Report Finds Washington Health Care Workers Often Victims of Violence

The most violent job in Washington state isn’t being a police officer or a security guard. It’s working as a nurse’s aide.

Seattle public radio station KUOW-FM made that finding as part of an investigative series on workplace safety airing this week. The station found that violence strikes health care workers in Washington at six times the state average, and frontline caregivers in emergency rooms and psychiatric wards get assaulted even more than that.

The single most violent workplace in the state is at Western State Hospital, where criminal defendants are taken when they are found incompetent to stand trial. Workers at psychiatric hospitals are assaulted on the job more often than anybody else — 60 times more than the average worker in Washington state.

KUOW also found that even though working on steel towers remains one of the nation’s most dangerous jobs, right up there with commercial fishing, line workers for Seattle City Light and other northwest power companies aren’t strapped in while they climb such towers. Instead, they only strap safety ropes to their harnesses once they’ve climbed up to where they’ll be working — around 200 feet above ground in some cases.

Though several line worker deaths from falls were reported in other states last year, none has been reported in Washington in the past decade.

James Robinson, president of the union for many workers at Western State Hospital, says there were 313 assaults there last year — a drop of nearly 30 percent in assaults per patient-care hour, though union officials also note that many incidents go unreported because of the time required to fill out paperwork about assaults.

At some hospitals, such as Tacoma General, emergency room security is obviously a concern. Everyone must pass through a metal detector to enter the ER, no matter the time of day. It’s one of many measures Pierce County’s biggest hospital has taken to keep patients from attacking hospital staff.

Other anti-violence measures are more subtle. Much of the staff is trained how to pacify agitated people. Even the colors and spaces of the ER’s new waiting area were designed to soothe injured, stressed out, impatient patients.

If that doesn’t work, some exam rooms have additional security measures — such as a metal gate that can come clanging down to protect medical equipment from violent patients.

Jeaux Rinehart, a Seattle nurse and president of the state’s Emergency Nurses Association, says he’s been clubbed in the head by a mentally ill patient seeking narcotics and, more recently, an intoxicated patient punched him in the face and threatened to kill him. That patient served three months in jail.

“A lot of hospitals don’t really encourage nurses to report violent acts against them, and some facilities just feel that it’s part of your job, and you should just simply tolerate it, knowing that if you work in an emergency department, violence is going to be there, so prepare for it,” he said.

Nurses’ unions want hospitals to do more to protect their workers, like more hands-on training on how to avoid or defuse violent situations.

Nan Yragui, a psychologist with the Department of Labor and Industries, studies workplace violence. She said budget cuts to the health-care safety net have made emergency rooms nationwide more violence-prone.

“When patients can’t get services they need, they end up going to the emergency department,” she said. “So more of the severely mentally ill are going to the emergency department and then that makes that group of nurses more at risk because they’re getting more exposure.”

Those factors helped fuel a 26 percent rise in violent incidents last year at Providence St. Peter Hospital in Olympia, said Jeff Glass, its director of facilities.

Even after a patient smuggled three guns into the St. Peter emergency room two years ago and wound up being shot to death by a police officer, the hospital hasn’t installed a metal detector, for fear it could dangerously delay patient care. Instead, they wave a hand-held metal detector at patients they deem high risk.

The guards at Harborview Medical Center in Seattle run a metal detector on the overnight shift.

The Department of Labor and Industries has cited Harborview 11 times in the past three years for serious workplace safety violations. In November, the state fined Harborview $13,000 for failing to provide a safe workplace for its security guards.

Public records show someone being assaulted at Harborview about every couple days last year. On a recent Saturday night, a patient managed to walk into the emergency room with a large knife, two cans of pepper spray, a cap gun and lots of bullets in his backpack.

Harborview has appealed the fines, calling them arbitrary and capricious enforcement of the state’s workplace safety rules.

Spokeswoman Susan Gregg said the hospital uses best practices from the health care industry to provide a safe environment.

Graveyard-shift guard Mike Nervik says despite the hospital’s shortcomings, Harborview is a lot less violent than it was in the 1990s.

“Like 15 years ago, you’d go home just wringed out in sweat, having gotten in confrontations with several people,” he said.