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"Our philosophy was simple," says ACEP member Dr. Todd Taylor, an emergency physician at Good Samaritan. "On the grand scale of things, how many times do you hear about an assault occurring at a police station? Never. Why? Because you'd have to be deranged to perpetrate a crime at a police station. That was our attitude about the ED. It's supposed to be a safe haven for someone who is down on their luck, ill or injured, and anyone who violates that should be penalized."
Taylor and another ACEP member, Dr. Patrick Connell, were also concerned that hospitals were minimizing incidents to deflect a negative image. "We all know stories about health-care workers being physically threatened or assaulted by a patient," Connell says, "but several years ago, we knew we'd get stonewalled when we did anything about it. The hospital administrators wanted the violence kept quiet 'cause it was bad publicity."
Police did little to encourage hospital workers to hold attackers accountable. "Several of our nurses had been assaulted and the police just blew it off. One had been punched by a patient. They said if we booked the perpetrator they'd come back in less than 24 hours with a submachine gun, so just ignore it."
Connell remembers a time when hospital emergency departments were practically immune to violence. When he began his medical practice at Maryvale 22 years ago, the janitor doubled as a part-time security officer.
"Sadly, we have evolved to where they are no longer hallowed healing places. The number of weapons and violence has escalated tremendously to the point where we now need trained, professional security forces," Connell says.
"I work in a part of town where there is a lot of violence in general," he says. "People are subject to gun violence and domestic violence and you end up with a lot of people impaired by drugs and alcohol. There's a climate here that is ripe for violence. Physicians, nurses and techs are particularly vulnerable. In order to effectively deal with patients, you have to get physically close to examine them. You don't know who they are or if they're armed."
Connell was recently threatened by a gang member whose buddy had suffered a chest wound.
"I was told, 'If anything happens to Homeboy, you're history.'"
Connell says half the assaults at Maryvale have been committed by family members. "They become frustrated with the system. Often they don't realize that we help people in the order of how serious their illness is, that we'll care for the person with a heart attack before someone who's been waiting three hours with a sore throat. Or they have unrealistic expectations of what we can provide them with and lash out when those expectations aren't fulfilled."
The availability of narcotics also poses a safety threat. Connell says he sees people on a daily basis looking for drugs.
"They'll go from ED to ED. Some are very creative. They'll say, 'My dog ate my prescription' or 'I came here for the weekend for my aunt's funeral and forgot my medicine.' I've had people threaten me if I didn't give them what they wanted."
In November 1993, a vicious incident occurred at John C. Lincoln Hospital which sent a shudder throughout Arizona's medical community. The assault happened at 4:30 on a quiet Sunday afternoon.
Marc Wayne Bachard, a 37-year-old patient-care technician, was gathering equipment from a cabinet on the sixth floor to draw blood from a patient, when he noticed a tall man (later identified as Nicholas Conn) in his mid-20s, wearing dirty blue jeans and a bloody denim jacket, approach the nurses' station.
"Do you have any meds on this floor?" Conn asked a nurse, his long, brown hair revealing watery, bloodshot eyes and a thin, unshaven face. When the nurse asked who the medication was for, Conn replied, "It's for me," whereupon he attempted to open a locked drug case.
Suddenly Conn became aware of Bachard, who was standing behind him, still searching through a cabinet. Surprised and agitated, Conn whirled around, reached into his boot, produced a six-inch carving knife and stabbed Bachard in the right arm, piercing the bone above the elbow. One of the technicians yelled, "Oh, my God, Marc's been stabbed!"
A nurse followed the assailant, who ran down the hall. As she passed the elevators, someone (allegedly Conn) struck her on the head and she lost consciousness.
Conn escaped (he was found later in a neighbor's backyard) and Bachard was wheeled to the ER with the blade still lodged in his arm.
The perpetrator was charged with five felonies and is serving a seven-year sentence. But knowing that Conn was in jail didn't make Bachard feel any safer.
"It was like being in a nightmare," recalls Bachard, who's going on his sixth year at Lincoln. "For an entire year after it happened, I carried Mace with me while I was working. I was constantly looking over my shoulder."
A week after the incident, Bachard was called by an ACEP member, who asked him to appear before the Senate. When ACEP members caught wind that Senator Mark Spitzer was spearheading the bill they had been lobbying for, they rounded up health-care providers who had been assaulted to give their testimonies.