Careers often align with personality, interests, morals, and aspirations. This allows professionals to develop a sense of passion for, and fulfillment from, their chosen field. I chose emergency medicine, like so many others, to care for patients who are in their most vulnerable state. We must know a little about a lot or, more accurately, a lot about a lot. We must be flexible. We must adapt to nuances that might be encountered. We must be ready to intervene.
Explore This IssueACEP Now: Vol 43 – No 01 – January 2024
Think about the person who served you your morning coffee with genuine friendliness, considering every detail in that process—from brewing to presentation—and everything in between. Their enjoyment for what they do is clear. Did you ever think about their safety as they are passing that cup of coffee over to you? Do they think about their safety as they are steaming milk or pressing espresso beans?
As a member of the Air Force, deployed to Afghanistan in 2011, I have seen war where I should have seen it—in a designated war zone. Unfortunately, I have also witnessed violence in places where in all regards I should not have. As an emergency medicine resident, I have seen the toll that workplace violence is taking on our specialty, our patients, and our entire medical community. A recent incident in which a colleague took his own life with a firearm while on shift has brought these issues into sharp focus for me, with the need to understand that workplace violence is not simply “part of the job.”1
The questions raised by this tragedy are many: How did a gun make its way into the emergency department in the first place? Data from the National Institutes of Health suggests that up to three percent of ED visits result in a weapon being confiscated, and there has been an increase of 20 percent of firearm deaths since 2019.2 But this was not a patient, it was a colleague! Why were there no safety measures in place to prevent this from happening? More than just security and metal detectors, where were the mental health resources to support this health care professional? Was anyone close to him checking on him, asking questions? Working in the emergency department, we are subject to high rates of burnout, depression, and anxiety that have all been exacerbated by the COVID-19 pandemic.3 Perhaps most importantly, how was this individual able to function at a high level, caring for patients while in such psychological distress? These questions are impossible to answer, and uncomfortable to discuss, but they demand our attention. The medical profession cannot continue to ignore our own personal safety. The gaps in safety that exist in our workplaces need emergent attention. It is not just a matter of physical safety. It is also necessary to address the critical issue of mental health. Stigma surrounding mental health among those who provide health care must change. We must create an environment in which it is okay to ask for help when we need it, without fear of judgment or repercussions.