Western Pennsylvania hospitals constantly aware of threat of violence
By Rossilynne Skena Culgan
Published: Saturday, March 2, 2013, 9:00 p.m.
For Jeanie Thomas, it began as just another day at work in the emergency room.
But before it ended, Thomas was kicked and grabbed by a mental health patient who grew more agitated as Thomas and other nurses attempted to treat him.
He called Thomas stupid, then kicked an EKG machine before lashing out at hospital security guards summoned to subdue him.
It wasn't the first time she'd been assaulted on the job and it probably won't be the last, said Thomas, a nurse in Excela Health Frick Hospital in Mt. Pleasant, who has been hit, pinched, pushed and spat on through her 16-year-stint in the emergency room.
Thomas' experience is similar to that of many ER nurses surveyed during the past four years by the national Emergency Nurses Association, half of whom said they had been physically or verbally abused at work during the past week.
Of that, about 12 percent suffered physical abuse, while about 42 percent suffered verbal abuse, said Lisa Wolf, director of the group's Institute for Emergency Nursing Research.
Recent incidents in Western Pennsylvania include:
• A man taken to Excela Health Westmoreland Hospital in Greensburg with a bloody mouth suffered in a scuffle was arrested after officials said he became belligerent and spat blood at two emergency room nurses. The nurses were treated for possible exposure to blood pathogens.
• Weeks earlier, an IUP student found walking with blood covering his face was arrested when authorities said he kicked and spat blood at hospital staff and a police officer in Indiana Regional Medical Center.
• In Uniontown Hospital's emergency room, a man was arrested when authorities said he attacked three employees before he was subdued by police with a Taser. The victims suffered injuries requiring treatment in the hospital.
• An intoxicated woman was jailed after police said she punched an emergency room nurse in Allegheny General Hospital in Pittsburgh on New Year's Eve as he was attempting to treat her. She later apologized, stating that she didn't remember the incident.
• On New Year's Day, to avoid injury and allow treatment, workers in Monongahela Valley Hospital in Washington County were forced to sedate a 310-pound semi-professional wrestler who had assaulted police and others following what authorities described as a drunken rage in Belle Vernon. He faces charges in the case.
The perfect storm
Emergency rooms — jammed with people who aren't feeling well or in control of their faculties — provide the perfect storm for violence, Wolf said.
“Sometimes it's ... a mental health patient,” Thomas said. “Sometimes it's ... someone who's been drunk or has taken drugs.”
These types of behavioral health cases are on the rise, and finding beds for such patients can be difficult, Wolf said.
In 2011, there were 5.1 million drug-related emergency room visits, according to the Substance Abuse and Mental Health Services Administration.
Data shows that emergency room visits involving misuse or abuse of pharmaceuticals increased 114 percent between 2004 and 2011.
Police in Monroeville, home to two hospitals, spend a lot of time at those facilities, particularly with intoxicated patients, Acting Chief Steven Pascarella said.
“A lot of times, we'll have to have officers stay with them throughout their treatment,” Pascarella said.
Although the threat of violence is constant, those in the field say the incidents are rarely reported, Wolf said,
Clay Duvall, who works with Thomas at Excela, has faced violence but has never pressed charges.
“That really comes back to what we are as nurses. We're caring for the patients, and a lot of the time, they're not in their right minds. Ultimately, our goal is to care for them and help them get better,” Duvall said. “We try to help them, not make their lives worse.”
Wolf said there's a perception that facing violence is part of the job.
Often, it falls on police to press charges.
But across the nation, that tide is beginning to turn as a lobbying effort to make attacks on health care workers punishable by significant jail time and fines is gaining momentum.
In Pennsylvania, such assaults are a felony aggravated assault charge punishable by three to 12 months in jail for those with no prior record, and 27 to 40 months for repeat offenders, according to attorney Tim Andrews, chairman of the Westmoreland Bar Association's criminal law committee.
Hospitals on guard
Hospitals have taken steps to protect their employees, according to officials throughout the region.
Excela nurses participate in “crisis prevention intervention” training, hospital spokeswoman Robin Jennings said. Nurses learn about blocking punches, releasing bites and escaping when a patient grabs a worker's hair, Thomas said.
Any physical or verbal abuse must be reported, Jennings said.
Emergency room staff and security officers in Monongahela Valley Hospital undergo training to learn how to defuse potentially violent situations, said spokeswoman Mary Kaufman.
About 25 people, mostly nurses, attended a recent training seminar at Robert Morris University on avoiding violence in the workplace.
Ashley Thompson, a Pittsburgh police detective with military experience, taught the nurses how to avoid putting themselves in a dangerous position by looking for body language, changes in behavior, drug or alcohol use, threats and verbal expressions of anger or frustration.
“Especially at the ER,” he said, “you are at a higher-risk level ... because of the potential of different types of people coming into the hospital.”
Hospitals everywhere in the region have introduced high-tech solutions to dealing with security issues.
In Allegheny General Hospital, visitors pass through a metal detector before entering the emergency department, according to spokesman Dan Laurent, who said incidents of violence there are rare. Alert buttons and an employee-card access program also are in place, he added.
UPMC declined to comment.
Carroll police have a substation based in the emergency room in Monongahela Valley Hospital. The hospital security staff is based there, Kaufman said,
In Westmoreland Hospital, guards man a command center around the clock, monitoring security cameras and responding to help hospital staff as needed, said Ken Bukowski, vice president of health care for AlliedBarton Security Services, which provides hospital guards. Guards can call in local police, if necessary.
Rossilynne Skena is a staff writer for Trib Total Media. She can be reached at 724-836-6646 or firstname.lastname@example.org
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