Concern from Healthcare Workers over Hospital Violence

Dealing with violent patients is part of job; Michigan study finds high rates of threats and violence

Carrison, who says guns have been found on some patients, isn't sure metal detectors would be helpful. He said someone who wants to get a gun past authorities generally can. And the cost of hiring people to man detectors could be problematic, said Carrison, a former FBI agent.

Brent Hall, a Clark County Fire Department emergency medical supervisor, said he and his staff are adept at defusing situations, but he has been bruised by violent patients or their friends.

"It's usually a loss of life that brings about this kind of change," he said of metal detectors. "It would be nice if we could learn from other people's situations instead of acting like it can't happen here."

Las Vegas police Lt. Craig Platt, who helps direct the area that includes UMC, said a combination of hospital security and police has been able to "de-escalate gang situations" that arise there.

The National Institute for Occupational Safety and Health reports that long waits at hospitals are a major factor in provoking hostile behavior among people who already are under stress.

The same study reported that stationary metal detectors supplemented by hand-held screening in a Detroit hospital found 33 handguns, 1,324 knives and 97 Mace-type sprays during a six-month period.

A 2002 study of violence in hospitals, though not focusing strictly on emergency rooms, reported 8.3 assaults per 10,000 workers compared with the rate of nonfatal assaults for all private-sector industries, which is 2 per 10,000 workers.

Las Vegas law enforcement authorities, who file reports by address, don't keep statistics on crimes in emergency rooms.

UMC was the only hospital to release such data, but UMC spokeswoman Cheryl Persinger said the documentation might be incomplete because people who go into health care "want to help people and probably tolerate more than they should."

"Our administration wants them to start reporting more of what happens," she said.

In 2004, there were eight disturbances at the adult emergency room and trauma unit involving altercations blamed on patients or visitors, Persinger said. UMC also took 13 "informational reports" at the two units in which something occurred that concerned an employee. Six trespassing cases were reported.

For-profit hospitals, which provide most health care services in the Las Vegas area, refuse to release statistics.

"We just want people to know that they have a safe place to come to," said Amy Stevens, who oversees marketing efforts at Sunrise, Southern Hills and MountainView hospitals.

Mike Tymczyn, public relations chief for Valley, Spring Valley, Desert Springs and Summerlin hospitals, said not discussing security concerns at Valley Health System hospitals will help "prevent acts of terror."

Golan said the beating he received at UMC the night of March 27, 2004, could have been prevented. He has since quit to take a similar position at St. Rose Dominican Hospitals.

Golan said the man who assaulted him told a nurse he was a schizophrenic and heard voices urging him to kill people.

"He was then taken back to a waiting area and left alone," Golan said. "Even though he appeared calm, action should have been taken right then. No one even checked him for weapons. We were just lucky he didn't have anything other than his fists."

In the past, he said security would be called when a person made threats. The person would be searched and restrained.

But the Joint Commission on Accreditation of Healthcare Organizations, which sets standards for medical institutions, decided in 2001 that restraints should seldom be used.

Dr. Mary Cesare-Murphy, executive director of behavioral health accreditation for the commission, said restraints aren't prohibited but should be used only as a last resort.