and self-defense are important. The American Nurses Association is pushing for legislation that mandates this type of training for the health care industry. The Emergency Nurses Association wants to make it a felony in all states to attack or commit battery (unlawful touching) on an ED nurse. Laws involving attacks on healthcare workers may have unfortunate language that limits their applicability. For example, Kansas has penalties limited to mental health personnel. This was passed after a client decapitated a social worker with a chainsaw during a home visit. Mississippi laws apply to public health personnel. Louisiana’s cover all emergency department personnel. Several states have recently used legislation to enhance the protection of healthcare workers.

In March, Idaho passed a bill that makes it a felony to assault any healthcare worker. Conviction may result in a three year imprisonment. Last August, a bill was passed in Louisiana that makes committing battery against emergency personnel or healthcare professionals an offense which carries a maximum fine of $1,000 and imprisonment of 15 days to six months. If the injury produced by the battery requires medical attention, the fine may be increased to $5,000 and the imprisonment to one to five years. In Texas, it recently became a felony to assault emergency department personnel. Previously, it was a misdemeanor. Until the new law passed, only an assault against EMS personnel working in the field was a felony.

Naturally, for any of this to be effective you must have an excellent working relationship with law enforcement and local prosecutors. You should have a reporting mechanism in place that is developed with them under the guidance of local counsel, your Medical Director, and appropriate internal staff, such as Human Resource professionals. How can laws be enforced when the events are not reported? We need to change our culture. If we do not view violence directed at us as unacceptable, how can we expect the public to do so? This is not punitive. It is protective and preventive.

The good news is we all have a chance to live longer. The bad news is that we all need an enhanced level of proactivity to survive our dangerous work environment.

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