A trio of nurses from the University of Vermont Medical Center held a press conference Thursday to issue a public plea to their bosses: Protect us.
They described an alarming series of physical and verbal attacks on nurses and other staff, which hospital data shows have occurred an average of 60 times a month this year.
About half of those incidents happened inside the emergency department, where staff were strangled, suffered broken bones, spat at and threatened with weapons, nurses said. During a single shift last week, three emergency room nurses were assaulted, each requiring medical attention.
The attacks, while not unheard of before the pandemic, have become much more common during it, the nurses said, and yet hospital leaders have responded only with empty promises. They demanded action – and fast.
“Workplace safety is our employer’s responsibility,” said Eisha Lichtenstein, one of the nurses. “We don’t feel that the UVMMC administration did everything in their power to protect us.”
UVM Medical Center President Dr. Stephen Leffler, who has worked in the emergency room for his entire three-decade career, confirmed in an interview on Thursday afternoon that the hospital has seen a “huge” increase in violence during the last years. He said the hospital is committed to making the emergency department a safer place and is already working to meet many requests from nurses. But he said it could take time due to staffing shortages.
“It breaks my heart,” he said of the nurses’ worries. “I worry about it every day. I lose sleep worrying about it. I want our people to feel totally safe when they come to work.
“We take this seriously,” he added.
Workplace violence has long been a concern in the medical profession. This is especially true for emergency department nurses, who routinely care for people at their most vulnerable points: patients in mental health crisis or having a bad reaction to medication; families receiving devastating news. A 2018 analysis by the US Department of Labor showed that healthcare workers suffered about three out of four non-fatal workplace injuries caused by violence.
The pandemic, which has added a new layer of stress and instability to most people’s lives, has only made the problem worse. But while some violent patients suffer from mental health or addiction issues, many others act “out of frustration, anger and entitlement,” said ER nurse Amanda Young.
“These are people who know what’s right and what’s wrong,” Lichtenstein added.
Noting that the Burlington Police Department routinely reports that it cannot immediately respond to incidents at the hospital due to staffing issues, the nurses called on the hospital to bolster its own security presence.
They called in armed officers and demanded that the hospital turn on a metal detector that had been gathering dust for months. “I personally took a cocked and loaded gun from a patient who had absolutely no skill to do it myself,” Young said. Vermont lawmakers passed a bill this session banning guns in hospitals; it comes into force on July 1.
Before the hospital can use the metal detector, however, it needs to hire more security guards, Leffler said, because not everyone can use the machine. “You need to be able to identify when someone potentially has a weapon, search it, and take it away from them,” Leffler said. The hospital is now trying to hire eight security guards to supplement its 36-member force.
According to the hospital, the average security salary is $19.45 plus benefits. The nurses say more money should be spent on this task, while the hospital says it cannot afford to pay more.
Meanwhile, the hospital ordered its existing security force to have a greater presence in the emergency department. There are now a minimum of two officers covering the service at all times, with a third on site from 4 p.m. to 7 a.m. each day.
But diverting more officers there would curtail other departments, where incidents also occasionally occur. It’s also not the same as having police protection: UVM security guards do not carry guns or tasers and have been assaulted themselves, said emergency nurses.
The hospital says it wants to establish a police presence within the ER and is willing to pay for coverage and training. But local police departments are suffering from their own staffing issues and have all had the same response to Leffler’s requests: “None of them have the manpower,” he said.
The prospect of cops patrolling the halls of Vermont’s busiest hospital likely won’t be accepted by everyone, especially as one of Burlington police’s most criticized use-of-force incidents happened just outside the medical center.
In March 2019 UVM security guards called the police in response to an upset man who had been denied access to see his wife inside the hospital. A responding BPD officer got into an argument with the man in the hospital’s ambulance bay and punched him, breaking several bones in his face. The man, Douglas Kilburn, was hospitalized, then found dead at his home a few days later. The town reached a $45,000 settlement with the Kilburn woman last year.
But unless the hospital finds a way to make the emergency department safer, it will continue to lose skilled workers, nurses said.
This includes Megan Martin, one of Thursday’s speakers, who said she was quitting her ER job to go to work as a school nurse. As a flight nurse who has spent time in the Middle East, “I know very well that I have to put myself in danger – for the right reasons,” she said.
“These are not the right reasons.”