Attacks leave hospitals strapped

Two months ago, while chatting with a custodian on a Western State Hospital ward, nurse Dagmar Jackson was attacked by one of the psychiatric patients there.

“She went straight for my face,” said Jackson, who stands 5 feet 2 inches tall and weighs 108 pounds.

Jackson recalls her glasses being knocked off and nails clawing her face. She doesn’t remember the several times she was struck, or the choking. The custodian finally pulled the attacker off.

“If it hadn’t been for him, they would have taken me out of there on a stretcher,” Jackson said.

On Friday, she and other workers at the state’s two mental hospitals told lawmakers that they need more staff, more training and more equipment to deal with an increasingly dangerous workplace.

The Department of Social and Health Services, which runs the two facilities, agrees. Despite safety plans, violence-prevention training and other efforts, DSHS says, worker injuries at both Eastern State Hospital at Medical Lake and Western State Hospital at Steilacoom have risen since 2000.

“There’s no disagreement here,” said mental health division director Richard Kellogg.

At Eastern State Hospital, patient assaults on staff are lower than a 2003 peak of 72 incidents but are still significantly higher than they were six years ago. The numbers are particularly stark at Western, which went from 153 attacks in 2000 to last year’s 275.

Brian Gralapp, a psychiatric security attendant at Eastern, told lawmakers that one co-worker was struck so hard in the head that he was left with a hematoma, depression, stuttering and a changed personality. Another co-worker, he said, was beaten so badly that her facial bones were broken in seven places. Gralapp himself said he had almost lost an eye when an out-of-control patient clawed his face.

“That’s what we’re dealing with on a daily basis,” he told lawmakers.

Kellogg said the attacks are traumatic for those involved – and for other patients and staff. They erode hope, trust, and morale and can spur paranoia and further conflicts. They leave both groups worrying for their safety. They also make it harder to find outside homes for patients and lead to high staff turnover.

“We’ve gotten open positions that just can’t be filled because people don’t want to work there anymore,” Jackson said. “It’s gotten too dangerous.”

The incidents are also extremely expensive. Western State Hospital alone accounts for nearly a quarter of the worker’s compensation premiums for the entire staff of DSHS, the state’s largest agency. Worker absences due to assaults are twice as long as they were six years ago.

Lawmakers on the House Health Care Committee seemed surprised by the number and severity of the assaults. Some wondered why DSHS hadn’t done more to boost staffing and safety on the wards.

“It sounds to me like this is a major problem,” said Rep. Dawn Morrell, D-Puyallup. “I work in a health facility, and I’m sort of shocked that these things weren’t being done all along.”

“Why is this coming to us now?” longtime Rep. Gary Alexander, R-Olympia, asked Kellogg. “Why hasn’t this been part of our budget since I’ve been here?”

“This issue is going to be a high priority for us, I think, this year, on both sides of the aisle,” said Rep. Bill Hinkle, R-Cle Elum. “It’s just unacceptable.”