Healthcare workers are continuously at risk of violence while they are working, more-so than in all other work environments put together. This is a problem for many obvious reasons. Here, I am going to suggest that there are large, hidden consequences to not addressing this problem.

If we continue to allow violence to be perpetrated against the healers and problem-solvers of the healthcare system, we will lose the ability to navigate in these complex and changing times.

Fear changes the way that the human brain thinks.  

Consider neurobiology:

The brain can be divided into three parts:

1. The survival brain/ the basic or reptilian brain

2. The emotional brain/ the limbic system

3. The thinking brain/ the neocortex

The reptilian brain is responsible for staying alive and related tasks including temperature control, hunger and fight-or-flight responses.  

The limbic system is more complex.  It involves emotions.

What makes us unique as humans is the neocortex. This is where complex thought, such as engaging in complex social environments and planning for the future happens.  This is where curiosity and problem-solving occurs.

To all of this, there is an efficiency.  When survival is threatened, the basic reptilian brain engages and leaves rational thought and detailed problem solving to a time when the being is no longer in danger.  Emotional responses can occur without having to draw on thought processing and rational consideration.

The consequence of this efficiency is that survival and emotional needs must be met before higher thought can occur.

This correlates well to framework of Maslow’s Hierarchy of Needs:

The idea of this pyramid is that you cannot ascend to the next level of the pyramid until those needs at the base have been met.  The reptilian brain aligns with physiologic needs and the limbic system, once safety is met, can ascend into love and belonging.  Once these needs are met, we can grow into higher thought, to move to esteem and eventually self actualization. At any point, if we disrupt needs at the base level, the ability to ascend to higher needs and complex problem-solving is halted.

We need to ask ourselves what we would like from our healthcare system and those that work within it.  We need to consider what a diet of violence and disrespect does to the two wolves within those that work in healthcare. If we want “joy, peace, love, hope, serenity, humility, kindness, benevolence, empathy, generosity, truth, compassion, and faith.”, we must have safety first.

If we want to effectively manage and problem-solve the complexity and change that is the constant of healthcare, we must have safety first.

If we do not prioritize resources to protect the health, safety and well-being of those that work with already vulnerable populations, we have already decided that compassion, empathy, respect, problem-solving, and good teamwork are also not a priority.  

Address safety.  Before any other topic.  

Safety is a basic need.