{"id":23151,"date":"2020-05-25T08:58:36","date_gmt":"2020-05-25T13:58:36","guid":{"rendered":"https:\/\/feminem.org\/?p=23151"},"modified":"2020-05-25T08:58:38","modified_gmt":"2020-05-25T13:58:38","slug":"in-harms-way","status":"publish","type":"post","link":"https:\/\/feminem.org\/2020\/05\/25\/in-harms-way\/","title":{"rendered":"In Harm’s Way"},"content":{"rendered":"\n

Dr. Rebecca Smith-Coggins is a practicing emergency medicine physician at Stanford University Medical Center and the Associate Dean for Medical Student Life Advising at the Stanford School of Medicine. She has been an ardent cheerleader for physician wellness long before it hit center stage. Initially fascinated by the challenge of lessening the impact of the dark, ugly night shift, she wired up residents and attendings with EEG\/EOG leads to study their sleep patterns. She started the EM residency at Stanford and was the first Residency Director for 12 years before she pivoted to the medical school environment and became an associate dean.  She developed, implemented and published a medical student mistreatment reduction program and has more recently taken on the worsening issue of patient aggression toward doctors. <\/p>\n\n\n\n

In her FIX19 talk, she shares a personal story of an encounter with a violent patient that resulted in a swing and a miss by the patient.       <\/p>\n\n\n\n

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When did we sign up to put ourselves in harm\u2019s way?  We have unwittingly discovered that we are\npoorly prepared and inconsistently supported to handle these tough\ninteractions. She advocates for physicians speaking up and helping to end the\nviolence that besieges our nation\u2019s Emergency Departments. <\/p>\n\n\n\n

Teaching de-escalation strategies and self-defense in our\nnation\u2019s medical schools is beneficial for physicians and patients alike.\nReplacing the workplace trial and error learning approach with evidence based,\nlearner engaged sessions would give us a toolkit of solutions.  Paraphrasing patient\u2019s statements, setting\nclear limits and staying close to the door are just a few options that would\nenlighten our medical students. A video scenario based curriculum that is newly\ndeveloped at Stanford University can be accessed for free here<\/a>.<\/p>\n\n\n\n

Dr. Smith-Coggins\u2019 personal vignette illustrates the need for a dramatic culture shift in how hospital\u2019s handle violence in the workplace. Increased resources for hospital security departments, widespread use of metal detectors, automatic debriefing sessions after threats of violence and \u201copt out\u201d mental health care for those who are assaulted so that an appointment with a therapist is made and the individual has to actively cancel it are ways to potentially lessen the negative influences of workplace violence.  Utilizing a new debriefing strategy called \u201cThe Hot Offload\u201d may prevent PTSD and can be accessed here<\/a>. <\/p>\n\n\n\n

She also emphasizes that it is\nimperative that we strongly advocate to abolish questions on state medical\nlicensing applications that require a physician to report prior mental health\ncare.  Presently, more than half of our\nstates include these questions. Research shows that physicians were more likely\nto be reluctant to seek help when they were working in states where medical\nlicensure requires answers to questions about prior mental health diagnoses or\ntherapy. (1) <\/p>\n\n\n\n

Violence must never be accepted as part of the job!  We must not accept what isn\u2019t working!  It is time we advocate for everyone\u2019s safety, so we are no longer in harm\u2019s way.<\/p>\n\n\n\n

Watch the FIX19 talk below!<\/em><\/p>\n\n\n\n

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