WASHINGTON, D.C. -- Violence against emergency department workers, like the recent violent abduction of the emergency medicine resident Abby Lockhart in the television drama “ER,” may be more fact than fiction. A new study to be published online today by Annals of Emergency Medicine finds verbal threats, physical assault and even stalking are not uncommon workplace problems for emergency physicians. (Workplace Violence: A Survey of Emergency Physicians in the State of Michigan).

Of the 171 respondents surveyed, 76 percent (131) reported experiencing at least one violent act over the previous 12 months. Three-quarters (74.9 percent) of respondents said they had encountered verbal threats; nearly one-third (28.1 percent) indicated they were victims of physical assaults; 11 percent indicated they were confronted outside the emergency department, and 3.5 percent reported experiencing stalking events.

“Emergency departments by their very nature are high stress for both the patient and staff,” said lead author Terry Kowalenko, MD, of the University of Michigan Medical Center in Ann Arbor, Michigan. “Add to that mix patients who are intoxicated, in a state of drug withdrawal, suffering from delirium, or have psychiatric problems that may make them more prone to violence — and you have a potentially volatile atmosphere.”

Despite the large majority of emergency physicians experiencing a violent act, 80 percent said they are only occasionally fearful of workplace violence, while a little more than 9 percent said they were frequently fearful. In response to their fear of violence, forty-two percent of emergency physicians report that they did obtain some sort of protection including obtaining a gun (18 percent); a knife (20 percent), a concealed weapon (13 percent), carrying mace (7 percent) or a club (4 percent). However, most (31 percent) used a security escort as their method of choice for personal protection.

The survey also found it is not just patients who are violent. Of the emergency physicians who reported experiencing physical assaults, 89 percent came from the patient, 9 percent from a family member, and 2 percent from a friend of a patient. Drugs and alcohol appear to be the major factor in the most violent acts. Emergency physicians reported that 45 percent of physical assaults occurred with patients who were believed to be intoxicated.

Despite the potential for violence in emergency departments, only one-third (27 percent) of  emergency physicians report their hospital has permanent security officers assigned to the emergency department, and 24 percent  reported having general hospital security staff that included the emergency department in their rounds of the hospital. However, the study authors said further research is needed to determine if increasing the presence of security personnel would decrease the violence.

Source: ACEP