More hospitals create police forces, as critics warn of pitfalls : Shots

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One person died and four were injured in a shooting at a medical office building in downtown Atlanta on May 3. The violence occurred one day after Georgia Governor Brian Kemp signed a hospital safety act into law.

Elijah Nouvelage/AFP via Getty Images

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Elijah Nouvelage/AFP via Getty Images

One person died and four were injured in a shooting at a medical office building in downtown Atlanta on May 3. The violence occurred one day after Georgia Governor Brian Kemp signed a hospital safety act into law.

Elijah Nouvelage/AFP via Getty Images

ATLANTA — When Destiny heard screams, she ran to a hospital room where she saw a patient attacking a care technician. As a charge nurse at Northeast Georgia Health System, she was trained to de-escalate violent situations.

But that day in the spring of 2021, as Destiny intervened, for several minutes the patient punched, kicked and bit her. And by the time a team of security guards and other nurses were able to free her, the patient had ripped out chunks of Destiny’s hair.

“We are not protected on our land,” she said as she summed up the story testimony later that year to the Georgia Senate Study Committee on Violence Against Health Care Workers. Destiny only used her name in the hearing, for fear of retaliation for speaking out against the patient who assaulted her.

This May, Georgia Governor Brian Kemp, a Republican, signed a law which strengthens criminal penalties for assaults against hospital workers and allows health care facilities in the state to create independent police forces. The law is a response to that testimony as well as hospital lobbying and data documenting an increase in violence against health care workers. In enacting the law, Georgia joined other states that have tried to reverse the rise in violence in recent years through tougher criminal penalties and strengthened law enforcement.

Almost 40 states have laws to establish or increase penalties for assaults on health care workers, according to the American Nurses Association. And legislators in 29 states have approved or are working on similar laws, as well as those that allow the creation of hospital police forces. Members of those forces may carry firearms and make arrests. In addition, they have higher training requirements than non-certified officers such as security guards, according to the International Association for Health Care Safety and Security.

Groups representing nurses and hospitals argue that such laws address the daily reality of aggressive or agitated patients who sometimes turn violent. However, such interventions are relatively new. Critics worry that the establishment of hospital police forces will escalate violence in health care settings and may have unintended effects.

“I worry about all the reasons why patients should not trust me and trust the health care system,” said Elinore Kaufman, a trauma surgeon at the University of Pennsylvania in Philadelphia.

Healthcare workers are five times more likely to experience violence than employees in other industries, according to federal data. On May 3, the day after Kemp signed the Safe Hospitals Act into law, a person opened fire in a medical office in downtown Atlanta, killing one woman and injuring four. other, including workers in medical practice.

Verbal and physical threats, which have increased during the COVID-19 pandemic, are exacerbating a major nursing shortage, he said. Matt Caseman, CEO of the Georgia Nurses Association. Destiny testified that one of her colleagues left the nurse after the 2021 attack, in which the patient smashed the care technician’s face into a wall and onto the floor. Destiny also suffered from post-concussion headaches for months, she said.

Last November, the Centers for Medicare and Medicaid Services (CMS) noted the alarming increase in violence in health care settings. the recommended federal agency that hospitals better identify patients who may pose a safety risk, increase staffing levels and improve training and education for workers. There was no mention of an increased law enforcement presence.

Health centers say they are better able to retain workers and improve patient care when they can reduce the number of violent incidents, said Mike Hodges, secretary of the Georgia chapter of the International Association for Health Care Safety and Security. State laws governing how hospitals can respond to violence vary.

In Georgia, the new law boosts criminal penalties for aggravated assault against all healthcare workers on a hospital campus, not just those in emergency rooms, which were already regulated. And hospitals can now set up law enforcement offices like those on university campuses. Officers must be certified by the Georgia Peace Officer Standards and Training Council and maintain law enforcement records that may be made public.

Having a dedicated police force would help hospitals better train officers to work in a health care environment, the state Republican said. Rep. Matt Reeves, which co-sponsored the Georgia bill. Officers can get to know staff members and regular patients, as well as the layout and protocols of the hospital campus. “If you have a specialized police department, they are more in tune with the needs of the facility,” he said.

That’s the case at Atrium Health Navicent, which operates hospitals throughout central Georgia, he said. Delvecchio Finley, its president. The health system was one of the few to employ certified law enforcement officers before the new law.

Atrium Health recruits officers who reflect the diversity of the community, conducts training to counteract implicit biases and holds debriefings after any incident, Finley said. Officers are trained to react when someone becomes violent in one of the facilities.

“The biggest thing we have to convey to the officers is that we are in the environment where we provide a safe environment, where we take care of everyone,” he said.

Unlike other businesses, hospitals can’t just dump patients who misbehave, said Terri Sullivan, an emergency room nurse in Atlanta. A patient once punched her in the chest, breaking two ribs, before running out of the room and trying to punch his doctor. Sullivan said that in her experience, the presence of hospital security can prevent patients from acting out.

However, little data exists on whether such forces are effective in preventing violence in hospitals. Ji Seon Song, a University of California, Irvine law professor who studies policing in health care settings, worries about the “unintended consequences” of legislation that boosts the presence of -law enforcement in places where people receive medical care.

“You can see where there could be a lot of problems,” she said, “especially if the patient is African American, undocumented, Latino — something that makes them susceptible to being criminalized.”

A ProPublica investigation found that the Cleveland Clinic’s private police force disproportionately charges and cites Black people. And in March, a video emerged showing police and hospital staff members in Virginia restraining a patient who was experiencing a mental health crisis, leading to his death. In 23% of emergency department shootings from 2000 to 2011, the perpetrator took a gun from a security officer, according to A Johns Hopkins University study. The November CMS memo noted several incidents at the hospital involving police in which the agency cited the facility for failing to provide a safe environment.

Georgia law does not require hospital police officers to arrest patients with outstanding warrants for crimes that occurred off a hospital campus, such as probation violations. But it also doesn’t limit those powers, said Mazie Lynn Guertin, executive director of the Georgia Association of Criminal Defense Attorneys.

“As long as the discretion is not limited, it will be exercised at some point, by someone,” she said.

Law enforcement should always be a last resort, argued Kaufman, the trauma surgeon. While the threat of violence is a concern, hospitals could spend more on healthcare staff, boost general training and teach de-escalation skills.

“Our primary lens should not be that our patients are a danger to us,” Kaufman said. “It’s a harmful lens and a racist one. We should develop safe and healthy workplaces through other ways.”

KFF Health Newsformerly known as Kaiser Health News (KHN), is a national newsroom that produces in-depth journalism on health issues and is one of the leading operating programs in KFF — the independent source for health policy research, polling and journalism.

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