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Nov 03 2009

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How safe is your hospital? Recent attacks highlight potential for violence

By Kyle Alspach , Taunton Daily Gazette.

Kathy Metzger knows that tense situations can turn violent at hospitals, just as tempers can erupt elsewhere in society.

As a registered nurse at Signature Healthcare Brockton Hospital, Metzger said there’s always a potential for doctors, nurses and even patients to end up in harm’s way if a situation escalates.

The rate of assault against health care workers is four times higher than other industries, experts say.

And three attacks at Boston medical facilities in recent days made it clear that staff and patients face more than just medical risks when they walk through the doors of hospitals, clinics and doctors’ offices.

On Tuesday, a patient at a Massachusetts General Hospital bipolar clinic was shot to death by an off-duty security guard after the patient stabbed his psychiatrist during an afternoon treatment session.

Last Sunday, a man was stabbed in the neck when a fight broke out in a waiting room at Boston Medical Center.

Earlier last month, a sex offender tried to rape a woman in a bathroom at Massachusetts General Hospital.

Last week on Beacon Hill, lawmakers heard testimony on the need for healthcare employers to create plans to prevent workplace violence.

“Hospitals don’t want a lot of security, because they want a welcoming environment,” David Schildmeier, spokesman for the Massachusetts Nurses Association, said. “But hospitals aren’t hotels.”

Financial pressures have led some hospitals to cut back on security and other support staff, Schildmeier said.

Lack of legislation, however, does not mean hospitals do not take steps to prevent and prepare for violence.

Locally, police and officials at Signature Healthcare Brockton Hospital and Good Samaritan Medical Center in Brockton say they are prepared as best they can be to prevent attacks — and know what to do if something does happen.

Police Chief William Conlon said officers train regularly on how to handle armed suspects — and the department’s Special Reaction Team drills often to prepare in the event of a hostage situation.

“Whether it be at a school or a hospital, anywhere, they are prepared,” Conlon said.

Signature Healthcare officials have taken hospital security issues very seriously in recent years, Metzger said.

“They have taken a very proactive stance,” said Metzger, who heads the hospital’s nurse union bargaining team and had criticized the hospital’s security efforts in the past.

Steve Friot, director of facilities at Signature Healthcare, said the hospital has a 24-hour security force that could be anywhere in the hospital “within minutes” in the event of a violent attack.

The security guards, who are not armed, are trained in how to de-escalate a situation and subdue or restrain a person who becomes violent, Friot said.

The main focus is at the emergency department, since “there are a lot of people that come into the emergency room that are agitated,” Friot said.

Overall, though, the hospital is consistently looking to see where improvements might be made throughout the hospital, he said.

“We’re always reviewing our security measures,” Friot said.

This comes two years after the federal Occupational Safety and Health Administration office asked Brockton Hospital to take steps to improve safety in the wake of several assaults and injuries to nurses at the hospital.

Signature Health care Brockton Hospital does not routinely hire police officers on paid details. Good Samaritan Medical Center, on the other side of the city, regularly hires police officers for weekly details.

Officials at Good Samaritan Medical Center also said security issues have been taken extremely seriously.

Last year, all emergency department doctors and staff members took part in an eight-hour training program on how to deal with a potentially violent situation.

They learned information such as ways to hinder an attack, how to recognize when someone is escalating a situation and ways to escape, said Laurie Raymond, patient care director of the emergency department.

“We’ve seen it as very beneficial,” Raymond said.

The hospital also has a 24-hour security force, with guards posted at the emergency department and doing rounds throughout the hospital, Raymond said.

In the event of a violent incident at the emergency department — or when a victim of violence is brought in — the department goes into “lockdown” mode in which no outside visitors are allowed in, Raymond said.

“Certainly the (MGH) incident exposes vulnerabilities,” she said. “Those of us who are in health care certainly are on the front lines.”

At Signature Health care Brockton Hospital, security guards are posted by the main entrance of the hospital and also do rounds throughout the hospital and in vehicles around the outside, Friot said.

The hospital also restricts access to surgical, critical care, maternity and emergency treatment areas, he said — the only way to get into those areas is through a card swipe.

“When there is a victim of violence being treated, sometimes the husband or wife who did the victimizing might come after the person,” he said. “But the victim is protected from that.”

At South Shore Hospital in Weymouth, security staff regularly train health-care workers in crisis intervention and to recognize and react to patients showing signs of turning hostile, hospital spokeswoman Sarah Darcy said.

“We’re taking care of people during the worst time in their life,” she said. In a high-stress environment, she said, “early intervention is key.”

Paramedics and police will often call ahead if they suspect an incoming patient might turn violent, Darcy said, giving security guards a chance to prepare.

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