Under the Knife

Even legislation can't end violence in Valley hospitals

Spitzer says Bachard's case drove him to sponsor what was then a controversial bill. "It just barely squeaked by," Spitzer says today. "People said, 'Why should these folks get more protection than anyone else? If I get assaulted walking down the street, why is that a misdemeanor?' Hospitals are a place of healing, and the health-care givers who work in them deserve more protection. Four years ago, when assaulting a health-care worker was a misdemeanor, the police would blow it off, like it was a pushing match in a bar."

Among those who testified were Bachard, Hanusosky and Dusty Sullivan, an emergency nurse who gave chilling testimony.

Having worked the night shift in trauma centers for 25 years, Sullivan has been assaulted on more than one occasion--she's been choked, and held at both gun point and knife point--but one particular incident made her feel violated more than any other.

The offender had been discovered molesting bodies in a mortuary. When confronted, the man became incoherent and was brought into the emergency room. Sullivan, then the head of the emergency department at Maricopa Medical Center, tried to inject him with a tranquilizer. The patient bit off a chunk of her flesh from her forearm, leaving a scar the size of a nickel.

Sullivan didn't report the incident to the police--it occurred prior to the passing of the felony law--since she knew there was little chance the man would be held accountable.

The underreporting of violence is typical, according to an OSHA report. Many ER workers and their supervisors regard violence as part of the job, some fear retaliation and often an excessive amount of paperwork is required for reporting an incident.

Besides, says Don Borgadus, hospitals often choose only to focus on those assaults resulting in injury. "There are dozens of incidents in which emergency staff members have been scratched, kicked and pushed, but we don't report those because they're not serious," Borgadus says. "The ones you report to the police are those in which employees require medical follow-up."

The only incident Sullivan reported was one in 1990 that drew the attention of the Phoenix Police Department's Riot SWAT team. While a patient's family and fellow gang member stormed the emergency department to see a gunshot-wound patient, they pushed one nurse to the ground and shoved another nurse against a wall. They threatened to kill her if she did not allow them into the trauma room.

"As you can see," Sullivan says, "we work with the dregs of society in a lot of cases. Emergency medicine is more than plumping pillows and smiling."

An hour after midnight on April 15, 1994, the day the bill was passed, Dr. Patrick Connell saw a health-care worker being threatened by a patient. "A big, angry man was standing over a tiny triage nurse, threatening to punch her out if he didn't get what he wanted. I said to him, 'Sir, I'm Dr. Connell and I just want to remind you that as of one hour ago, assaulting a nurse is the same as assaulting a police officer.' That stopped him right away."

These days, Connell looks to the law for protection, but only to a limited degree.

"Legislation is only a piece of the puzzle," he says. "I view it as more of a deterrent than as a measure to punish people."

Unfortunately, its effectiveness in deterring violent crime has been minimal. Few people are aware of the law. Some hospitals have posted a sign in the ER stating it's a felony to assault a health-care worker, but others shy away from the negative publicity.

"Hospital administrators don't want the public to think they're coming to a place that's potentially violent," says Connell.

To make matters worse, the law has been ineffective in punishing offenders.
Even though the presumptive sentence for a Class 6 felony is one year for a nondangerous offense and 2.25 years for a dangerous offense, ever since the law was instituted in 1994, not a single felon has served the full term.

One possible explanation is a clause in the law which creates a gray area for prosecutors. It reads, "The provisions . . . do not apply if the person who commits the assault is seriously mentally ill . . . or to persons afflicted with Alzheimer's disease or related dementia."

"That clause takes a lot of teeth out of the law," says Dusty Sullivan, "because it doesn't address people who are mentally or chemically impaired, making them not responsible for their actions."

Don Borgadus agrees. "It's not an easy statute to prosecute under for a simple assault," he says. "If a patient is coming in on a gurney and is high on meth and kicks a health-care worker, you wonder if they'll ever be prosecuted. We had one case at Desert Samaritan in the last 18 months where a doctor was assaulted, and one at Maryvale where a nurse was assaulted, and both victims pressed charges. But it's tough to have that law enacted on anybody because often the people committing the violence are totally out of control and don't know who they are and what they're doing."

Consider the case of Jean Dooley. At 2:50 p.m. on February 13, 1995, the 73-year-old woman left room 503 on the fifth floor of the Valley Lutheran Hospital in Mesa, where she had been recovering from a hysterectomy. She was carrying a .38-caliber Smith and Wesson revolver.

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