Over almost 35 years working in a state hospital, former nurse Katie Coughlin says she can’t even count the number of times she’s been assaulted physically, verbally, and sexually. She says she’s had knives pulled on her, has been bitten, kicked, jumped on in an elevator. But by the end of 2018, Coughlin had enough.
“The day before I decided, okay, it’s time to retire, I had found myself with a patient who was much younger than I, and probably had 75 pounds on me, and she had been trying to hurt herself, and when I went to intervene, she suddenly decided, well, I'm not going to hurt myself anymore- I'm just going to try to hurt this person instead,” she told WAMC.
As Coughlin lay on the floor grappling with the patient, trying to shield herself from the onslaught as she waited for her co-workers to arrive, she said she realized it was the end of a long, painful journey.
“I just thought to myself, OK, I'm getting too old to be wrestling on the floor with somebody who's trying to kill me or whatever, and I need to leave here before I get seriously injured, which, luckily, over my career, I never got seriously injured, but I had worked with multitudes of people who were seriously injured, ranging from broken collar bones, concussions, broken jaw, back spasms, traumatic brain injuries, loss of peripheral vision in an eye, just on and on and on,” she said.
The decision to move on wasn’t just a personal one. For years, her husband had asked her to leave nursing, and the strain the work put on her children was unavoidable.
“I still remember when my son was 14 years old, and he asked me one day if anyone had tried to kill me that day at work, kind of like in a joking, sarcastic manner," said Coughlin. "But I knew he meant it, and it just broke my heart. And I thought to myself, no kid should worry about their mother at their place of employment.”
Today, Coughlin is working to bolster protections for nurses as chair of the Workplace Violence and Abuse Prevention Task Force of the Massachusetts Nurses Association. It’s the largest labor union for registered nurses and health professionals in the commonwealth with over 23,000 members. Some of them are in the State House today to press lawmakers to pass legislation to protect nurses from workplace violence.
“People tell the same stories, of being punched, of being threatened, of being threatened with the sharp objects, having either patients or visitors put their hands around a nurse's throat. Really scary stuff, really, really scary stuff. And I hear it everywhere I go, big medical centers, smaller hospitals," said MNA President and ICU nurse Katie Murphy. “Prevention is really going to go a long way, whether that's safety protocols, security guards, whatever monitoring has to be present and having adequate staffing for that unit, because you can understand when someone's not getting the care that they need in a timely fashion, that might set somebody off.”
Murphy says preventive measures should be tailored to the distinct needs of every healthcare facility in Massachusetts, not applied in broad strokes that might fail to capture the differences between big city hospitals and smaller rural ones. She said legislators, administrators, and the average person on the street may not fully understand what nurses are going through.
“Maybe since they're not experiencing it firsthand and that they're not the supervisor that it's being reported to, maybe they just don't understand how dire the situation is," Murphy told WAMC. "And maybe this is a way for us to say, you know, it is dire, it is really dangerous, you're losing your staff because of this. And so, this is why we feel that we have to codify it in law. Because what's been in place in the past is just not serving the needs that we're seeing on the front line.”
Leilani Hover of Pittsfield’s Berkshire Medical Center has been a nurse for 12 years, with experience in the ICU and Post Anesthesia Care. She notes that the county – with its dwindling population and one of the lowest per capita income averages in Massachusetts – poses some unique challenges to healthcare professionals.
“We live in Berkshire County, which is one of the few areas that still has quite a large population of substance abuse people, because we have treatment here," Hover told WAMC. "So, a lot of other areas in Massachusetts are closing down those kinds of facilities because they don't make money. But yet, here in Berkshire County, we still have all of those. We have an inpatient psychiatric unit, we have outpatient, all kinds of outpatient abilities.”
Hover says since the Covid outbreak in 2020, violence toward nurses has escalated without a safety net in place.
“When it happens to you, you're like, oh my gosh, what, have I done wrong?" she explained. "Or your employer makes you feel like you should have done something different, something better, that could have put you in a different position instead of being assaulted at work.”
She says the state must establish legal recourse for nurses.
“I don't feel like they're covering the employee's safety," said Hover. "We're here to make sure that the patient and their family are safe, but who is here to make sure that we're safe? And also, holding hospitals responsible for making those adjustments so that we are safe- having enough security on staff, making sure that the secure the staff is educated in de-escalation policies and safe restraint policies, making sure that all of nursing has those same, those same credentials like de-escalation and restraint, so that we can do it safely for ourselves and for the patient.”
The current legislation working its way through Beacon Hill is the product of a rare agreement between labor unions and hospital owners. It has already been unanimously passed by the House of Representatives, and is now waiting on State Senate approval. If passed into law, one of its sections would reclassify assaulting a healthcare worker from a misdemeanor to a felony- a standard already in place in more than 30 other states.
Hover says that if the situation for nurses doing highly skilled, vital work in communities like the Berkshires continues to degrade, the impact on the lives of working people and the Massachusetts healthcare system at large will be both long lasting and severe.
“We're already facing a nursing shortage, they say, or a shortage of nurses who are willing to work in this kind of environment, really, is what I call it," she told WAMC. "I mean, if you're not going to provide for their safety, and they have to deal with this on a regular basis, they're just not going to come back. They're going to shy away from nursing in general.”
