Years ago, when nurse Danielle Bobek was working a shift in the emergency room, she revived a patient from a drug overdose. The woman responded by twisting Bobek’s arm, causing a sprain.
“She then threatened to come after me and my family,” Bobek recalled.
This is one of many violent episodes Bobek said she has experienced in her decades-long career. She’s seen colleagues suffer concussions and fractures after being attacked while working at the hospital.
Patients sometimes lash out because they are angry, desperate or scared. Some may be distrustful of the medical system. Others are in the throes of a mental health crisis. But with violent incidents on the rise, doctors and nurses like Bobek are demanding stronger protections — and tougher penalties for those who intentionally assault them.
“Right now, health care workers don’t feel supported,” said Bobek, associate chief nursing officer at Cambridge Health Alliance. “I should not have to fear for my own personal safety when I’m taking care of somebody. It’s not part of the job, and it’s not OK.”
After years of inaction, the Massachusetts House of Representatives approved legislation aimed at addressing this last November. The bill awaits a vote in the Senate.
The legislation — which has support from hospital executives, labor unions and physician groups — would bring Massachusetts in line with more than 30 other states by classifying assault on a health care worker as a felony, instead of a misdemeanor. This change would allow police to arrest people for attacking health care workers, even if officers did not witness the assault, and would impose stricter penalties on those convicted.
The legislation would also allow workers who are assaulted to take time off to recover from their injuries and pursue charges in court. And it would require hospitals to improve their prevention measures.
Violent outbursts sometimes happen when patients are in a crisis and unable to fully control their actions. They may experience hallucinations or other mental health symptoms that affect their behavior.
Danna Mauch, president of the Massachusetts Association for Mental Health, said she’s concerned that people in these circumstances could be punished unfairly for their mental health conditions. The bill would allow a prison sentence of up to five years for an assault — and 10 years if the attack causes a serious injury.
“It’s a pretty severe penalty,” Mauch said
Supporters of the legislation say it is intended to hold accountable people who are knowingly and willingly committing assault — not to stigmatize patients with mental health conditions.
“There are a lot of assaults that are not mental health-related, that are out of anger and aggression,” said Dr. Benjamin Milligan, chief of emergency medicine at Cambridge Health Alliance.
Milligan said the bill would hold hospitals accountable by requiring them to study risks and strengthen policies for keeping workers safe.
“It needs to be an ongoing process,” he said, “not something that is just going to be done once, and the box is checked, and everybody moves on.”
Health care workers have long been a target of violence, but the problem appears to have worsened in the years following the COVID-19 pandemic, according to state and national surveys, federal workforce data and interviews with workers.
The Massachusetts Health & Hospital Association estimates that a health care worker is verbally or physically assaulted in the state every 36 minutes, with the violence most commonly occurring in emergency departments.
In interviews, doctors and nurses said patients sometimes punch them, throw objects, scream insults, or threaten to come after them with a gun. Visitors can become belligerent, too.
“It’s happening every day in one of our emergency departments here in Massachusetts, someone is being assaulted,” said Dr. Melisa Lai-Becker, the chief of emergency medicine for Mass General Brigham’s community hospitals.
Every incident adds trauma for an already burned-out workforce, she said: “The entire staff is getting mentally assaulted every time something like this happens.”
“I’m a nurse, and I’ve learned that I’m the human punching bag for society.”Olivia Smith, emergency department nurse
Under current state law, police generally don’t arrest someone for assaulting a health care worker unless officers witness the incident. So staff have to continue caring for the person who attacked them. And if they want to press charges, health care workers usually have to go to court and plead their case.
“I can’t tell you how many times I’ve heard of colleagues that I work with getting physically assaulted, and it just goes nowhere,” said Olivia Smith, a nurse who has worked in the emergency department at Brigham and Women’s Hospital for 10 years. “We just move on and internalize it.”
Smith said a patient once tossed a can of ginger ale at her head, but fortunately missed. Another time, Smith said she watched a patient attack an emergency medical technician and had to call police for help.
Verbal abuse, Smith said, occurs daily.
“I’m a nurse, and I’ve learned that I’m the human punching bag for society,” she said.
Smith and other health care workers described the steps they take to protect themselves: never turning their backs on a patient, standing near an exit, bringing along a colleague when the situation appears dicey. But she said this isn’t enough — bigger changes are needed.
“If there are more significant repercussions for the person doing the assault, it would be huge in our favor,” Smith said.
Two years ago, the state’s hospital association, the Massachusetts Nurses Association and the SEIU — a large union that represents health care workers — reached a consensus on legislation to protect workers. These organizations often disagree on major workplace issues, so their cooperation was significant. But state legislators didn’t act on the proposal.
The bill was later reintroduced, and lawmakers now have until July 31 to take action before formal sessions end.
Sen. Joan Lovely, a Salem Democrat who sponsored the bill, said she’s optimistic it will get approval before that deadline.
“ I don’t think we’ll ever eliminate assaults in the medical setting, but we certainly want to reduce them,” Lovely said. “And this is what this bill aims to do.”
This article was originally published on WBUR.org.
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