MADISON, Wis. - Patients assaulting doctors and nurses at hospitals has been an issue for years, and the problem is getting worse.
Doctors and nurses are assaulted on the job more times than any other professional, and three times more than police officers and firefighters.
Each day, on average, nearly 375,000 people visit hospital emergency departments all across the country looking for help.
In June, Rhonda Bleecker, a certified nursing assistant at St. Mary's Hospital, said she found herself in a situation she never imagined as she was monitoring a patient.
"It was a fairly routine day. I got pulled into a room to sit one-on-one with a patient," she said. "He was withdrawing from alcohol and street drugs. He had grabbed around my wrist area, and yanked me towards him, grabbed up (on my arm) and just kept twisting and bending."
Bleecker said she is going to school to become a surgical tech and she was afraid the patient might break her arm.
"I was like, 'Oh, I hope he does not break anything, because I start school again in August.' I'm not dealing with broken bones or surgery or anything. Worst case scenario, I did not want to get anything broken," she said.
Nothing was broken, but the patient tore ligaments in Bleeker's wrist and sprained her bicep. Last year, St. Mary's Hospital reported 20 workplace injuries such as Bleecker's, up from 14 the year before.
The University of Wisconsin Hospital in Madison reported 53 injuries last year and 56 in 2010. Meriter Hospital reported 17 injuries in 2011 and 26 in 2010.
While the numbers vary from hospital to hospital, industry publication Health Facilities Management said 23 percent of hospitals across the country reported an overall increase in attacks and assaults.
"Whether it's behavioral health or substance abuse, we take care of everyone, and sometimes to our own peril," said Sue Hohenhaus, executive director of the Emergency Nurses Association. "You're going to have folks that are upset with care, or upset that a loved one has died, or they're under the influence of some sort of substance that can't control their own behavior."
The Emergency Nurses Association, based just outside Chicago, has researched this trend and said its No. 1 priority is to reverse it.
In a survey last year among ER nurses, the group found that one in 10 nurses experienced physical violence over a seven-day period. Most of those cases involved patients who were drunk, and in most cases, nurses didn't file a formal report.
"People see it as only a problem in metropolitan, urban areas. It's wherever people live," Hohenhaus said.
Hohenhaus said she believes the number of cases is up because more and more nurses are talking about the issue. She said change starts with support from hospital administrators admitting there's a problem and encouraging the reporting of incidents, as well as instituting a zero-tolerance policy for violence.
That's what's happening at St. Mary's Hospital and all of the parent company's 16 other hospitals. Not only does this problem cause physical and emotional pain for its workers, but it's also costly. Last year, workplace violence cost the company $1.4 million in lost time.
In Bleecker's case, she was completely off work for two weeks and on light duty for another six. She said her employer was 100 percent supportive and encouraged her to report the incident.
"I try not to dwell on it, but sometimes (the memory) it does come back when a combative patient comes in. I'm kind of like, 'OK, let's not hit me.'"
Many hospitals, including St. Mary's, have implemented policies and procedures for reporting incidents and required training on how to diffuse a possible dangerous situation.Hospitals seek to decrease attacks on health professionals
Advocates said that's the right solution. They said they'd also like to see federally-mandated training for health professionals and guaranteed penalties for offenders.
For example, an attack on a police officer carries a felony charge just about everywhere. In many places, it's also a felony to assault a taxi driver and, in some states, strippers.
But when it comes to nurses and medical personnel, many states have no such law guaranteeing a harsh penalty.
In Wisconsin, though, it is a felony to assaulting a health care professional.
Some believe security or a police presence inside hospitals and ERs helps. Last year, UW-Madison police started a daily, night-time presence at UW Hospital's emergency department.
The Emergency Nurses Association said that while it's always good to have that presence to help deter some sort of violence that might happen, the group said that in its research, rates of assault were actually higher when police or security personnel were present. It's unclear, however, if that security presence was a contributing factor.