Medical professionals are increasingly reporting incidents of physical and verbal aggression from patients and their families in emergency rooms, leading to calls for improved behavior in these high-stress environments.
"Patients and their families come to the Emergency Department on their worst and most stressful days, and we’re here to support them through it," said Dr. J. David Gatz, associate medical director of the Adult Emergency Department for the University of Maryland Medical Center. "We’re extremely understanding overall, but we’re often seeing many cases at one time, and it’s critical that the behavior of one person not negatively impact another."
According to a study, 66% of emergency room physicians reported being assaulted in the past year, with over a third reporting multiple assaults. Another study found that 71% of physicians have witnessed an assault at work, and 97% of those perpetrators were patients. Incidents that Gatz has witnessed include staff and equipment damage, and the smearing of bodily waste.
Medical professionals emphasize the importance of patience, especially during long wait times. Dr. Jared L. Ross, an emergency physician, explained that care is prioritized based on the severity of a patient's condition, a concept that can be difficult for those experiencing discomfort. "I know that wait times can be atrocious in busy ERs," Ross stated, acknowledging the frustration. However, he added that demanding immediate attention can disrupt staff focus and create unnecessary tension.
Kisha Pickford, an acute care nurse practitioner, noted that ER teams are managing a wide range of critical cases, from trauma to sepsis, and that courtesy and patience are vital. "People forget that ER teams are juggling trauma, sepsis, stroke and COVID, not just mild fevers or stubbed toes. Courtesy and patience go a long way," she said.
The behavior of companions also impacts the ER environment. Registered nurse Karen Selby stated that while a calm companion can be helpful, large groups can create noise and chaos, potentially delaying care. Visitors sometimes exhibit aggressive behaviors, such as yelling about wait times or threatening staff, which diverts attention from critically ill patients.
Staff also pointed out that many individuals visit the ER for non-emergencies, which can exacerbate wait times. "ERs are designed to prioritize life-threatening conditions first, such as heart attacks, strokes and trauma," Selby said. "If you come in with a minor issue, you may wait hours while more critical patients are treated." Additionally, ER visits are often significantly more expensive than urgent care or primary care appointments. Dr. Ross advised patients to consider "self-triage" to determine if their condition could be treated more quickly and affordably at an alternative medical facility.