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Strategies for Managing Violence Against ED Personnel

[polldaddy poll=7143096] According to published data, about one in four emergency physicians (EPs) and nurses report that they were victims of physical assault in the past year. A recent study found that as many as 78% of EPs reported at least one act of physical or verbal aggression in the previous year, and 21% reported more than one episode. Another analysis revealed that before completion of training, more than 50% of emergency medicine residents had been physically hit or pushed by patients. Fear of assault or being shot was their second-leading concern, trailing only needlestick injuries from patients with HIV. EDs have been identified as high-risk settings for workplace violence (WPV), says Terry Kowalenko, MD. “In addition to the immediate concern of personal safety, WPV can decrease productivity and job satisfaction and contribute to the problem of early burnout. The toll of WPV may be even higher for non-physician staff. What’s clear is that data from recent reports on WPV are concerning, as the threat of violence in EDs is escalating throughout the United States.” A Call to Action: Preventing Violence in Healthcare Several organizations, most notably the Occupational Safety and Health Administration (OSHA), have recently issued a call to action to improve initiatives aimed at preventing violence in healthcare settings. In the Journal of Emergency Medicine, Dr. Kowalenko and colleagues had an analysis published that reviewed ED workplace violence in the context of risk factors for WPV. The study also reviewed current concepts for interventions designed to prevent WPV in the ED. “The reasons behind WPV in the ED are multifactorial,” explains Dr. Kowalenko. “Factors such as mental...

Laparoscopy: Patients Benefit, But Do Surgeons Suffer?

When compared with open surgical techniques, the benefits of minimally invasive surgery have been well documented in medical literature, including increased safety, quicker recovery, shorter hospital stays, and cosmetic advantages. Nonetheless, surgeons who perform a majority of their cases laparoscopically appear to encounter physical stress and mental strain beyond what they experience when performing open surgery. New survey findings suggest that surgeon burden may be greater than previously assumed. “Surgeon injuries appear to be a significant problem that not only affects surgeons but also all stakeholders in the delivery of healthcare, particularly surgical care,” says Adrian E. Park, MD. “Any type of surgery, particularly minimally invasive surgery, takes a physical and mental toll on surgeons. They continuously adapt to ensure the best outcome for patients, often dipping hugely into their own health reserve. We’re not going to serve our patients, the public, or the healthcare system well if we have prematurely shortened careers because of the physical tolls and cognitive ravages of what we do.” Scant literature is available on the extent to which strain during laparoscopy affects surgeons’ bodies when compared with open surgery. In a study in the March 2010 Journal of the American College of Surgeons, Dr. Park and colleagues published a study that sought to confirm the prevalence of minimally invasive surgery-related operator symptoms and discomforts within a broad population of laparoscopic surgeons. Since previous surveys, the adoption rate of minimally invasive procedures has steadily grown, and more surgeons are now performing these surgeries than ever before. According to findings from the study, a fairly astounding number of injuries or symptoms were related to occupation...
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