Dem Senator Introduces Bill to Stem Attacks on Healthcare Workers

WASHINGTON -- Emergency nurses and physicians met outside the Capitol building Wednesday to raise awareness of the threats and physical assaults they encounter on the job, and to voice support for a bill that aims to help prevent such violence and create an environment where these incidents aren't tolerated.

Among the many healthcare workers at the press briefing was Todd Haines, RN, BSN, state council president for the Tennessee Emergency Nurses Association. Haines has a neatly trimmed beard, wears a cross in one ear, and is roughly the size of your average NFL linebacker. Before becoming a nurse, he worked in law enforcement, he said.

"Despite my petite stature," Haines quipped, "I've been verbally and physically assaulted more times in my 12-year career as a nurse than in my 10 years in law enforcement," he told a huddle of nurses, physicians, congressional staffers, and reporters. Rates of nonfatal workplace violence are up to 12 times higher for healthcare workers in both private sector and state inpatient facilities than for all other workers, according to a 2016 report from the Government Accountability Office.

Nearly half (47%) of emergency physicians have been "physically harmed" at work, according to a 2018 survey from the American College of Emergency Physicians. And roughly 7 in 10 of those polled said that violence is increasing. With the pandemic, violence in hospitals keeps escalating, due in part to measures like visitor restrictions enacted in the name of safety. About 31% of hospital nurses said they witnessed an increase in workplace violence during the pandemic, according to a survey from National Nurses United.

The "Workplace Violence Prevention for Health Care and Social Workers Act" directs the Secretary of Labor, through the Occupational Safety and Health Administration, to mandate that employers "develop and implement workplace violence prevention plans that are worker-driven and comprehensive," noted a flyer about the bill written by the Emergency Nurses Association.

Sen. Tammy Baldwin (D-Wis.), the author of the bill, said she plans to fast-track the legislation through the Senate. She described the bill as one that "would provide long overdue protections and safety standards for our healthcare and social services workforce -- promoting a healthy environment that is good for both workers and those who they serve."

The legislation, which was expected to be introduced later on Wednesday, also calls for workplaces to "adopt proven prevention techniques" and ensure that facilities are prepared to respond "in the tragic event of a violent incident." A companion bill authored by Rep. Joe Courtney (D-Conn.) passed the House in April 2021.

Another speaker at the press conference, Jennifer Casaletto, MD, president of the North Carolina College of Emergency Physicians, recalled back-to-back violent incidents at nearby hospitals in January 2022 that resulted in severe injuries and one fatality.

During her own encounter with an angry patient, Casaletto recalled "instinctively" feeling for her stethoscope and dropping it to the ground, lest it be used to strangle her.

In another incident, Casaletto witnessed a patient in his 60s pacing and yelling in the emergency department -- she saw one nurse silently creep over to the phone to call 911 while another tried to close all the doors and curtains to other patients' rooms. She recalled a third "brave nurse" who intentionally drew the attention of the agitated man and was struck by an IV pole in the process. "As in greater than 95% of these hospital violence cases, no charges were pressed," she said.

Her husband gave her an ultimatum to either leave her position or wear a Kevlar vest to work. A "long time" passed before she felt safe enough to work in a community hospital setting again, but Casaletto said she is grateful that her own facility has significantly improved its safety protocols, so she felt secure when she did return.

Haines, who was often called on to manage aggressive or agitated patients, told MedPage Today after the press briefing that he saw an opportunity to leave bedside nursing and took it. He now works as the director of trauma services for a community hospital in Tennessee.

He explained that Baldwin's bill isn't meant to target every patient. "This legislation's not for the 92-year old Alzheimer's patient that's threatening to whoop your ass, when they know they can't get out of bed," he told MedPage Today. "We're talking just mean people. People that ... know that there's no repercussions" for harming a healthcare worker, he said.

"I'm a firm believer in signage," he added. "If we have a sign in the ER that says, 'It is against the law to assault a healthcare worker, you will be arrested, you will be prosecuted,' I think that would make people stop and think about it a little more."

Haines said he feels guilty about leaving staff behind, especially with a wave of new nurses coming in who may not be able to handle "tense or angry situations."

"We're putting them through an environment that's kind of a 'sink or swim' [situation] because everybody's so busy trying to take care of their own patients," he said.

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