Beginning Dec. 1, anyone who attacks a hospital worker on hospital premises may face felony charges.
The new law, House Bill 560, was passed this summer by the North Carolina General Assembly and signed into law by Gov. Pat McCrory. It extends protections to all health care workers beyond the emergency room.
“It’s a victory for health care workers,” said Lori Kroll, director of government relations at Novant Health. “In the past, the protections only applied to emergency personnel.”
Kroll said the new measure will cover workers on nonemergency floors as well as administrators and other staff that come in contact with patients and families. “People on floors are victims of violence, too,” she said. “We see it particularly in pediatrics where staff may get attacked as part of a domestic dispute.”
The bill was in response to the rising tide of workplace violence faced by health care workers.
A report issued by the Occupational Health Safety Network, an injury-tracking system for health care facilities, found that injuries as a result of workplace violence continued to increase overall from 2012 to 2014, but that these incidents nearly doubled for nurses and nurse assistants.
Attacks on health care and social service workers comprised 70 to 74 percent of all workplace assault in the U.S. between 2011 and 2013, according to the Occupational Safety and Health Administration. The study found 99 percent of the violent injuries to health care workers reported were physical assaults and 95 percent were committed by patients.
Like other health systems, Novant Health is not immune to workplace violence.
Jim Finn, senior director of public safety at Novant Health, said the types of assaults that occur most often are verbal and physical, with the vast majority of incidents at the health system being verbal. “The Novant Health public safety service handles probably 99 percent of the situations that are reported,” Finn said.
The majority of the individuals who act out are patients and, to a lesser extent, family members or friends of patients, according to Finn. Many of these patients are highly anxious, have behavioral health issues or are under the influence of drugs or alcohol.
Finn said he does find that the incidence of violence has increased over the last five years or so, which he said may be related to the state cutting back funding for behavioral health programs. “Unfortunately, without behavioral health resources in the community, hospitals become the only option for some people, particularly those without means,” Finn said.
North Carolina lost 700 psychiatric beds, nearly half, between 2005 and 2010, according to the federal nonprofit Treatment Advocacy Center. Consequently, behavioral health patients admitted to an ER may have to wait days, even weeks for a psychiatric bed to open, the center noted.
While the new law is welcome, it may not stop violence in health care settings. “In the heat of the moment, it may not necessarily stop someone from attacking a health care worker,” said Kroll, “but with stiffer penalties, I believe over time it will dissuade someone from assault.”
Finn agreed. “While I appreciate the legislature for stepping up and making these attacks felonies, I don’t think the majority of folks who exhibit this type of behavior have the mental capacity to understand the consequences,” he said.
Novant Health is aggressive about stemming violence at its facilities, according to Finn. It employs its own in-house public safety officers and all officers receive training in diffusing violent situations annually. Additionally, many emergency room personnel take the same course in order to recognize warning signs, so that they can intervene early.
Cam Pressley, a loss prevention coordinator at Novant Health, used to work in public safety at night in Presbyterian Medical Center’s ER in Charlotte. He said he’s seen nights when the emergency room was packed, but yet there were no incidents. On other occasions when the ER was empty, one volatile person could cause an incident.
He recalled one incident when he got a call from the behavioral health unit where initially he was asked only to walk the ward. “Minutes later, they called to say the patient was tearing the unit apart and the nurses and doctors were terrified,” Pressley said.
Pressley remembered team members had told him the patient had recently been released from prison for killing his father.
“From my training, I knew how to diffuse the situation,” he said. “Respect is important in jail so when I arrived on the scene I asked him what I could do and was able to calm him down.”
Pressley credited training and a close working relationship with nursing staff in keeping patients and other team members safe. Nurses know to call when they see signs of aggravation or irritation, he said.