POWELL — In March, a patient objected to being discharged from Powell Valley Healthcare.
According to an affidavit, the patient said she didn’t want to go home because she didn’t have shampoo or shoes. The nurses at the hospital attended to the patient’s needs as best they could; as a nurse put on the patient’s shoes, she began to hit the nurse. The patient continued to attack the nurse.
The police were called. The patient ended up hitting the responding officer, who took her to jail, which the patient said she wanted rather than go home. The attacked nurse was slightly injured.
This situation is becoming more and more common and it is a problem in places like Cheyenne.
With stressed staffing levels and already difficult recruiting in the state, the problem makes the job much less attractive.
In 2021, police were called to PVHC eight times to assist a patient who was acting violently. In April, the police had been called 11 times. “So a huge increase in violence here in our organization,” Arleen Campeau, PVHC’s chief nursing officer, said at the June board meeting.
It’s a problem across the state, as well as the nation.
Representatives from the state’s health care industry, including Campeau, addressed the Wyoming Legislative Judiciary Committee in May to discuss a bill that would toughen penalties for violence. against health care workers, in the same way that assaults on law enforcement personnel carry harsher penalties.
Josh Hannes, vice president of the Wyoming Hospital Association, said members of the organization are talking more about the issue. They say it is becoming more frequent and serious.
Nationally, between 2016 and 2020, Hannes noted, there were 44 workplace homicides against healthcare workers. He added that he was not aware of any of these murders in Wyoming.
Tracy Garcia, vice president and chief nursing officer at Cheyenne Regional Medical Center, said between Jan. 1, 2021, and April 15, 2022, CRMC had 34 assaults on hospital staff. Another assault was committed by a family member of a patient.
“This includes verbal abuse, slapping, hitting, scratching, grabbing an employee’s head and slamming it against a door, grabbing staff by the arms and reaching for their throat, punching them in the chest, pushing them against the door, kicking him in the chest and face, pulling his hair… (and) sexual harassment,” Garcia testified.
Keith Ungrund, clinical director of Cody Regional Health, argued that hospital staff are obligated to treat patients in emergencies, and that includes people with mental illnesses and those under the influence of drugs and drugs. ‘alcohol.
“So healthcare workers have an obligation to treat these patients and not discharge them, and these patients can become very violent,” Ungrund said.
He told the story of a patient who regained consciousness in an ambulance on the way to the hospital. The patient assaulted a paramedic and a policeman. The patient was charged with a felony for the assault on the officer, but only a misdemeanor for attacking the paramedic.
“I think we are sending the wrong message. We ask them to look after the sick and not to send the patients away… but we do not recognize the risk that they put themselves at risk,” Ungrund said.
Some of the committee members, while sensitive to the problem, wondered if harsher penalties were the best way to deal with it. Garcia had mentioned that these assault cases are not often prosecuted, and it is sometimes seen as part of the job of caring for people.
Rep. Ember Oaklee, R-Riverton, asked how enhanced penalties would help if these cases aren’t prosecuted with existing laws.
“It is currently illegal to kick someone in the face,” Oaklee said.
Hannes said while he agreed more lawsuits would be helpful, healthcare workers are trying to take care of people, which is hard to do in an unsafe environment.
“It is important to say that this type of attack is different, and we are not going to tolerate it,” he said.
Sen. John Kolb, R-Rock Springs, wondered if healthcare workers and law enforcement could be so easily equated. He also pointed out that since mental illness plays a role in many of these attacks, tougher sentences against people who don’t always consider the consequences won’t be very effective.
“What we are looking for is recognition that violence in healthcare facilities is endemic,” countered Hassen, “that it impairs patient care, in an already struggling healthcare environment in this state. .”
Karlee Provenza, D-Laramie, asked if improving sentencing has led to a decrease in violence. Hassen said he would research as the legislature and the association worked together to find a way to resolve the issue.
Rep. Rachel Williams-Rodriguez, R-Cody, explained how the committee broached the tentative topic of bias-motivated crime laws last year, which was not viewed favorably. She pointed out that workers in other institutions – including schools and airports – face the same problem of violence. These institutions responded by increasing security and training.
Safety and Security
Campeau said PVHC has been responding to an incident three years ago in which a person entered the facility after hours and attacked nurses with an IV pole. The hospital has since added a network of security cameras and automatic locks that prevent access at night without being buzzed. He also works with the Powell Police Department.
” They are wonderful. They come when we call them, but they tell us they have limited resources,” Campeau said.
Brian Jones, director of information at the Billings Clinic, which is affiliated with PVHC, told the PVHC board meeting that his clinic had been working on the issue for months.
It has implemented in the patient records software a way for staff to flag potentially hostile patients so that when they are transferred between facilities, admitting provider staff can take precautions.
Scott Shopa, Director of Facilities Management for PVHC, conducted mock drills and training to help staff respond to the “Armstrong Code,” which is a call for help in a hostile situation.
Last month, Shopa coordinated an unannounced mock drill with a hospital employee who played the role of an unruly patient. The drill began as the nurses carried out their duties. Shopa had not told the two house guards who were on duty at the time that he was leading the exercise.
“I think they understood, as I was watching and they know I do exercises from time to time,” he said.
Hospital staff were thus able to identify weaknesses and areas for improvement in their response to these situations. Shopa said these policies are being reviewed, but haven’t been scrutinized since before the COVID-19 pandemic, and with the frequency increasing, now is a good time. for it.