Healthcare workers, particularly nurses and nursing assistants, face an inordinate number of safety hazards at work. Chemical exposures, infectious diseases, needle sticks and physical injuries from lifting and turning patients are just a few of the ways in which healthcare workers are injured on the job. What’s more, in recent years, injuries due to physical assaults by patients and visitors have become a greater threat to front-line healthcare workers than ever before. This fact was tragically highlighted earlier this month when a Louisiana nurse died as a result of injuries sustained during an assault.

Lynne Truxillo, 56, was an employee of Baton Rouge General Hospital, and was working on the behavioral health unit when the attack occurred. The perpetrator, Jessie Guillory, 54, initially attacked another nurse but turned on Ms.Truxillo when she stepped in to help. According to official accounts, Guillory smashed Ms.Truxillo’s head against a counter, and she injured her leg while trying to escape. She continued working despite her injuries, and reported to the emergency department after finishing her shift. At that time it was determined that she would need surgery to repair a torn ACL.

But Truxillo never made it to the operating room. Several days after the injury, she developed a blood clot in the injured leg, which traveled to her lungs and caused her death. The death was ruled a homicide. Mr. Guillory, who reportedly has a history of violence against healthcare workers, has since been arrested and charged with manslaughter.

Safety Not a Priority, Healthcare Workers Claim

Sadly, the attack on Ms. Truxillo was far from an isolated incident, healthcare workers say. According to data from the Bureau of Labor Statistics, of the 18,400 intentional injuries sustained by workers in 2017, 71 percent were injuries to workers in the healthcare field.  More importantly, the number of healthcare workers injured by patients has risen steadily since 2012.

The problem is so severe that Dr. Tom Mihaljevic, president and CEO of Ohio’s Cleveland Clinic called it “an epidemic” in a recent interview with Modern Healthcare. And yet, “no one is talking about it,” he said.

Mihaljevic’s sentiments were echoed by Michelle Mahon, R.N., a representative of National Nurses United, a nursing labor group. Speaking of Ms. Truxillo’s death to Baton Rouge’s The Advocate, she decried a system that treats healthcare workers as “somewhat expendable” and is so unresponsive that nurses don’t even report violent encounters because they “have the perception that nothing will change.”

Kristi Tortorich, a former nurse who left the profession over a decade ago after being “held at gunpoint, choked, punched, [and]come home with bruises multiple times,” agrees. “This is nothing new and it’s happening everywhere, not just in Baton Rouge …” she said to the Advocate. “Until we start treating nurses as people again, this is never gonna get fixed.”

Arresting Patients Not An Answer

But arresting mentally unstable patients is hardly an answer, says Mahon, and most mental health experts would agree. Instead, hospitals should be required to implement evidence-based solutions that stop assaults before they occur. According to a 2017 report from the Joint Commission, these should include:

• Improved recognition of workplace violence, including verbal abuse.  
• Standardized tools that help healthcare workers identify behaviors that may be precursors to violence
• A culture that encourages the reporting of violent encounters
• Appropriate and timely follow up with workers who are intentionally injured while on the job
• Accurate and complete collection and aggregation of all data on violent encounters
• Identification of the areas and situations that are most in need of intervention
• Creation of quality improvement initiatives that address high-priority situations and environments
• Evaluation of initiatives to determine if reductions in workplace violence occur

Additionally, Mahon says, states should implement legislation that mandates OSHA reporting of violence against healthcare workers to help track incidents and hold hospital administrators accountable. California instituted such a measure in 2018 with its revised Workplace Violence Prevention in Health Care standards, and several other states have followed suit. A similar measure was introduced to the U.S. House of Representatives in November 2018  by Rep. Joe Courtney, a Democrat from Connecticut. As of this writing, the bill has not been brought to a vote.

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