September 11, 2017

CEOs up security as Harrington nurse fights for safer hospitals

Matt Wright
Elise Wilson, 65, is recovering at home following a stabbing attack on June 14 at Harrington Hospital in Southbridge.

It started out just like any other day at work for 65-year-old registered nurse Elise Wilson.

A veteran emergency room nurse who worked at Harrington Hospital in Southbridge for 43 years, Wilson didn't notice anything unusual at first about the patient she was triaging on June 14. Then the demeanor of Conor O'Regan, the suspect who police say stabbed Wilson multiple times before fleeing, changed. His widened eyes began darting around the room. Wilson said by the time she realized he was a threat and that she needed to alert others, it was too late.

"I couldn't get up. I couldn't get away," Wilson said in an interview last month.

Wilson, a Dudley resident, remembers most of the attack, but little of the aftermath. She suffered severe wounds to her arm and neck, resulting in nerve damage and a severed brachial artery. She nearly died of blood loss, but after receiving quick treatment from her coworkers at Harrington and then being airlifted to UMass Memorial Medical Center in Worcester, Wilson made a remarkable recovery over the summer.

Perhaps just as miraculous is her upbeat attitude following such a violent attack. Wilson said it helps she remembers the attack, and isn't experiencing it through frightening flashbacks. She's also acutely aware that she narrowly escaped death, and the loss of her arm.

"None of those things happened. I did survive it. I got a lot of units of blood," Wilson said.

Legislating safety

Now faced with the decision of whether to retire early as her recovery continues, Wilson has become an advocate for legislation the Massachusetts Nurses Association (MNA) says will make nurses, other hospital staff, and patients, safer.

The bill, renamed Elise's Law in the wake of Wilson's attack, would require healthcare employers to conduct annual safety risk assessments, and to develop and implement workplace violence prevention plans based on the findings.

The bill provides healthcare workers assaulted on the job up to seven paid days off per calendar year to address legal issues, allows nurses to use their healthcare facility address instead of their home address to handle legal issues related to an assault, in order to protect their privacy, and requires semiannual reporting of assaults on healthcare employees to district attorneys.

Similar bills have been filed and batted around in recent years but failed to pass. The current legislation was filed in January, and supporters, including Wilson, are hopeful the Harrington attack will be the catalyst for its success this time. The bill was approved by the Joint Committee on Public Safety and Homeland Security in July after previous versions sat in committee since 2009.

"I kind of need something really good to come out of this," Wilson said.

Wilson's stabbing was a particularly heinous case of workplace violence in a healthcare setting, but the MNA has highlighted an increase in violence against nurses and other healthcare workers in recent years. Biting, hitting and pushing are common, said Chris Pontus, associate director of Health and Safety at the MNA.

Pontus been involved in workplace violence prevention for years. A certified occupational health nurse, Pontus educates nurses about safety on the job and provides assistance to victims of workplace violence.

Pontus cited U.S. Bureau of Labor Statistics Data indicating a huge spike in workplace violence incidents. According to BLS, incidents increased 110 percent in private hospitals between 2005 and 2014. Meanwhile, the agency estimated in 2013 that healthcare workers experience workplace violence at rates 5 to 12 times higher than workers overall.

Pontus attributes much of the increase to the increasing mental health needs of the population, which is pertinant to Wilson's stabbing, as the suspect O'Regan last month was deemed mentally incompentent to stand trial. In Massachusetts and elsewhere, there is a shortage of psychiatric beds available. More people are also struggling with drug and alcohol abuse. Pontus said much of this presents itself in emergency rooms, where staffing is stretched thin.

"We believe the secret is to hire more workers and that the system do a better job to protect the workers," Pontus said, advocating for steps like creating computer database systems that flag patients who are deemed high risk for violent behavior and installing bulletproof glass in hospital reception areas.

Harrington's response

Harrington HealthCare, the system that owns Harrington Hospital, has taken a hard look at safety measures and protocols in the aftermath of Wilson's attack. Harrington CEO Edward Moore said he brought in a consulting firm within two days of the incident, to review safety at the hospital's main campus in Southbridge, as well as the Webster campus, which is the site of another emergency room.

As a result, Harrington installed metal detectors at the entrances of both emergency rooms; equipped staff with panic button necklaces so they can alert security immediately if needed; locked entryways to the emergency room besides the main entrance; and limited visitors in the emergency room. By this month, security staff were also expected to be carrying pepper spray, which Moore said the consultant suggested would be the best line of defense in the event of an attack. Arming security with guns was ruled out, as Moore said he felt that overall safety would be reduced if security guards with armed.

Of Elise's Law, Moore said there are parts he supports tremendously, though the portion that deals with adding paid time off for people recovering from assault in the workplace is unnecessary, he said, because worker's compensation policies provide for that already.

The Massachusetts Health and Hospital Association (MHA), the industry group representing Massachusetts hospitals, has raised concerns about the bill but hasn't specified areas to be improved.

"I would be pushing harder to have the Legislature require the things that we have done," Moore said.

UMass Memorial to add metal detectors

Both Moore and UMass Memorial Medical Center CEO Patrick Muldoon visited Wilson in the intensive care unit soon after her attack. Muldoon said Wilson's husband urged him to boost safety efforts, as the chief executive of the region's largest hospital.

A formal safety review followed. One result is the decision to install metal detectors at the hospital's two Worcester campuses, which Muldoon said would happen imminently.

Given the climate around safety in hospitals, Muldoon said other measures were added this year, but before Wilson was stabbed. For example, a group of about two dozen managers meets daily to discuss safety issues. Muldoon said stories of assault, unfortunately, are frequent.

"It just hits home how prevalent workplace violence is," Muldoon said.

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