We Must Demand More From Those In Power: Holding Police Officers to A Higher Standard
While I’ve never been a police officer, I know what it’s like to endure constant threats of violence in the workplace and the need to make life or death, split second decisions, about my life and others’. I know that we are right to demand more from those in whom we place enormous trust to make the right call in tough situations.
When I was in college, I worked at the VA Hospital my last summer before graduation. I worked as a nursing assistant and was excited to get some real experience before graduating nursing school. It was a little bit of a different on-boarding process though: this was a job with the federal government, which meant fingerprinting, background checks, and even an interview with an FBI agent to make sure I was who I said I was. For a 20 year old, it was a pretty intimidating process for a summer job! But I was excited to get to work. Then they told me what I would need to do for my new job orientation, besides the usual stuff: get training on how to literally survive this job.
This was the VA Hospital in Battle Creek that specializes in mental health long term care. As they told us “every patient in this hospital has been trained to kill by the US military, so you need to know how to defend your life. However, every patient here is YOUR patient, and you are in charge of their health and safety.”
We learned defense, we learned de-escalation, we learned to escape and regroup, and we learned how three completely unarmed people can safely “take down” anyone, no matter how strong, armed or not, without hurting the patient.
During the entire training series, they emphasized not only our safety, but the need to keep the patient safe while we “took them down.” The entire time we were to be laying hands on a patient, we were to be talking to the patient, asking them to calm down, asking about their airway and breathing, explaining what we’re doing, why we’re doing it, what we want them to do and what’s going to happen next (usually involving some kind of sedative.) This tactic of course was only ever to be used in the most extreme situations when all other diversion and de-escalation measures failed and the person was causing immediate danger to themselves or others around them. It was never used for someone destroying property. As our instructor told us when someone asked about laying hands on if someone was “trashing a room.” He replied “Stuff is stuff, it can be replaced. People cannot be replaced. If they need to take their rage out, better on stuff than people.”
Luckily I never had to use this training while working at the VA. But I did use all the self defense and de-escalation tactics I was taught. Sometimes it worked, two times it did not.
During my time at the VA I was attacked twice. In the first incident I was punched in the face by a patient, who indeed told me he was going to punch me in the face. I did not take him seriously, and kept doing whatever I was doing at the time assisting the nurse. Sure enough he reared back his fist and punched me right in the eye. I learned to always listen to threats after that and believe a patient when they say they are going to hurt you. The second incident happened one afternoon while walking down a hallway and found myself alone passing a patient. Faster than I could react he pushed me against a wall, put his forearm into my neck and groped me. I remembered my training on how to escape a situation like that, broke free and ran. While I reported each incident to my manager, and was understandably incredibly upset, I never hit or hurt either of them back, nor would I ever have dreamed of it.
Did I deserve that? No. Should I have used that as a rationale to physically retaliate against these men as a means to regain control and assert my authority? Absolutely not. It was my job to remain professional and uphold my mission — to maintain the health, safety and dignity of my patients. So I remained calm, I remained professional, and I learned in those moments that I had what it took to be a nurse — that I could still feel a compulsion to help even those who were threatening me or even hurting me, because they still deserve compassionate care.
Unfortunately, violence against nurses is not just contained to one kind of hospital system, or one kind of patient population, and doesn’t just come from patients themselves.
I have had my life threatened, I have had weapons pointed at me, I have had objects thrown at me by family members of patients. I have been bitten, slapped, stabbed with needles and kicked more times than I can count by patients while on the job.
I have been disrespected, sworn at, yelled at, bitched out, flipped off, and had people get in my face many, many, many times.
I have had bodily fluids thrown at me, had my pregnant belly jabbed at with an angry finger and received more verbal threats of bodily harm than I can count.
These responses usually came in times of chaos like code blues, emergency procedures, placing patients in restraints and/or telling someone “no” when they wanted something “RIGHT NOW!” (Many times I was just the messenger with no power in a given situation, which then of course put me right in the line of fire.)
Even given these chaotic, scary and tense situations, I knew it was essential that I remain calm, work to keep my patient safe, and de-escalate the situation so we could all get back to the job at hand: helping the patient. I never, not once, ever returned fire. I never once, even when in fear for my life, felt emboldened to use my immense power over someone’s life or death, by virtue of my role as their nurse, to get revenge for how I felt wronged, disrespected or intimidated. I de-escalated, walked away when appropriate and I only ever called for security back up when someone’s safety was in immediate jeopardy. I always put the safety, health and DIGNITY of my patients at the forefront of everything I did. That’s what my profession calls me to do, and that is what I would expect from anyone acting as my nurse.
And should I ever fail to act according to my professional standards, should I ever let my fear or rage take over and intentionally harm a patient or their family members, I would never be allowed to practice ever again. I would have shown that I do not have what it takes to be a nurse, and I would be relieved of my license and barred from practicing again as a nurse, anywhere. I would likely even face civil or criminal charges, which would be warranted.
So I understand what it’s like to work in high pressure settings where life or death decisions are made in some of the most hostile situations. I also know what it’s like to have the highest expectations for conduct imposed on me, and know that professionals rise to the occasion every day on a mission to “Do No Harm.” I have never been a police officer, I do not know what it’s like to do that job. But I have had to do my job under extreme duress. And that has never, ever, given me permission to hurt the people I’m trying to help.
I expect the same level of mission driven professionalism from those sworn to protect and serve. They have the same, if not greater at times, power over life and death of our fellow citizens than healthcare professionals do and therefore must be held to the highest standards. We need to know that when we give someone power over life and death, that they are trained, accountable, supported and have the discipline to be given such awesome power.
As we continue to make the needed changes to our law enforcement systems, we need to be resolute in our demands to ensure real lasting progress happens. From my perspective, it’s far past time to place the highest level of professional standards upon police offers, while at the same time, acknowledging the need for enhanced peer review, increased funding for professional level pay and dynamic supports deserved by those willing to step up and serve their community.
So what kinds of changes should we be demanding? Well, from my perspective of accountability in the healthcare profession, here are five recommendations I have on how we can start to reduce police violence through not just culture change, but policy change as well:
- We must have updated policies and procedures related to the use of force, when you can and cannot lay hands on someone, and when you can and cannot discharge your weapon. (Read more about #8CantWait for recommendations for policies to decrease police violence.)
One way to reduce bias is to have clear, standard procedures, intense documentation and serious accountability for anyone who does not follow policy. We have these expectations for high risk situations in healthcare. Take for example when it is necessary to restrain a patient against their will. The use of restraints are always a last resort. Every other diversion tactic, including having a bedside sitter, needs to be attempted prior to them being administered. But when they are necessary, they have to be ordered by a doctor, who has to lay eyes on that patient within a certain time from of ordering that restraint, and that order has to be renewed every 24 hours. If these requirements are not met, then the restraints must be removed. The nurse needs to assess a restrained patient every 15 minutes-2 hours (depending on the type and reason) to ensure their skin is intact, their basic needs are met, and that they are safe. There is robust documentation needed at every step of the way until that patient is no longer restrained so should someone have a negative outcome as a direct result of restraints, there can be clear and definitive accountability. And the second they are no longer needed or appropriate, they are removed. They are never used as a punishment for any real or perceived insult from the patient.
The very seriousness of restraining someone under arrest, or being held in a cell awaiting release, needs to have the same high level of standard protocol, intense documentation, and serious accountability for any violations.
2. We need a system to certify and track licenses, complaints and disciplinary actions taken against law enforcement officers which is made available to the public.
We license everyone from nurses and respiratory therapists to barbers and nail technicians. My license is available through the Michigan Department of Licensing and Regulatory Affairs (LARA). You can see when I was first licensed (2006), when my current license is valid through (2021), and if I have any complaints filed against me or any disciplinary action on my license. (Spoiler alert, I do not.) Any potential employers can verify my license and have access to my license record. This is a safety measure to ensure that anyone licensed who acts dangerously is not able to job hop, and the public is kept safe.
Anyone who has the ability to do harm by virtue of their profession should have to prove competency to gain a license, undergo continuing education in order to renew that license regularly, and their status must be made publicly available. Their ability to practice their profession should depend on maintaining that license, and the risk of losing their license increases compliance with all laws regarding their profession.
We also require anyone with a license to undergo continuing education and there can be requirements for a certain topic to be addressed. For example, we could require continuing a minimum number of education hours for racial bias training as a condition of license renewal. I would prefer this to be a requirement of licensing rather than a suggestion made that may or may not be followed.
3. We need a state professional board that oversees licensed police professionals complaints instead of relying on just an“Internal Affairs” system for handling complaints.
No good comes of allowing any organization to police their own, including, the police. In Michigan, complaints made against officers are handled by the Professional Standards Section of the Michigan State Police. According the MSP website the process for handling complaints against an officer regarding misconduct are: “Depending on the nature of the complaint, allegations of misconduct will be investigated by Internal Affairs, a field investigator, or the employee’s supervisor.” This internal only system, with no public accountability, is a gigantic conflict of interest, diminishes accountability and is one of the reasons we have seen systemic problems go unaddressed.
Similar to the state Boards of Nursing, and State Bar associations, we need a centralized body for accountability, discipline, revocation of license and documentation of any and all substantial complaints brought against a professional license. These kinds of peer review boards can uphold professional standards, and should be made up of active and retired police professionals from across the state. This kind of centralized system ensures that everyone in the state is held to the same standards, and decisions are made in an unbiased and impartial manner.
4. We must educate, train, support and pay police officers as professionals.
We need to elevate policing to the profession that it could be. If we are to expect professional judgement and accountability from even the newest member of the force given a gun and a badge, then we need to make sure we are able to recruit, train and retain the kind of talent we need to fulfill these crucial roles. That means we need to offer robust educational opportunities, pay police officers as professionals, and support police unions that ensure police officers get the pay and benefits they deserve. It’s not enough to say “be better” without giving someone the tools to do so.
5. We need more programs that emphasize community policing that fully utilize community resources already available.
When I was dealing with hostile, violent, inconsolable and irrational patients, I was never alone. I had backup. I had a village of professionals I could draw from: clergy, social workers, patient advocates, and community non-profits. Our police forces should be able to fully utilize these same networks while they are doing their job in incredibly hostile and violent situations. We need to see more multi-disciplinary teams in police precincts, who are active, employed members of the law enforcement teams. For example, Mental Health Rapid Response Teams, which include social workers and psychologists, could be utilized, as many times those are the best people to address a crisis or de-escalate a situation. We need to give our police as many resources as possible to deal with their incredibly dangerous and stressful jobs.
Bottom line, those of us who are given the power of life or death over other people should be held to the highest standards, and held to the highest levels of accountability. I know what it’s like to work in a dangerous and sometimes violent setting, and I have the same feelings and fears as anyone else. But I was given a great power, and as we know, that comes with great responsibility. All I ask is the same responsibility from everyone else who holds this awesome power. If I am lucky enough to represent the people of Michigan’s 39th House District next year, please know that this will be one of my top priorities. I am committed to working with everyone in every position of power to maintain the health, safety and dignity of every person in this state. www.juliapulver.com
