Hostility in the Hospital: The Challenge of Caring for Combative Patients (Ethics Committee Sponsored)
Healthcare workers are five times more likely than the average worker to be the victim of workplace violence and surveys indicate these incidents are on the rise. The emergency department faces unique challenges in the provision of care for hostile or aggressive patients and these clinical scenarios pose complex legal and ethical dilemmas. Striking a balance between delivering patient care, ensuring patient safety, and preserving staff well-being can be a daunting task. This presentation aims to help attendees form an ethical framework to apply to these encounters and explore strategies to implement it. Following a brief review of the relevant ethical and legal considerations and the principles to be applied, our panel of discussants will illustrate these principles in practice using a case-based format. Cases will offer an opportunity for reflection on ethical practice in challenging clinical moments that can physically and emotionally strain healthcare workers. The speakers will draw from their experience and expertise to offer tips to listeners on the safe and ethical management of combative patients in the ED and measures to avoid common pitfalls.
Presenters:
- Kevin McGurk, MD
- Ashlea Danielle Winfield, MD, MSPH
- Edward J. Durant, MD, MPH
- Sanché N. Mabins, MD
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Kevin McGurk, MD
Assistant Professor
Medical College of Wisconsin
Dr. McGurk is an assistant professor in the emergency medicine department at the Medical College of Wisconsin. Prior to pursuing medicine, he worked as an elementary school teacher in the D.C. public school system. He received his medical degree from the Virginia Tech Carilion School of Medicine and completed his residency at Cook County Health, where he also served as chief resident. Dr. McGurk's professional interests include medical education, retrospective research, and medical humanities. He is the M3 EM clerkship director and the 2023 recipient of the Joseph C. Carin Excellence in Teaching Award. -
Ashlea D. Winfield, MD, MSPH
Cook County Health
Dr. Ashlea Winfield is an Assistant Professor of Emergency Medicine and the Associate Director of the Cook County Health Simulation Center in Chicago, IL. Dr. Winfield earned her Master of Science in Public Health from the Tulane University School of Public Health and medical doctorate from the Louisiana State University Health Sciences Center School of Medicine in New Orleans. She then went on to complete her residency at Cook County Health where she served as a chief resident, earning her the highest leadership award granted by her department to a resident physician, the Robert Simon Leadership Award. She then completed her emergency simulation fellowship at Cook County Health.
Dr. Winfield has created multiple initiatives aimed at fostering a culture of safety and equitable treatment for all individuals within her program and institution. Dr. Winfield has lectured nationally and regionally on topics related to caring for gender expansive patients, trauma informed care, racism, implicit bias, and promoting equitable processes in residency recruitment. Dr. Winfield is a member of the Academy for Diversity and Inclusion in Emergency Medicine (ADIEM) Executive Committee and co-chair of the Resident and Trainee committee. Due to her ongoing diversity, equity, and inclusion efforts she was awarded the Cook County Health Physician of the Year in 2022-2023 and is a member of the National Minority Quality Forum (NMQF) 2022-2023 40 under 40.
As the Associate Director of the Cook County Simulation Center, Dr. Winfield directs simulation-based education for emergency medicine residents with a focus on procedural competency and task trainer development as well as using simulation to teach topics in diversity, equity, and inclusion. Dr. Winfield also uses her expertise in medical simulation to inspire youth to pursue careers in STEM by partnering with local high schools. She is also a board member of local non-profit; the I Am Abel Foundation which helps youth in Chicago reach their dreams by allowing exposure to careers in healthcare and providing resources to achieve their educational goals. -
Edward J. Durant, MD
Kaiser Permanente Central Valley
Ed is an emergency medicine physician at the Kaiser Permanente Modesto Medical Center in Modesto and a clinical assistant professor for the Kaiser Permanente Bernard J. Tyson School of Medicine. He is an associate investigator and site lead for the Clinical Research on Emergency Services and Treatments (CREST) Network, local research chair for the Central Valley, and research director for the emergency medicine residency program. He received his Masters in Public Health from the University of California at Berkeley and his medical doctorate from the University of California, San Francisco School of Medicine. He completed his EM residency at Alameda Health System (Highland Hospital) and his ultrasound fellowship at Oregon Health & Sciences University.
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Sanché N. Mabins, MD
Cook County Emergency Medicine Residency
Dr. Sanché Mabins is an Emergency Medicine Resident at John H. Stroger Cook County Health in Chicago, IL. Her professional journey encompasses two years of research at the National Institutes of Health in Bethesda, Maryland, culminating in the successful completion of her Medical Doctorate at Loyola University Stritch School of Medicine. Dr. Mabins has established herself as a published author, contributing to SAEM Pulse in July 2023 with her insights on "Racial Trauma: The Burden of Being Black in Medicine," and to AEM E&T, where she explored "When Screens Become Mirrors: Black Women in Medicine Finding Belonging through Social Media." She has been recognized in the ACEP Annual Report 2021, ACEP HeART of Emergency Medicine, and Academic Life in EM Graduation Art Exhibit for her exceptional talent as a watercolor artist.
In addition to her academic pursuits, Dr. Mabins exhibits a profound dedication to Social Emergency Medicine and community involvement. Currently serving as a PGY-4, she is poised to embark on a new chapter as the inaugural Social Emergency Medicine Fellow at the University of Illinois Chicago, commencing this July.