VIOLENCE IN THE ER: staff suffer threats, assault

“This is Vermont, what are they going to do?” ER assailant taunted

By Guy Page

A bill offering increased protections for health care workers against assaults and threats has highlighted a growing problem: chaos and violence in Vermont’s emergency rooms. 

S36, permitting an arrest without a warrant for assaults and threats against health care workers and disorderly conduct at health care facilities, has been passed by Senate Judiciary. It is scheduled for review by Senate Health and Welfare Friday. 

Hospital officials say the law is needed because the extensive and expensive measures they’ve already taken simply haven’t fixed the problem. The ‘arrest without warrant’ language would enable police to immediately remove the disruptive patient, State House health care experts say. 

Thomas Dee, President and CEO of Southwestern Vermont Medical Center in Bennington, testified Feb. 1 that the hospital had:

• Increased private security presence 

• Contracted with the Bennington Police Department and the Bennington County Sheriff’s Department for additional coverage withinour Emergency Room (at an annual additional cost of over $400,000). 

• Installed an additional 75 security cameras throughout our hospital campus.

• Provided specific risk avoidance training for Emergency Room staff

• Implemented a protective No-Trespass policy and procedure for

• removing threatening and harassing patients, family members and visitors.

Nevertheless, the assaults continued. 

“Despite these steps, in the past year, 61% of our clinical staff have reported physically aggressive behavior towards them,” Dee said. “In 2022, we had 183 workplace violence events (that were reported) and we are on track to go  beyond that number this year.” 

Alison Davis, Medical Director of ED at Rutland Regional Medical Center, testified about the trauma ED workers face:

“We are regularly taunted by our patients to go ahead and call the police. One night, a female staff member had a urinal thrown at her and was punched in the side of the head by a patient. The patient remained in the ED that night, awaiting bed placement, but the following day was reported by staff to be bragging about ‘hitting that broad’ and asking staff ‘this is Vermont, what are they going to do?’

“Staff reported that the patient appeared to be fully aware of the physical assault he had carried out. In fact, he told staff that he did it to ‘see what you would do.’ Later that day, this same patient punched a different staff member, another woman, in the face, breaking her nose so severely it required two surgeries to repair. As they waited for police to arrive, staff noted that the patient was smiling/smirking while saying that it was our fault that she was punched and how we should’ve restrained him yesterday after he assaulted another RRMC staff member.” 

Why are Vermont emergency rooms now inundated with violence? An ER nurse who testified Tuesday, February 21 speculated there are at least four likely reasons:

1. We live in an immediate gratification society. People do not like to wait. When forced to wait, they get angry.

2. Pandemic isolation increased anger and isolation. Social skills suffered. 

3. Drug and alcohol abuse is on the rise. 

4. And above all, the shortage of both beds and workers. Vermont health care facilities (including ERs and the regular hospital beds ER patients are waiting for) often are at capacity, and workers are in short supply.