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After Dallas hospital shooting, nurses call for greater protection


Nursing groups say violence is on the rise. Following the killing of two healthcare workers, nurses are asking lawmakers to pass legislation to improve safety.

Nurses are demanding greater protection in healthcare facilities after the fatal shooting of two healthcare workers at a Dallas hospital.

Authorities say a suspect fatally shot Katie Flowers, 63, and Jacqueline Pokuaa, 45, in the maternity unit at Methodist Dallas Medical Center. Flowers was a nurse and Pokuaa was a social worker, the Fort Worth Star-Telegram reported.

The suspect, Nestor Hernandez, 30, was shot by a hospital police officer and is in custody, authorities said. Hernandez, who was on parole for an aggravated assault conviction, was given permission to be at the hospital because his girlfriend was giving birth, according to media reports.

Nurses, doctors and healthcare organizations have bemoaned the uptick in violence seen in hospitals in recent years, particularly in the COVID-19 pandemic. Nurses are speaking up and calling for steps to make hospitals safer. Nurses have said the uptick in violence is driving some nurses out of hospitals.

National Nurses United, a union with nearly 225,000 members, is pushing for legislation to help protect healthcare workers.

“We mourn the devastating loss of a nurse and a health care worker and offer our deepest condolences to their families and colleagues at Methodist Dallas Medical Center,” Jean Ross, RN, president of National Nurses United, said in a statement. “No one should lose their life because they went to work. Health care settings should be places of healing, not harm.”

“This unimaginable tragedy is a stark reminder that workplace violence in the health care industry is increasing and that we urgently need legislative action to ensure the safety of our caregivers, other health care staff, and every patient or family member in those facilities,” Ross said in the statement.

Methodist Health System, which operates Methodist Dallas Medical Center, said in a statement this week it has increased the police presence at the hospital.The health system said it has a highly trained police force.

The system said the medical center has recently installed internal and external camera systems, added increased security measures and ongoing active shooter training. All of the system’s campuses have daily safety huddles, and security procedures will be evaluated, Methodist Health System said.

Two nurses assaulted each hour

Nursing groups have called for lawmakers to take action to protect nurses and other healthcare workers. The Texas Nurses Association said in a statement that it has been working with lawmakers on workplace safety, albeit with little success, but aims to make it a priority in the upcoming legislative session.

After the shooting in Dallas, Serena Bumpus, CEO of the Texas Nurses Association, said in a statement, “This is unacceptable.”

“No person should fear for their life for merely going to work, especially a nurse or healthcare worker whose passion is to help others heal,” Bumpus said. “We hope our legislators understand that we need to protect our healthcare workers.”

Nurses have spoken out vocally about the increase of violence they are seeing, and surveys and reports put more perspective on the hazards nurses are facing.

More than two nurses are assaulted every hour, and 57 assaults are taking place each day, according to a recent report from Press Ganey.

About half of all hospital nurses (48%) said workplace violence is increasing, according to a National Nurses United poll in the spring.

National Nurses United is pushing for Congress to approve legislation that would require healthcare and social service organizations to create workplace violence prevention plans.

U.S. Sen. Tammy Baldwin, D-Wisc., has introduced legislation directing the U.S. Occupational Safety and Health Administration to require the creation of such plans. More than 30 senators have co-sponsored the bill. The U.S. House of Representatives passed a similar bill sponsored by U.S. Rep. Joe Courtney, D-Conn., last year.

U.S. Reps. Madeleine Dean, a Pennsylvania Democrat and Larry Bucshon, an Indiana Republican and a doctor, introduced the Safety From Violence for Healthcare Employees (SAVE) Act in June. The legislation would impose tougher penalties on those who attack and intimidate health system employees. The bill was referred to the House Judiciary Committee in June.

The American Hospital Association, which has endorsed the House bill, sent a letter to U.S. Attorney General Merrick Garland in March and urged him to strengthen protections for hospital workers, pointing to federal laws protecting airline and airport workers.

Creating a culture of safety

Hospitals can take steps to reduce workplace violence, nursing leaders say. Robyn Begley, chief nursing officer for the American Hospital Association and CEO of the American Organization for Nursing Leadership, and Nancy MacRae, CEO of the Emergency Nurses Association, wrote about some of those steps in a blog post this week.

Health systems and hospitals need to promote a culture of safety and ensure staff are committed to reporting violence. Staff should be accountable for promoting standards and health systems should employ evidence-based violence reduction strategies.

Many nurses don’t report the violence they endure, nurses and nursing leaders say. Nurses must be supported in coming forward, Begley and MacRae wrote.

“While health care workers have long accepted violence as an unavoidable part of the job, being shoved, kicked, hit, harassed, intimidated, yelled at or even worse is NEVER part of anyone’s job,” they wrote.

Nurses have said the increased violence is adding to burnout, and studies have shown it’s driving some nurses to consider leaving hospitals, or nursing altogether.

The American Association of Critical-Care Nurses issued a report in August that said less than half (47%) of nurses feel their organization values their health safety. Two out of three nurses are considering leaving their position in three years. Among those thinking about leaving, 36% of nurses said they’d leave in a year.

Jenn Schmitz, president of the Emergency Nurses Association, said in a statement earlier this week, “Health care workers driven by a desire to help others should not go to work worried about their personal safety or if they will make it home from their shift.”

The National Association of Neonatal Nurses said in a post on Twitter it mourns the loss of the two healthcare workers in Dallas in “senseless” violence.

The group’s post also included a message: “End workplace violence. Now.”

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