US hospitals outfitting nurses with panic buttons to prevent assaults

In 2019, Laura Paul, a registered nurse, was seeing a sedated patient in the intensive care unit at Cox Medical Center Branson in south-west Missouri when “he went from out cold to swinging in a matter of seconds,” she said.

Paul, a house supervisor who moves among different units of the hospital, tried to dodge the patient’s attack and screamed for help.

Fortunately, a nurse in an adjacent room heard Paul, rushed over and called for additional help. With four or five people, they were able to sedate the patient, who was severely ill and unaware of his actions. While the staff was able to restrain the patient, had the ICU been noisier, as is common, that might not have been the case, Paul said.

Now hospital administrators plan to provide more than 300 panic buttons to healthcare staff over the next two months, which Paul thinks could help avoid such potentially dangerous situations. The hospital is buying the buttons with a $132,000 grant from a local charity, the Skaggs Foundation, because of increasing concerns about violence against its staff, a problem that predates the Covid-19 pandemic but appears to have since worsened at hospitals around the country.

Indeed, across the US – as America’s hospitals and clinics have strained under the impact of Covid-19 – there have been reports of staff facing increased threats and violence, making an already difficult and dangerous job even more so.

Lynne Yaggy, who became a nurse in 1991 and is now chief nursing officer and vice-president of clinical services at the Branson hospital, said: “There has always been violence against healthcare workers, but what I have seen is an escalation of that in intensity and in the number of incidents.”

Some hospitals have limited the number of public entrances. In Idaho, nurses said they are scared to go to the grocery store unless they have changed out of their scrubs so they aren’t accosted by residents enraged conspiracy theories about the vaccine.

Doctors and nurses at a Coeur d’Alene, Idaho, hospital have been accused of killing patients by grieving family members who don’t believe Covid-19 is real, said hospital spokesperson Caiti Bobbitt. Others have been the subject of hurtful rumors spread by people angry about the pandemic.

“Our health care workers are almost feeling like Vietnam veterans, scared to go into the community after a shift,” Bobbitt said.

Over Labor Day weekend in Colorado, a passerby threw an unidentified liquid at a nurse working at a mobile vaccine clinic in suburban Denver. Another person in a pickup truck ran over and destroyed signs put up around the clinic’s tent.

About 3 in 10 nurses who took part in a survey this month by an umbrella organization of nurses’ unions across the US reported an increase in violence where they work, stemming from factors including staff shortages and more visitor restrictions. That was up from 2 in 10 in March, according to the National Nurses United survey of 5,000 nurses.

Still, while healthcare workers and people who study workplace violence say the panic buttons help protect hospital staff, they also say they are not a cure-all but instead must be part of larger effort to improve safety at hospitals.

“There is no one simple solution,” said Judy Arnetz, a Michigan State University professor who studies the health, wellbeing and safety of healthcare workers.

Hospitals must also take measures such as training staff in de-escalation techniques and implementing a system for reporting and collecting incident data, said Arnetz, who has studied workplace violence in the healthcare sector for more than 25 years.

Healthcare workers already faced a greater risk than other parts of the labor force and were experiencing a steady increase in violent incidents before the Covid-19 pandemic, according to data from the US Department of Labor.

Arnetz attributes the reported spike in violence in part to the increased volume of patients and Covid patients’ inability to be with their loved ones because of quarantines.

“The violence can come both from patients themselves and from [their] loved ones,” said Arnetz. “There is a lot of frustration. Patients can be in great discomfort, in pain.”

Concerns about safety has also become a top priority among staff considering working at a hospital in recent years, said William Mahoney, president of the Cox Branson hospital.

“When we were recruiting nursing students, it used to be that they would ask, ‘How much money am I going to get paid? What department am I going to work in?’” recalled Mahoney. In 2018, nurses started asking, “How are you going to protect me?”

In 2020, CoxHealth tested the panic buttons with staff at its hospital in Springfield, Missouri. Staff wore the buttons, which are about half the size of a credit card, on their nametags. When staff pressed the button, it triggered an alert through the same nurse call system that a patient might use to request that staff turn on the television.

The alert and the nurse’s location also goes to security staff.

Mahoney said the panic buttons led to public safety officers and nurses responding quicker to incidents. An internal survey of clinical staff also found the buttons made staff feel more secure, Mahoney said.

Still, panic buttons are not the sole answer.

The Joint Commission, a nonprofit hospital accreditation organization, issued new workplace violence prevention standards that will take effect in January and require hospitals to train staff in nonphysical and physical intervention skills and to use a reporting process for workplace violence incidents.

The House also passed the Workplace Violence Prevention for Health Care and Social Service Workers Act in April. The American Hospital Association opposed the legislation because “hospitals have already implemented specifically tailored policies and programs to address workplace violence,” and the new requirements were not warranted, a letter from the group argued.

A spokesperson for the hospital association said in an email that panic buttons are “one effective method among many that hospitals and health systems use to keep their staff safe”.

Nurses at the Branson hospital hope that’s the case.

Paul, the nurse involved in the 2019 incident, said the buttons have “provided such peace of mind, just to know that you’re not in there alone and there is an easy way to get help.”

The Associated Press contributed to this report