Long wait times, mental illness linked to rampant hospital violence

Most emergency room and psychiatric hospital workers face violence on daily basis, a disturbing rising trend, reports the Los Angeles Times yesterday.

Nearly 40 percent of emergency room employees in California have been physically assaulted on the job, subject to hitting, kicking, and even biting. Although most of the assaults do not cause serious injuries, the hundreds of claims filed each year can cost a pretty penny in workers' compensation.

Nurses, in particular, may be vulnerable to attacks. About one in 10 emergency room nurses have been attacked, according to the Emergency Nurses Association, notes the article.

For instance, emergency room nurse Lorraine Sandoval at Ventura County (Calif.) Medical Center started keeping count and found that she faced violent threats once or twice a day on average.

"We should not have to wait until a nurse, doctor or EMT or patient is seriously injured or killed before something is done," said Sandoval in the article.

The Medical Center hired an armed officer in the emergency room. However, security officers and providers might not always be able to detect when violence will strike.

For example, interviews indicated that something as seemingly benign as long wait times might lead patients to become violent.

"We have a lot of men who have lost their jobs, lost their homes, 50-year-old men who have worked their whole lives," said Colleen Sichley, a 17-year nurse at Antelope Valley Hospital in Lancaster and a union representative, in the article. "They're angry. Just between the cursing and the bad language, and the physical stuff, and it's anybody" who can lash out, she said.

Meanwhile, psychiatric units are getting busier. For example, because of reduced outpatient care, Augusta Health in Fishersville, Va., sometimes must room two patients together because there are not enough beds.

"We've seen more days than I can count when we've been running full," said Kelly Watson, program director, in a News Leader article. "Augusta Health is seeing an impact with all of the state mental health cuts in general, especially those that involve state hospital and bed cuts."

Further compounding the problem, many incidents go unreported. A 2009 study published in the Annals of Epidemiology found that more than half of hospital workers in California and New Jersey did not notify their supervisors of violent events, accepting that the incidents were simply part of their job.

For more information:
- read the LA Times article
- read the News Leader article

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