The work environment is becoming increasingly dangerous for health care providers in the state.
“I have been spit on, hit, kicked and abused verbally by patients when my only goal is to provide a safe environment and medical interventions as appropriate to each case,” a member of the Hilo Medical Center ER staff said recently in testimony to the state Legislature.
State lawmakers are seeking tougher criminal penalties for people who assault health care workers.
There were 1,075 assaults against health care workers in Hawaii hospitals, nursing homes and patients’ homes — during in-home health care — in 2017, legislators were told.
And according to testimony from the Hawaii Nurses Association, 84 percent of nurses who have served 21-plus years have been physically threatened by patients.
“There are rising rates of assault and violence against health care workers in Hawaii,” Dan Brinkman, CEO of Hilo Medical Center, said in his testimony to the Legislature. “At Hilo Medical Center, the largest hospital on Hawaii Island, we experienced 20 incidents of assault against our employees in the last year.”
About 95 percent were perpetrated by patients. The associated costs to the hospital in 2017 were $400,000, Brinkman said.
Currently, if a patient is found guilty of assaulting a lab tech, nurse or physician in a Hawaii ER, the crime is classified, by law, as a felony.
But if the assault occurs instead in a patient’s hospital room, at a nurses’ station, in a hallway or during in-home health care, the crime is just a misdemeanor.
Senate Bill 2491 and House Bill 1906, if passed, instead will classify assault against a health care worker in a patient’s home, private clinic or anywhere in a hospital as a felony.
A hearing by the House Health and Human Services Committee was held Tuesday morning. The committee recommended unanimously that HB 1906 should pass.
“I had one of the patients not just attempt to harm me but also my pregnant belly at the time,” a Hilo Medical Center behavioral health nurse, who was six months pregnant during the assault, testified.
Assaulting an EMT, educator or correctional facility staff member is already a felony under state law.
Proponents of the new legislation said assault victims must relive the assault when they testify in court.
But they also must often witness perpetrators of a misdemeanor set free after the court hearing because, by then, the perpetrators already served enough time to cover the relatively short sentence — in some cases about 30 days. A Class C felony is punishable by up to five years of incarceration.
Dan Busheme, nurse manager of the Hilo Medical Center Behavioral Health Unit, said administrators, volunteers and students all would be covered under the new law.
Busheme, a retired Air Force lieutenant colonel, said he has been assaulted “multiple times” by patients during his 30-year career as a nurse.
The new legislation does not apply to patients with conditions such as dementia, exacerbation of schizophrenia or acute traumatic brain injury, Busheme said. Those conditions can result in behaviors that patients who are cognitively aware don’t exhibit.
Only people “capable of forming an intent to cause substantial bodily injury” to a health care worker could be charged with a felony under the new legislation, according to the bills.
Busheme said medical crews are affected emotionally by the trauma of an assault, which can make returning to work difficult. And it’s not just the direct victim affected.
During a break in his duties Tuesday at the Hilo Medical Center ER, registered nurse Nelson Vo said he once witnessed a man assault a co-worker.
“He grabbed one of my co-workers and started swinging her around,” Vo said, noting it took multiple health care and security personnel to intervene.
The perpetrator was “young, he had no history of psychiatric issues — and it came out of nowhere,” Vo said.
Supporters of the legislation to address assaults at locations outside the ER include unions representing health care workers, the Hawaii Medical Association, Hawaii Primary Care Association and insurers Kaiser Permanente and Hawaii Medical Service Association.
Email Jeff Hansel at firstname.lastname@example.org.