‘Constantly weighing the risk’: Emergency room nurses contend with rising violence

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

Lindroos, a registered nurse at Rutland Regional Medical Center’s emergency department, said she had her back against a hospital gurney. She later found a bruise on her back the size of the gurney’s metal rail.

The patient, an unhoused woman who refused to be discharged from the hospital, had aimed at Lindroos’ pregnant belly, Lindroos said.

“I had this flashbulb moment with her face over mine where all I could think was, ‘Our nursery isn’t finished. My daughter’s life isn’t worth this,” 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 addiction or a psychotic break to people with a history of violent outbursts.

In her seven years of nursing, Lindroos said, she has been strangled, punched and threatened. One patient dislocated her shoulder. She’s had to drag injured colleagues out of patients’ rooms.

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

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

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

The pandemic, which led to 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.

“This is not a new issue,” he said. “It’s not OK. We need 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 is pervasive violence from patients at the UVM Medical Center’s emergency department in Burlington.

Annie Mackin, the network’s spokesperson, said Wednesday that the hospital hired two more members of its security team this week, increasing the total to 30. The security team still has six vacancies to fill, she added. The hospital has stepped up the security team’s presence in the emergency department, according to Mackin.

Fort, the Rutland Regional CEO, said his hospital has increased its security team by roughly 25%, even though the organization is struggling with significant operating losses. Hospital staff members have also resurrected the Violence Committee, a working group that explores solutions to workplace conflict. That committee was suspended early in the pandemic. The hospital is also looking into additional training for staff focused on identifying problem patients and responding to violent outbursts.

Fort vowed to continue to work on initiatives that put the safety of health care workers at the forefront.

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

Lindroos and her husband spent most of Sunday at Rutland Regional’s 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 Gov. Phil Scott to enact stricter criminal penalties for assaulting health care workers. As of Thursday, the petition had garnered more than 600 signatures.

After her assault, Lindroos took a day off. The bruises on her back and stomach faded by Wednesday, just in time for another shift. The 28-year-old said she’s not ready to work with patients just yet, but she’ll be on the floor, performing other duties.

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

Don’t miss a thing. Sign up here to get VTDigger’s weekly email on Vermont hospitals, health care trends, insurance and state health care policy.

Did you know VTDigger is a nonprofit?

Our journalism is made possible by member donations. If you value what we do, please contribute and help keep this vital resource accessible to all.