According to the OSHA, there are approximately 1,875 workplace assaults reported annually in health care and social service settings. This doesn't include the unreported incidents.

We all know. We already know. About the violence. And that we love what we do for a living anyway.

The numbers that run through my head during the day aren't about the 154 hospital-related shootings identified between 2000 and 2011…the 235 deaths and injuries…about where the statistics for 2012-2018 might be…how the numbers might look like if statisticians started including stabbings…or even just threats.

The numbers that run through my head are how much longer I might be able to go without a bite to eat, how many mg/kg to dose my next patient, how many beats per minute room 414's heart can sustain before going into a lethal arrythmia. I'm counting down hours and I'm counting grocery money.

My mind wanders sometimes, when it's quiet.

We all know. We already know.
That the perpetrators of violence in the workplace are sometimes patients, sometimes family members, and most recently, sometimes outsiders running into where we work. Sometimes the violence is premeditated, sometimes spontaneous.

I thought about a "safe space" and I laughed to myself about the irony of it. The average patient room size in the U.S. is 320 square feet. I close the door behind me each time I enter a patient's room, for patient privacy.
If I'm in a bigger room, it'll give an assailant more space to charge at me. Smaller? Closer to grab me or stab me, and less time for me to escape or fight.
Could anyone hear me out there, in that big hallway? Could I reach the call button for help?
Pull a fire alarm or press that little code blue button? How quickly could security come?

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"I should have taken those self-defense classes."

I'm not alone in this weary healthcare worker community, because I've looked around, and I can see. "The weaponized nurse." The singularity that travels and works alone, carrying a small protective device. We've made our choices carefully, something we can grab in an emergency, but not something anyone can see or disarm from us. Is a wave across the country? The weaponized nurse? Our newest jargon include phrases like "lock-down" and "active shooter." We have new code colors. "Weapons threat." "Bomb threat." Should we be comfortable with being weaponized, even though minimally? Get dressed at the beginning of your shift: ID badge, stethoscope, shears, pocket knife.

Now we have "self-care" and "mindfullness" too. My self-care includes this small token of protection. I'm being mindful of my own safety.

Now I ponder, there's the active shooter. "What does rapid gunfire sound like?" I think to myself. The news articles say it sounds like fireworks. I suppose there'd be screaming and some sort of alarm going off. I can handle screaming and alarms. I've had years of schooling and years of medical training. But gunfire?
I'm not ready for this. I'm not prepared for this.
Is the gunfire nearby? My ears would ring, it would be deafening. It's hard to work when you can't hear. I'd have the urge to flee. But where do you go, if you can't hear and you don't know which direction in which to flee? Maybe stay put. Check my cell phone. For who? For what? Call for help? Who do I call? I'm not ready for this. I'm not prepared for this.

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My mind wanders sometimes when it's quiet.

But it's time for me to snap out of it; get out of the shower, put on my scrubs. Time for another 12 hour shift. As a weaponized nurse.

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