ATlanTA – When Destiny heard screams, she ran to a hospital room, where she saw a patient assaulting a care technician. As a nurse in charge at the Northeast Georgia Health System, she has been trained to reduce situations of escalating violence.
But that day in the spring of 2021, when Destiny intervened, the patient punched, kicked, and bit her for several minutes. And by the time a group of security guards and other nurses were able to free her, the patient was ripping off Destiny’s locks.
“We were unprotected on our floors,” she said as she recounted the story at a hearing later that year before the Georgia Senate Research Committee on Violence Against Healthcare Workers. Destiny used her name only at the hearing, out of fear of reprisal for speaking out against the patient who assaulted her.
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In May, Republican Governor Brian Kemp signed a bill that strengthens criminal penalties for assault on hospital staff and allows health care facilities in the state to set up police forces. independence. The law is a response to that testimony as well as hospital lobbying and data documenting an increase in violence against healthcare workers. In enacting the law, Georgia joined other states in trying to reverse the surge in violence over the past few years through tougher criminal penalties and increased law enforcement.
Nearly 40 states have laws that establish or increase penalties for assaulting healthcare workers, according to the American Nurses Association. And legislators in 29 states have passed or are drafting similar laws, as well as those authorizing the establishment of hospital police forces. Members of those forces can carry guns and make arrests. In addition, they have higher training requirements than non-certified officers such as security guards, according to the International Association for Health Safety and Security.
Groups representing nurses and hospitals argue that such laws address the everyday reality of aggressive or excitable patients who sometimes become violent. However, such interventions are relatively new. Critics fear that the establishment of a hospital police force will increase violence in health care settings and could have negative effects.
“I worry about all the reasons why patients don’t trust me and the healthcare system,” said Elinore Kaufman, a trauma surgeon at the University of Pennsylvania.
According to federal data, healthcare workers are five times more likely to experience violence than employees in other industries. The day after Kemp signed into law the Safer Hospitals Act, a person opened fire at a medical office in downtown Atlanta, killing one woman and wounding four others, including staff at medical facilities.
Matt Caseman, CEO of the Georgia Nurses Association, said verbal and physical threats, which have increased during the pandemic, are exacerbating a severe nursing shortage. Destiny testified that one of her colleagues left her nursing job following an assault in 2021 in which the patient banged the care technician’s face against the wall and floor. Destiny also suffered from post-concussion headaches for months, she said.
The Centers for Medicare & Medicaid Services recorded an alarming increase in violence in healthcare settings last November. The federal agency recommends that hospitals implement a patient risk assessment strategy, increase staffing levels, and improve staff training and education. There was no mention of increased law enforcement presence.
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Health centers say they can better retain staff and improve patient care when they do, said Mike Hodges, secretary of the Georgia branch of the International Association for Health Security and Safety. they can reduce the number of violent incidents. State law governs how hospitals may respond to violence differently.
In Georgia, the new law strengthens criminal penalties for aggravated assault against all medical personnel on hospital premises, not just those in the already regulated emergency room. And hospitals can now set up law enforcement offices like those on university campuses. Officers must be certified by the Georgia Peace Officers Standards and Training Board and keep law enforcement records that can be made public.
Republican Representative Matt Reeves, who co-sponsor the Georgia bill, said having a dedicated police force would help hospitals better train officers to work in healthcare settings. . Officials can familiarize themselves with regular staff and patients, as well as the layout and procedures of the hospital premises. “If you have a dedicated police department, they are better suited to the needs of the facility,” he said.
Such is the case with Atrium Health Navicent, which operates hospitals across central Georgia, said Delvecchio Finley, its president. The health system is one of the few certified law enforcement officers before the new law.
Finley said Atrium Health recruits officers who reflect community diversity, conducts training to combat implicit biases, and holds interviews after any incidents. Officers are trained to react when someone becomes violent at one of the facilities.
“The most important thing we want to convey to the officers is that they are in an environment where we provide a safe environment where we care about anyone,” he said.
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Terri Sullivan, an emergency nurse in Atlanta, said that unlike other businesses, hospitals cannot simply remove patients who misbehave. A patient once punched her in the chest, breaking two ribs, before running out of the room trying to punch her doctor. Sullivan says that, in her experience, the presence of hospital security can prevent patients from being aggressive.
However, there is still little data on whether such forces are effective in preventing hospital violence. Ji Seon Song, a University of California-Irvine law professor who studies policy in health care facilities, worries about the “undesired consequences” of legislation promoting agency presence. law enforcement in places where people get medical care.
“You can see where there could be a lot of problems, especially if the patient is African-American, undocumented, Latino – which makes them vulnerable to conviction,” she said.
An investigation by ProPublica found that the Cleveland Clinic’s private police force disproportionately accused and cited Blacks. And in March, a video emerged showing police and hospital staff in Virginia restraining a patient who was going through a mental health crisis, which led to his death. In 23% of emergency department shootings between 2000 and 2011, the perpetrator took a gun from a security guard, according to a Johns Hopkins University study. The CMS memo notes a number of hospital incidents involving police, in which the agency cited the facility for failing to provide a safe environment.
Georgia law does not require hospital police officers to arrest patients without warrants for offenses that occur off-campus, such as violations of probation. But it doesn’t limit those powers either, said Mazie Lynn Guertin, executive director of the Georgia Criminal Defense Attorney’s Association.
“Unless decision power is limited, at some point it will be exercised by someone,” she said.
Kaufman, a trauma surgeon, argues that law enforcement should always be a last resort. While the threat of violence is on the rise, hospitals can spend more money on medical staff, increasing overall training and teaching stress-reduction skills.
“Our primary lens should not be that our patients are a danger to us,” she said. “It is a harmful and racist lens. We should develop safe and healthy workplaces through other ways.”
KFF Health News is a national health policy news service. This is an editorially independent program of the Henry J. Kaiser Family Foundation that is not affiliated with Kaiser Permanente.
