Health Care Providers Seek Legislative Action To Curb Workplace Violence

punch him in the face. Pushed and drowned. It hit you in the stomach so hard you froze.

Nurses, doctors and hospital administrators in Vermont on Wednesday shared examples of abuse from the past week with lawmakers. In what were often tearful testimonials, immediate caregivers also described, one after another, their most traumatic experiences in recent years.

"I've been spat at, kicked, hair pulled, sexually assaulted, my life is in danger," said Jill Maynard, emergency room director at Southwestern Vermont Medical Center in Bennington. In one case, he says, a patient who threatened him began harassing him in society and near his family home.

In a joint hearing of the Senate Judiciary Committee and the Health and Welfare Committees, 10 witnesses organized by the Vermont Association of Hospitals and Health Systems called on lawmakers to support c.26. The new bill will add three clauses related to healthcare professionals and medical facilities to Rule 3 of Vermont's Code of Criminal Procedure, which governs when law enforcement officers can arrest someone without a warrant.

According to the US Bureau of Labor Statistics, healthcare workers across the country suffer the vast majority of non-fatal illnesses and injuries caused by workplace violence, with 73% of them in 2018 Many hospitals and other health care facilities in Vermont and across the country are trying to reduce risk by sending staff to de-escalation training, reserving quiet decompression rooms, and forming crisis response teams that include mental health professionals. and security personnel.

However, as all eyewitnesses say, the frequency and intensity of violent incidents have increased significantly in recent years. As the hospitals and long-term care facilities where they were discharged faced the Covid-19 pandemic and severe staffing challenges, patients became frustrated with long waits for care and institutional systems began to break down. .

Currently, in most cases, police officers come to the hospital in response to reports of violence, but only give notice in writing, witnesses said. As a result, the person who hits or threatens, sometimes sick, sometimes a family member, often remains in the hospital after the incident. Sometimes this leads to more violence.

In one case, a night shift patient threw a urinal at a nurse, struck her and was taken into custody, but no arrests were made, said Alison Davies, medical director of the emergency room at Rutland Regional Hospital. The next day, he said, he continued to taunt and threaten employees, and then punched another employee, breaking his nose so badly that he required two surgeries to recover.

"One of the most sobering statements I hear from my employees when it comes to abuse is, 'Nobody's going to do anything,'" Davis said. "I look forward to reaching out to them and telling them that our legislature will help them."

Will it change anything?

Vermont law now allows law enforcement to make arrests in the situations outlined Wednesday, said several legal experts who testified before the Senate Judiciary Committee Thursday morning.

“It appears that it is really a matter of discretion for the officer how he decides to proceed after speaking with the parties and possibly the prosecutor,” Chief Justice Thomas Zonai said.

Senate Judiciary Chairman Sen. Dick Sears, the bill's main sponsor, conceded that this may be true. "Whether they already can or not, you're probably right, but they don't," he said.

The purpose of the legislation, he said, is to fundamentally emphasize the importance of responding to violence against health care workers. Similar wording of Rule 3 defines cases of violence against family or family members and vulnerable adults as particularly sensitive situations and allows law enforcement to make quick arrests.

Tim Lueders-Dumont, an attorney for attorneys and sheriffs with the Vermont Department of State, agreed that the specific language around domestic violence has practical, if not legal, implications.

“Usually these are fast-changing situations,” he said. "You don't have to dig too deep into the facts to figure out how to help this cop when he says, 'What can I do now?'

At the same time, he added that in many cases the detainee is not detained, but simply arrested and released.

“I'm less concerned about the outcome than what's going on,” Sears said. "This is about getting Panicker out of the ER."

Attorney General Matthew Valerio said law enforcement needs more training to respond to these situations for the new law to have any effect. He suggested that learning what is possible under current law would have the same effect.

“For me, the problem of law enforcement is solved by changing the law,” he said.

But he said: "It's not a legal issue at all. It's about mental health, drug abuse, poverty, hopelessness and the like. Rule 3 doesn't apply to that."

Senator Tanya Wichowski of the Essex Police District agreed. “To me, this is a sign that we need to invest in our communities,” he said. "Obviously, I support anything we can do to keep our healthcare workers safe, but I don't think we're getting to the bottom of this problem."

baby step

Patient caregivers say these more abstract issues mean less than taking steps to address a situation that is exacerbating turnover and limiting recruitment.

Medical personnel are leaving at an alarming rate due to increased violence, said Danielle Boudreau, a registered nurse and director of advanced care at Northwestern Medical Center in St. Louis. Albans said:

This concern was shared by Ben Smith, MD and Medical Director of the Emergency Department at Central Vermont Medical Center in Berlin. “We are not an infinite resource that can consume everything forever,” he said.

For caregivers, each episode of abuse can mean the end of a career and the chance to change a life.

Nurses at the University of Vermont Medical Center in Burlington and Mount Askutney Hospital in Windsor have described brutal physical attacks on patients in emergency rooms in recent years. As a result of beatings and beatings, they received significant head injuries, constant fear and, in the latter case, permanent hearing loss.

Matthew Loft, a registered nurse at UVM Medical Center, is still on high alert 20 months later, he said. She works with network administrators to improve mental health support for caregivers who have been injured on the job.

Mark Sacco, head of the emergency room at Mount Ascutney Hospital, said all or nearly all of the nurses on the night shift were seriously injured when she tried to restrain a teenager whose parents were taking him there. Three out of six no longer train. He thinks that he should probably retire. But after a painful three-month recovery, he returned to help his colleagues during the covid-19 outbreak.

“Please take this one small step, I beg you,” Sacco said.

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