The Reality of Healthcare Safety
You chose this profession to help people. But no one warned you that helping people would sometimes mean being screamed at, grabbed, threatened, or worse.
Healthcare workers face more workplace violence than almost any other profession. And the response from employers is often inadequate — a quick training video, a "be aware of your surroundings," a security guard who's always somewhere else when you need them.
You're expected to provide compassionate care while also managing patients in crisis, family members in grief, and the exhaustion of 12-hour shifts. "De-escalation training" doesn't account for the reality of being cornered in a room at 3am with a patient who outweighs you by 100 pounds.
Your safety is not in conflict with patient care.
It's a prerequisite for it.
The Six Layers Applied to Healthcare
Inside Fierana, we teach the Six-Layer Protection System — a framework that gives you decision points before, during, and after high-risk situations. Here's how it applies to your work:
Layer 1: Your Operating System
The foundation: Managing fatigue-induced vulnerability. Maintaining awareness even at hour 11. Building habits that protect you when you're too tired to think.
Layer 2: Environmental Control
Your workspace: Positioning in patient rooms. Knowing where panic buttons are. Never letting yourself get blocked from an exit.
Layer 3: Verbal Boundaries
De-escalation that works: Phrases that calm without condescending. Setting limits while maintaining rapport. Knowing when talking won't work.
Layer 4: Physical Escape
When it's not working: Creating distance. Getting out of a room. Techniques designed for someone who can't "fight back" against a patient.
You are not required to absorb abuse. "Customer service" expectations do not override your safety. You have the right to remove yourself from any situation where you feel threatened.
What You Can Do Today
The Room Scan
Every time you enter a patient room, take 3 seconds: Where's the door relative to you? Where's the call button? Is there anything that could be used as a weapon? Make this automatic.
The Positioning Rule
Never let a patient or family member get between you and the exit. If they move toward the door, you adjust. Subtle, professional, effective.
The Buddy Check
Before entering a high-risk situation, tell a colleague. "I'm going to check on room 412 — if I'm not back in 10, come check." It takes 5 seconds.
The Parking Lot Protocol
End of shift: keys in hand, phone accessible, scan the lot before you exit. If something feels off, go back inside and wait or ask for an escort. You've earned the right to get home safe.