Under the Knife

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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.

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."

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Leigh Silverman