ATLANTA — When Destiny heard screams, she raced to a hospital room where she saw a patient assaulting a care technician. As a charge nurse at Northeast Georgia Health System, she was trained to de-escalate violent situations.

But that day in spring 2021, as Destiny intervened, for several minutes the patient punched, kicked, and bit her. And by the time a team of security guards and other nurses could free her, the patient had ripped out chunks of Destiny's hair.

"We are not protected on our floors," she said as she recapped the story during testimony later that year to the Georgia Senate Study Committee on Violence Against Healthcare Workers. Destiny used only her first name at the hearing, for fear of retaliation for speaking out against the patient who assaulted her.

In May, Republican Gov. Brian Kemp signed a law that boosts criminal penalties for assaults against hospital workers and allows health care facilities in the state to create independent police forces. The law is a response to that testimony as well as hospital lobbying and data documenting a rise in violence against health care workers. In enacting the law, Georgia joined other states attempting to reverse a rise in violence over the last several years through stiffer criminal penalties and enhanced law enforcement.

Nearly 40 states have laws that establish or increase penalties for assaults on health care workers, according to the American Nurses Association. And lawmakers in 29 states have approved or are working on similar laws, as well as ones that allow the creation of hospital police forces. Members of those forces can carry firearms and make arrests. In addition, they have higher training requirements than noncertified officers such as security guards, according to the International Association for Healthcare Security and Safety.

Groups representing nurses and hospitals argue that such laws address the daily reality of aggressive or agitated patients who sometimes become violent. Still, such interventions are relatively new. Critics worry that establishing hospital police forces will escalate violence in health care settings and could have downstream effects.

"I worry about all the reasons patients have to not trust me and trust the health care system," said Elinore Kaufman, a trauma surgeon at the University of Pennsylvania.

Health care workers are five times as likely to experience violence as employees in other industries, according to federal data. The day after Kemp signed the Safer Hospitals Act into law, a person opened fire in a midtown Atlanta medical office, killing one woman and injuring four others, including workers at the medical practice.

Verbal and physical threats, which increased during the pandemic, are exacerbating a dire nursing shortage, said Matt Caseman, CEO of the Georgia Nurses Association. Destiny testified that one of her co-workers left nursing after the 2021 assault, in which the patient smashed the care technician's face into a wall and the floor. Destiny also suffered from post-concussion headaches for months, she said.

The Centers for Medicare & Medicaid Services noted the alarming rise of violence in health care settings last November. The federal agency recommended hospitals implement a patient risk assessment strategy, increase staffing levels, and improve training and education for staffers. There was no mention of boosting law enforcement presence.
Health centers say they are better able to retain workers and improve patient care when they can reduce the number of violent incidents, said Mike Hodges, secretary of the Georgia chapter of the International Association for Healthcare Security and Safety. State laws governing how hospitals can respond to violence vary.

In Georgia, the new law boosts criminal penalties for aggravated assaults against all health care workers on a hospital campus, not just those in emergency rooms, which were already regulated. And hospitals can now establish law enforcement offices like those on university campuses. The officers must be certified by the Georgia Peace Officer Standards and Training Council and maintain law enforcement records that can be made public.

Having a dedicated police force helps hospitals better train officers to work in a health care setting, said Republican State Rep. Matt Reeves, who co-sponsored the Georgia bill. Officers can get to know staff members and regular patients, as well as the layout and protocols of hospital campuses. "If you have a specialized police department, they are more in tune with the needs of the facility," he said.

That's the case at Atrium Health Navicent, which operates hospitals across central Georgia, said Delvecchio Finley, its president. The health system was one of a handful to staff certified law enforcement before the new law.

Atrium Health recruits officers who reflect the diversity of the community, conducts training to counteract implicit biases, and holds debriefings after any incidents, Finley said. Officers are trained to react when someone becomes violent at one of the facilities.

"The biggest thing for us to convey to officers is that they are in the setting where we provide a safe environment where we care for anyone," he said.

Unlike other businesses, hospitals can't merely throw out patients who misbehave, said Terri Sullivan, an emergency nurse in Atlanta. A patient once punched her in the chest, fracturing two ribs, before running out of the room and trying to punch his physician. Sullivan said that, in her experience, the presence of hospital security can prevent patients from acting out.

Still, little data exists on whether such forces are effective at preventing hospital violence. Ji Seon Song, a University of California-Irvine law professor who studies policing in health care settings, worries about the "unintended consequences" of legislation that boosts the presence of law enforcement in places people receive medical care.

"You can see where there might be a lot of problems," she said, "especially if the patient is African American, undocumented, Latino — something that makes them prone to being criminalized."

A ProPublica investigation found Cleveland Clinic's private police force disproportionately charges and cites Black people. And in March, a video emerged showing police and hospital staff members in Virginia holding down a patient who was experiencing a mental health crisis, leading to his death. In 23% of emergency department shootings from 2000 to 2011, the perpetrator took a gun from a security officer, according to a Johns Hopkins University study. The CMS memo noted several hospital incidents involving police, in which the agency cited the facility for failing to provide a safe environment.

The Georgia law doesn't require hospital police officers to arrest patients with outstanding warrants for offenses that occurred off a hospital campus, such as violating probation. But it doesn't limit those powers either, said Mazie Lynn Guertin, executive director of the Georgia Association of Criminal Defense Lawyers.

"Unless discretion is limited, it will be exercised at some point, by someone," she said.

Law enforcement should always be the last resort, argued Kaufman, the trauma surgeon. While the threat of violence is concerning, hospitals can spend more on health care staffing, boost overall training, and teach de-escalation skills.

"Our primary lens shouldn't be that our patients are a danger to us," she said. "It's a harmful lens and a racist one. We should develop safe and healthy workplaces through other ways."


Health centers say they are better able to retain workers and improve patient care when they can reduce the number of violent incidents, said Mike Hodges, secretary of the Georgia chapter of the International Association for Healthcare Security and Safety. State laws governing how hospitals can respond to violence vary.

In Georgia, the new law boosts criminal penalties for aggravated assaults against all health care workers on a hospital campus, not just those in emergency rooms, which were already regulated. And hospitals can now establish law enforcement offices like those on university campuses. The officers must be certified by the Georgia Peace Officer Standards and Training Council and maintain law enforcement records that can be made public.

Having a dedicated police force helps hospitals better train officers to work in a health care setting, said Republican State Rep. Matt Reeves, who co-sponsored the Georgia bill. Officers can get to know staff members and regular patients, as well as the layout and protocols of hospital campuses. "If you have a specialized police department, they are more in tune with the needs of the facility," he said.

That's the case at Atrium Health Navicent, which operates hospitals across central Georgia, said Delvecchio Finley, its president. The health system was one of a handful to staff certified law enforcement before the new law.

Atrium Health recruits officers who reflect the diversity of the community, conducts training to counteract implicit biases, and holds debriefings after any incidents, Finley said. Officers are trained to react when someone becomes violent at one of the facilities.

"The biggest thing for us to convey to officers is that they are in the setting where we provide a safe environment where we care for anyone," he said.

Unlike other businesses, hospitals can't merely throw out patients who misbehave, said Terri Sullivan, an emergency nurse in Atlanta. A patient once punched her in the chest, fracturing two ribs, before running out of the room and trying to punch his physician. Sullivan said that, in her experience, the presence of hospital security can prevent patients from acting out.

Still, little data exists on whether such forces are effective at preventing hospital violence. Ji Seon Song, a University of California-Irvine law professor who studies policing in health care settings, worries about the "unintended consequences" of legislation that boosts the presence of law enforcement in places people receive medical care.

"You can see where there might be a lot of problems," she said, "especially if the patient is African American, undocumented, Latino — something that makes them prone to being criminalized."

A ProPublica investigation found Cleveland Clinic's private police force disproportionately charges and cites Black people. And in March, a video emerged showing police and hospital staff members in Virginia holding down a patient who was experiencing a mental health crisis, leading to his death. In 23% of emergency department shootings from 2000 to 2011, the perpetrator took a gun from a security officer, according to a Johns Hopkins University study. The CMS memo noted several hospital incidents involving police, in which the agency cited the facility for failing to provide a safe environment.

The Georgia law doesn't require hospital police officers to arrest patients with outstanding warrants for offenses that occurred off a hospital campus, such as violating probation. But it doesn't limit those powers either, said Mazie Lynn Guertin, executive director of the Georgia Association of Criminal Defense Lawyers.

"Unless discretion is limited, it will be exercised at some point, by someone," she said.

Law enforcement should always be the last resort, argued Kaufman, the trauma surgeon. While the threat of violence is concerning, hospitals can spend more on health care staffing, boost overall training, and teach de-escalation skills.

"Our primary lens shouldn't be that our patients are a danger to us," she said. "It's a harmful lens and a racist one. We should develop safe and healthy workplaces through other ways."

link: https://www.medscape.com/viewa..._hospitalist_etid545

What we really need are the big fellows in padded white coats, and rubber rooms.

I get specializing LEOs for the role. I know of a couple small departments which, informally, used particular officers to respond to people in mental distress, as they were known for their compassion for those people.

"In May, Republican Gov. Brian Kemp signed a law that boosts criminal penalties for assaults against hospital workers and allows health care facilities in the state to create independent police forces. The law is a response to that testimony as well as hospital lobbying and data documenting a rise in violence against health care workers. In enacting the law, Georgia joined other states attempting to reverse a rise in violence over the last several years through stiffer criminal penalties and enhanced law enforcement."

So defunding the police and replacing them with social workers and mental health professionals didn't create the "safe environment" the advocates claimed and now the answer is more police??? Perhaps if these idiots were more honest, they'd admit that their "theories" had no basis in reality and police officers/prosecutors/criminal courts are as relevant now as they've ever been. Laws are nothing more than suggestions, if they aren't enforced and only cops can bring offenders to the attention of prosecutors and the courts for crimes they commit.

Whoever wrote this stupid article should have spent at least a little time actually interviewing a policeman who actually works at a hospital and see what he has to offer in terms of public safety. Don't interview the president of some hospital which has police, instead interview an actual policeman.

The author chose to mostly interview a bunch of people who "have concerns" and just use the words "the police" to describe a faceless power who they fear might escalate things.

Oh wait....

quote:

according to a Johns Hopkins University study

Johns Hopkins can kiss my ass. Enough of their bogus "studies" paid for by Bloomberg that are not based on facts. link for proof of my accusation.

Mrs.BurtonRW, as some of you know, is an RN. She spent 13 years bedside in a major hospital (thankfully NOT in Baltimore) and then another 2 in an urgent care setting. I could tell you stories, but suffice it to say, I'm glad she's now in an outpatient procedural clinic where she doesn't have to encounter random people.

Non-sworn Hospital Security is window dressing - security theater at best. And yes, patients assaulting medical staff is a significant problem that the hospitals won't do a damned thing about for fear of bad press.

The Johns Hopkins bit cracks me up, as they are one of the first hospital systems I think of when the subject of private police forces comes up. They're in the heart of Baltimore and guess what... they have one.

-Rob

quote:

Having a dedicated police force helps hospitals better train officers to work in a health care setting, said Republican State Rep. Matt Reeves, who co-sponsored the Georgia bill. Officers can get to know staff members and regular patients, as well as the layout and protocols of hospital campuses. "If you have a specialized police department, they are more in tune with the needs of the facility," he said.

In theory.

However, these types of small specialized departments (airport police, hospital police, railroad police, school district police, etc.) can have a tendency to end up undertrained, underfunded, and hamstrung by ridiculous policies implemented by their non-police administration that are designed primarily to cover the company's ass rather than allow for effective policing and public safety. Policing doesn't tend to be a priority for a non-police company/facility, even if they happen to have a police department.

In my opinion, it's a better option for facilities like that to coordinate with their larger local law enforcement agency to have a specialized subunit stationed there, with the facility supplementing the cost to the department. That way, the officers get the benefit of the resources, training, and policies of the actual police department. But many facilities won't do this, because it would mean they wouldn't have total control. And on the flip side, some departments wouldn't agree to that, even if the cost was subsidized, because they wouldn't want some of their officers "sitting around at the hospital/school/airport/etc." when the rest of the department was understaffed for the "real police work".

quote:

Originally posted by Aglifter:
I get specializing LEOs for the role. I know of a couple small departments which, informally, used particular officers to respond to people in mental distress, as they were known for their compassion for those people.

That's no longer an informal thing. There's been a big, formal push nationwide for instituting what are known as "Crisis Intervention Teams", which involves training specific officers to better equip them to deal with the mentally ill. These CIT cops are then specifically dispatched to those types of calls, and tend to be picked from those who already have a heart for that kind of work, or who have shown a knack for that kind of work.

WTF?? Every hospital I worked at had a police force. Typically they were sworn officers and had the ability to terminate miscreants if necessary.

They were not rent-a-cops or nonsworn security guards.

RMD

Wow, an anti-cop group had anti-cop findings….


I’m shocked.

quote:

The Johns Hopkins bit cracks me up, as they are one of the first hospital systems I think of when the subject of private police forces comes up. They're in the heart of Baltimore and guess what... they have one.

Rob, as you know, my wife is from the Baltimore area. I've been to Johns Hopkins. My daughter considered going there.

My wife has also spent her career in healthcare, the largest part of which was with a hospital.

I've seen these hospital systems, most of which started out small, and as legitimate charities, grow and merge and become powerful. In fact, during Covid, we saw the dark side of big hospitals in collusion with big pharma and big government.

In my opinion, we don't need anything that makes hospital systems even more powerful.

When I moved to the Yoop, I was amazed to be able to walk all over the hospital without the slightest presence of security. The hospitals in my former home town resembled jails, with sworn armed police.
The hospital here (and this seems odd) now contracts with NMU campus police for security. But its a token operation. If the SHTF, MQT PD responds.
I wonder if increased assaults are tied into the new level of pissed off that the current state of our health care induces in people?

[quote]I wonder if increased assaults are tied into the new level of pissed off that the current state of our health care induces in people?

Both. In the 70s the hospital police force looked like Mayberry. Then a few physicians and of course nurses were assaulted. Not generally criminals, but psychiatric patients. Our gang problem grew and gang members would show up in the ER to finish the job. Waiting for hours for care did not help. Gang members never heard of triage. Some cops have had the skills and training to deal with psychiatric patients. Most have not, and the hospital is reluctant to pay for their training. In years past Chicago PD did some training. The Tribune published the video, profanity and all.

My closest real hospital (not clinic) is the one mentioned in the article.
Even though the immediate area around there isn't particularly bad, they do have people hauled into the ER at times that have been involved in crimes, violent altercations and from the local jail that require a law enforcement presence. Spend a few hours in the ER waiting room is an eye opener if you haven't been there before.
The officers I've seen there appear to be regular local (and armed) police, not the social worker types the article mentions.
A hospital setting can be an emotional place, even with otherwise law abiding types, and with our society becoming less respectful of politeness and rules things can go south easily.
Just like having police in schools wasn't tradition when I grew up, this is likely to stay and even get worse due to the cultural rot that seems to be setting in in many places.

I work in healthcare for a large healthcare system in the Carolinas. The system has signs, posters, etc. all around stating that violence toward staff, patients, etc. won't be tolerated. Great. But the fact is that by the time the public safety offices or the local police arrive, the damage will already be done.

If you dare to defend yourself, it's made very clear that you'll lose your job at best and could face criminal charges (or worse) at worst. It's all about liability and public image. They want the general public to feel that our facilities are safe and welcoming, so they prohibit us from protecting ourselves.

If a weapon is found on you (any weapon) or anywhere on your property while on any of the systems locations, it's immediate termination. However, there is the old adage of "concealed is concealed" Proceed at your own risk.

In 12 years on the job, I've been in more fights in the ER than anywhere else. And I'm not a hospital cop. Crazies, druggies, drunks...they all end up in the ER. It's not an easy place to work.

When I was on the department my partner and I were leaving the ER after riding in two critically injured patients. AS we were leaving we heard a commotion in an ER room and investigated. A guy was going nuts and hospital security was not doing well. Both being in full turn out gear we yelled for help and dove in.

Big mistake....

I recall watching my partner fly across the room then I was flying across the room and hit the wall upside down about 4' up the wall. As I was getting up several local cops poured in and it took all of us to get the guy, strung out on PCP, under control.

quote:

Originally posted by 92fstech:
In 12 years on the job, I've been in more fights in the ER than anywhere else. And I'm not a hospital cop. Crazies, druggies, drunks...they all end up in the ER. It's not an easy place to work.

Plus, there is the practice of transferring the problem. Our hospitals serve many jurisdictions in three states. So, cops will often call an ambulance for their problems knowing that in 20 minutes they are someone else’s problem.

A lot of the problems that society ignores winds up at the ER. And it’s ridiculous to be against hospitals having armed police for fear of “becoming too powerful”. Ridiculous is probably too soft a word. If schools need armed police to keep kids safe, ERs damn sure need it so the doctors and nurses can worry about stuff like saving lives.

Hospitals SHOULD get their own security / police force for their grounds. It's their property, therefore their responsibility. Smaller towns/smaller hospitals, I can understand, but they better have some big, tough guys hanging around for WHEN the cray-cray goes nuts. Police if the Hospital is connected with a University with a police force.

Yes, have them "crisis intervention" (or whatever the term is) trained.

You'd be amazed at the shit that goes on in a Hospital, especially a busy one. Crazy people gettin' their crazy on in full swing, drug addicts doing their shit, homeless, gang members doing what gang members do best, opposing gang members doing their dumb shit, families fighting each other over dumb shit...

Haven't worked in a hospital with it's own police force. Mostly it has been the hospitals own security personnel. My last hospital in Phoenix contracted to have a uniformed off duty police officer in the ER at all times.

That solution seemed to work. It was a core of officers that worked it and we knew them and they knew us, the situations and the regulars. It was also a fundamental change in attitudes between there and here in Alaska. There, if a patient acted aggressively towards staff, they got a set of stainless steel bracelets and hauled out. Violence against healthcare workers was a felony and they were prosecuted. Here in Alaska, it's a misdemeanor, rarely are patients arrested and taken away, they're simply given a summons to appear in court. Had a patient take a swing at our charge nurse one night; police contacted, came out, issued a summons to appear and left, patient remained on premises. We found out that night that lying to obtain a fishing license is a felony and carries stiffer penalties than assaulting a healthcare worker.

The other fun one for a while the attitude of the officers was to take no action at all. A number of them told us that if the person was homeless and residing at a city shelter, the DA's office would not prosecute. Stated they did not want the publicity of crime statistics making the shelters look like a magnet for criminal activity. The officers' attitude was why bother with the time and paperwork if they won't be prosecuted.

The other thing that was great about my last hospital in Phoenix was our security staff had canines. Nothing brings about a change in a patient's attitude quicker than bringing 90lbs of fang and fur into the room. The dogs rarely had to do anything other than sit in the corner. Just their presence de-escalated the situation. Security at my current hospital has canines but they are rarely used.

Yes, there are signs stating violent behavior will not be tolerated, but there's rarely consequences. Attitude from administration usually is, "What could YOU have done differently in that situation." Then there's the attitude of it's not their fault they were drunk, high, in withdrawal, having a breakdown, etc.

Our security staff is usually pretty good and they've saved our asses many times. But their hands are tied at how much action they can take and at times it depends who's in command of the staff for the shift. Recently had a patient we discharged after he repeatedly got naked and masturbated inside the room. After discharged he just hung out in the lobby. We repeatedly asked security to remove him from the premises. Their shift supervisor's position was to give him a cup of coffee and a blanket and let him hang out in the lobby until busses were running later in the morning. Supervisor said it was his discretion what action to take. My response was, "Fine let him sit in your office and jack off and I hope you washed your hands after handing him that cup of coffee."

I have no problem with a hospital having a private police force. But I can see administrations resisting it out of fear of liability. As a result of a lawsuit against one of our associate hospitals in the lower 48, we now have to chart racial demographics of every patient we place in 4 point violent restraints. As I told my supervisor when this policy got announced, "Placing someone in 4 points has nothing to do with race, it has everything to do with being an asshole."

The double standard is frustrating of what we have to put up with at work compared to any other place. People behave differently at a hospital than they do anywhere else. Try whipping it out and pissing on the floor in the middle of McDonald's and see what happens. In the hospital, you get cleaned up, tucked back into bed and somebody else mops up the puddle.

But the attitude of administration is always concerned with the public perception. One of the biggest wastes of time at my former hospital in Phoenix was empathy training. Everyone one; doctors, nurses, and techs had to attend a mandatory 8 hour training session. The training session was conducted by an educator that had no ER experience. She was absolutely fried by staff. One of the docs told her, "I do not want to know what it feels like to experience IV drug use and unprotected anal sex." Then nurses had to have an, "Empathy Coach" follow them for an entire shift to make observations and suggest more appropriate communication. I walked in one night at start of shift and one of our regulars was acting up. As I walked by he was pissing on the floor and screaming, "I demand to be treated with respect!" I rather sternly told him, "Then quit pissing on our floor!" Well guess what, it was my shift to have a coach and she instantly ripped into me about how that was not the right way to handle the situation. I told her I was confused by what she was asking and asked if she would set the example. She walked into the patient's room, he whipped it out and pissed all over her. She ran screaming from the ER and I got hauled into the manager's office at the end of shift and told that I needed to be nicer to the coaches.

So yes, I think the critics all need to be pissed on by a patient to gain more empathy for what we have to put up with as healthcare workers.

years ago I was a Store Manager for a Grocery Chain,

my first store for that company was in a hoody areas, and for the obvious reason the guy in charge of the district RX's hired hotties,

so I would get a call, hey,, can you stop by the RX, we may have an issue,

sure as shit, some dumbass was all manned up going to kick the cute Rx's ass up one side and down the other because she would not fill his script , that he sold for $$, before it was due to be filled,


I am not a big guy, but it was amazing how some of the blustering big shits would back down when you look them in the eye, tell them their behavior is not appropriate, and they needed to vent on the Doc, not my pharmacist,, and go elsewhere, or else


some tried to push the or else, but it is amazing how dipshits will back down when confronted,
and while I never had to lay hands on one, they all decided to go elsewhere, I was prepared to deliver a beat down, or get one, until the police arrived,


that was 13 yrs ago now, I can only imagine that has gotten a lot worse for those in Rx's and hospitals,


sad

quote:

Originally posted by 2000Z-71:
...
The other fun one for a while the attitude of the officers was to take no action at all. A number of them told us that if the person was homeless and residing at a city shelter, the DA's office would not prosecute. Stated they did not want the publicity of crime statistics making the shelters look like a magnet for criminal activity. The officers' attitude was why bother with the time and paperwork if they won't be prosecuted.

...

How did your coworkers vote in the last election? Because in Anchorage at least the commies won all the city assembly seats but one, so there are a total of 3 conservative (rational) assembly members. The rest of the assembly works against the mayor (because he is conservative) and the assembly has enabled the criminal, homeless, drug addicted, and mentally ill in the city without providing any treatment, much less law enforcement or judicial consequence.

The vast majority of health care workers that I have met are liberal, particularly the providers. But you have much greater knowledge of hc workers' voting than I.