‘Weighing the risk constantly’: ER nurses face rising violence

Rutland Regional Medical Center. File photo by Emma Cotton / VTDigger

Myla Lindroos was at the end of her shift on Saturday night when a patient tackled and kicked her in the stomach, she said.

Lindroos, a registered nurse in the emergency department at Rutland Regional Medical Center, said her back was against a hospital stretcher. Later, she found a bruise on her back the size of the metal rail of the stretcher.

The patient, a homeless woman who refused to be discharged from the hospital, had targeted Lindroos’ pregnant belly, Lindroos said.

“I had that lightning moment with his face on mine where all I could think was, ‘Our nursery isn’t finished. My daughter’s life is not worth that,’” said Lindroos, who is eight months pregnant with her first child.

Emergency departments, often the provider of last resort, have long been a place where violence and healing coexist. Staff must treat everyone who walks through the door – from patients in the throes of drug addiction or a psychotic breakdown to people with a history of violent outbursts.

During her seven years of breastfeeding, Lindroos said, she was strangled, beaten and threatened. A patient dislocated her shoulder. She had to drag injured colleagues out of patient rooms.

Lindroos has been a nurse at Rutland Regional for a year and a half. In recent months, attacks on staff have become more frequent, she said.

Claudio Fort, president and CEO of Rutland Hospital, confirmed the increase in violent episodes in an interview Wednesday, but did not speak directly about Saturday’s incident. He attributed the worsening situation to a pandemic that has damaged patients’ overall resilience, patience and ability to cope with stressful situations. These tensions come to a head in the ER, a stressful environment even at the best of times, he added.

Rutland is not alone. A recent survey of nationwide healthcare workers revealed that the vast majority – 92% – have absorbed or witnessed abuse from patients, including insults, threats and physical violence. Of all healthcare workers, nurses were the most susceptible to abuse.

The pandemic, which has resulted in extreme staffing shortages and prolonged wait times, has only worsened the crisis, said Mike Del Trecco, interim president and CEO of the Vermont Association of Hospitals and Health Systems, a lobbying organization.

“It’s not a new problem,” he said. “It’s not ok. We have to prevent this and it’s unacceptable.

Earlier this month, nurses who work for the University of Vermont Health Network, the state’s largest hospital operator, protested what they say was pervasive violence by patients at the emergency department at UVM Medical Center in Burlington.

Network spokeswoman Annie Mackin said Wednesday that the hospital hired two more members of its security team this week, bringing the total to 30. The security team still has six vacancies, it said. -she adds. The hospital has increased the presence of the security team in the emergency department, according to Mackin.

Fort, the Rutland area CEO, said his hospital has increased its security team by about 25%, even as the organization struggles with significant operating losses. Hospital staff members also resurrected the Violence Committee, a task force that explores solutions to workplace conflict. This committee was suspended at the start of the pandemic. The hospital is also considering additional training for staff focused on identifying problem patients and responding to violent outbursts.

Fort promised to continue working on initiatives that put the safety of healthcare workers first.

“Obviously they don’t deserve this,” he said. “That’s not what they’re here for.”

Lindroos and her husband spent most of Sunday in the Rutland Regional labor and delivery unit, monitoring their daughter’s heartbeat. After it became clear their daughter was unharmed, Lindroos’ story sparked a Change.org Petition calling on Governor Phil Scott to enact tougher criminal penalties for assaults on healthcare workers. By Thursday, the petition had garnered more than 600 signatures.

After his assault, Lindroos took the day off. The bruises on his back and stomach faded on Wednesday, just in time for another shift. The 28-year-old said she is not yet ready to work with patients, but will be on the floor doing other tasks.

“It changes the way you interact with people,” she said of ER violence. “It increases burnout. It makes you less compassionate because you are constantly assessing risk at the same time that you should be trying to meet a patient’s needs and fears, but you have your own.

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Dora W. Clawson