"You don’t walk through the doors of a Kaiser or a Mercy (Hospital facilities in California) every day and worry about coming home each night.," says Nancy Kincaid, the spokesperson of California Corrections Health Care Services as she is quoted by Matt Clark of Signs on Signs San Diego. But this mindset can be dangerous. Health care workers in all health care facilities must remain ever vigilant; they are not guaranteed a safe return home each night as each institution has safety hazards.
Health care workers are at risk from patients, pathogens, and even equipment. Needle-stick injuries and attacks from patients are just two in a long list of hazards that nurses and other care providers face. However, each environment varies in the degree and severity of safety risks. Registered nurses, physicians, and other health care providers who interact with mentally unstable or violent clients are at exceptional risk. Whether working in a correctional facility or standard health care facility, nurses and staff members face danger while interacting with the population.
Caring for Violent Clients
Doctors, nurses, and other health care providers in standard hospitals and prison hospitals encounter clients who may be violent, confused, mentally unstable, and/or combative. In some instances, the hospital worker may encounter a violent client who will eventually be incarcerated for assault, battery, or murder; that is, the health care providers in a standard medical facility or hospital may encounter the same population as workers in a correctional facility but without the same safeguards or safety nets afforded at a correctional facility.
The Star Tribune article, "Workers at Small Psychiatric Hospital Say They have no Safety Net" details the hazards of working in a mental health care facility. Josephine Marcotty begins the article by discussing the ordeal of registered nurse Marnie Jansen. Marcotty explains that RN Jansen worked at "one of 10 small psychiatric facilities Minnesota opened two years ago (2007) across the state. It was part of an innovative effort to improve psychiatric care while reducing the cost of treating Minnesota's most difficult mental patients."
When a Hospital Needs More Police Than Medical Staff
Jansen quit working at the facility after a mentally disturbed patient threatened to use loaded syringes to stab her in the stomach (she was six months pregnant). The patient then tore off Jansen's security badge and used it to escape. Although the patient later calmed down and voluntarily returned to the hospital without causing any injuries, Jansen refused to continue working in the unit. As her story illustrates, the psychiatric units in Minnesota have not been successful.
Writing about the Minnesota facilities, in the December 1, 2010 article, Marcotty observes that. "The 16-bed hospitals have been bedeviled by assaults, patient-on-patient confrontations and other safety problems that often required them to rely on local police rather than trained staff for security. Just last month, a patient at the Fergus Falls hospital hijacked a van while in transit, triggering a chase that ended only when police crashed into his vehicle." Marcotty adds that further complicating the issue of police responding to hospital incidents, "The use of handcuffs, Tasers or guns is a violation of federal guidelines, according to the Center for Medicare and Medicaid Services (CMS)"
In response to the conditions, "One of the hospitals closed and two were converted to other forms of care." Marcotty reports that, state mental health officials, learning from the mishaps, "say they are more cautious about admitting potentially aggressive patients to the community hospitals." But the workplace hazards of mental health care facilities are nationwide, and California provides more examples of workplace dangers in mental health care.
Safety of Nurses and Health Care Providers in Correctional Facilities, Nonexistent?
Lee Romney of the Los Angeles Times reported in August 2011 article "California Mental Hospitals are Dangerous Legislators Told," that mental health facilities often lack adequate safeguards. Romney reported August 2, 2011 that California lawmakers received testimony about "faulty alarm systems, daily assaults and an increasing number of patients with criminal histories."
The murder of psychiatric technician Donna Gross at a Napa State Hospital is a tragic illustration of a failed safety net. Vic Lee, of ABC News, reported in the October 25, 2010 news story Murder at Napa State Hospital Raises Safety Questions, that Donna Gross was killed by correction's facility inmate Jess Massey. In relating the story, Lee describes Napa State Hospital as a "prison hospital."
Prison Hospitals and Mental Health Care Facilities
One might assume that corrections facilities or prison hospitals would have stronger safeguards or safety nets as such institutions are structured to incarcerate inmates; this is their primary purpose. But despite safeguards and emergency procedures, employees at correctional facilities argue that they also lack a safety net or adequate safeguards.
Nancy Kinkaid described some of the threats during her interview with reporter Matt Clark in the Signs on San Diego August 26, 2011 article, "Prison Health Workers Rank High in Pay Survey." According to Kincaid "prison health-care workers face physical or verbal threats, assaults, frivolous inmate lawsuits and staff complaints routinely. She said inmates fling feces, urine or HIV-infected blood at their health care providers. 'It’s called gassing,' adds Kincaid."
Hazards and Risk of Death in every Facility Warrant Caution
In trying to convince California lawmakers to develop laws and policies to better protect mental health care providers, a representative read a letter from Anna Bock, the daughter of Donna Gross. Los Angeles Times writer Lee Romney provides details writing that, "The hearing came 10 months to the day after Napa psychiatric technician Donna Gross was strangled by a patient with a history of predatory violence while on the outside grounds, where alarms do not work. Gross, 54, had spent nearly 14 years caring for the mentally ill."
Pleading for faster reform, Bock's letter reads, "The damage by countless assaults on patients and staff has no doubt spread like a sickness to their families....Each moment that passes without change allows another split second for an attack to take place."
Mental health care workers in hospitals and correction facilities face threats from the clients they treat in their facilities. Although the primary focus of the hospital is health care while the primary focus of a correctional facility is incarceration of prisoners and security of personnel, some health care providers warn that both institutions have lapsed security. The lack of security is a risk in all facilities.
Health care providers face multiple hazards in their profession from dangerous microbes and equipment to dangerous clients. Doctors, nurses, therapists, and others who care for violent or mentally unstable segments of the population face exceptional risk in their profession. As no one is guaranteed a safe return home from work, all health care providers must remain ever vigilant against threats to their safety.
Sources:
- Clark, Matt. Prison Health Workers Rank High in Pay Survey. Signs on Signs San Diego. August 26, 2011.
- Marcotty, Josephine. "Workers at Small Psychiatric Hospital Say They have no Safety Net." Star Tribune. Updated 2010.
- Nurse Zone. "California Nurses Plan to Strike; Hospital Association ask them Not To." 2009.
- Romney, Lee. California Mental Hospitals are Dangerous Legislators Told. Los Angeles Times. August 23, 2011.
- Freedman, Wayne. Hospital Worker Murdered by Insane Patient. ABC. October 10, 2010.
Marian Henderson - I was in the Marine Corps for 12 years, and after completing my last four-year enlistment, I became a Merchant Marine. I worked aboard ...
Join the Conversation