"You don’t walk through the doors of a Kaiser or a Mercy (Hospital facilities in California) every day and worry about coming home each night.," says Nancy Kincaid, the spokesperson of California Corrections Health Care Services as she is quoted by Matt Clark of Signs on Signs San Diego. But this mindset can be dangerous. Health care workers in all health care facilities must remain ever vigilant; they are not guaranteed a safe return home each night as each institution has safety hazards.
Health care workers are at risk from patients, pathogens, and even equipment. Needle-stick injuries and attacks from patients are just two in a long list of hazards that nurses and other care providers face. However, each environment varies in the degree and severity of safety risks. Registered nurses, physicians, and other health care providers who interact with mentally unstable or violent clients are at exceptional risk. Whether working in a correctional facility or standard health care facility, nurses and staff members face danger while interacting with the population.
Caring for Violent Clients
Doctors, nurses, and other health care providers in standard hospitals and prison hospitals encounter clients who may be violent, confused, mentally unstable, and/or combative. In some instances, the hospital worker may encounter a violent client who will eventually be incarcerated for assault, battery, or murder; that is, the health care providers in a standard medical facility or hospital may encounter the same population as workers in a correctional facility but without the same safeguards or safety nets afforded at a correctional facility.
The Star Tribune article, "Workers at Small Psychiatric Hospital Say They have no Safety Net" details the hazards of working in a mental health care facility. Josephine Marcotty begins the article by discussing the ordeal of registered nurse Marnie Jansen. Marcotty explains that RN Jansen worked at "one of 10 small psychiatric facilities Minnesota opened two years ago (2007) across the state. It was part of an innovative effort to improve psychiatric care while reducing the cost of treating Minnesota's most difficult mental patients."
When a Hospital Needs More Police Than Medical Staff
Jansen quit working at the facility after a mentally disturbed patient threatened to use loaded syringes to stab her in the stomach (she was six months pregnant). The patient then tore off Jansen's security badge and used it to escape. Although the patient later calmed down and voluntarily returned to the hospital without causing any injuries, Jansen refused to continue working in the unit. As her story illustrates, the psychiatric units in Minnesota have not been successful.
Writing about the Minnesota facilities, in the December 1, 2010 article, Marcotty observes that. "The 16-bed hospitals have been bedeviled by assaults, patient-on-patient confrontations and other safety problems that often required them to rely on local police rather than trained staff for security. Just last month, a patient at the Fergus Falls hospital hijacked a van while in transit, triggering a chase that ended only when police crashed into his vehicle." Marcotty adds that further complicating the issue of police responding to hospital incidents, "The use of handcuffs, Tasers or guns is a violation of federal guidelines, according to the Center for Medicare and Medicaid Services (CMS)"
In response to the conditions, "One of the hospitals closed and two were converted to other forms of care." Marcotty reports that, state mental health officials, learning from the mishaps, "say they are more cautious about admitting potentially aggressive patients to the community hospitals." But the workplace hazards of mental health care facilities are nationwide, and California provides more examples of workplace dangers in mental health care.
