Violence toward staff of concern at Worcester Recovery Center

When the Worcester Recovery Center and Hospital opened in 2012 it was touted as a state-of-the art facility that emphasized the “natural structure of home, neighborhood and community.”

The $305 million, 430,000-square foot structure, with 320 beds – 60 for adolescents and 260 for adults – was built to have a “non-institutional look” where the “intent is to provide a private, quieter space.”

However, there has not been much quiet at the hospital as of late. The hospital has seen a dramatic rise in incidents of violence against staff by patients – far and above anything the Massachusetts Nurses Association has ever seen before.

In 2014, there were more than 425 reported assaults against staff at the Worcester Recovery Center and Hospital, according to the association. That same year, 394 staff suffered injuries because of workplace violence in 2014 which resulted in 4,102 lost work days. Over the last two years, 189 staff members have been out of work due to workplace violence.

“Hundreds of hours of work being lost,” said David Schildmeier, spokesman for the Massachusetts Nurses Association/National Nurses United. “We are not just talking about assaults; we are talking about people being out of work for months for being seriously injured.”

He says the issue stems from a staffing shortage and lack of “difficult to manage units” that used to operate at the now closed Taunton State Hospital.

“Now you have in this facility where patients who would normally go to a highly staffed unit to deal with highly assaultive dangerous patients are put in the general population in an under-staffed environment and it’s a recipe for what is happening,” said Schildmeier.

The state Department of Labor Standards issued a Written Warning and Order to Correct in July for the Worcester Recovery Center and Hospital after an inspection of the facility in May. The report states the tour of the hospital was initiated “as a result of the high pattern of work-related injuries that have occurred over the past two years due to patient’s aggressive behavior towards hospital staff.”

“In March and April of 2015, 74 percent of work-related injuries which required medical treatment or lost days were caused by aggression of patients against staff,” the report says.

The report lists examples of incidents from 2013 to 2015, including:

• March 8, 2014: The client came up behind the employee and squeezed the employee’s neck; the employee was not able to breathe or scream.

• March 4, 2015: The client became upset and punched employee in the left arm and employee’s head hit the wall.

The order lists seven corrective actions the hospital needed to take by the end of September, including implementing a written Workplace Violence Prevention Program, providing patient medical and behavioral history for new admissions, evaluating the design of the facility for safety (patient doors do not have windows for example, so staff can’t see in the room when they enter), evaluating work practices for safety (safe areas for staff only, uniforms, requiring closed-toe footwear), improving security measures, improve staff training, and improving the policy for reviewing staff injuries.

Michelle Hillman, spokeswoman for the state’s Department of Mental Health, said all of the action items listed in the order have been completed or closed, with the exception of the workplace violence program, which received an extension until Jan. 31.

“DMH is committed to the safety of staff and patients in all of our facilities,” she said in an email. “We welcome and appreciate the Department of Labor Standards’ input into our safety programs and activities. We look forward to completing the remaining action step by the end of January.”

Schildmeier says the hospital has addressed some issues in the report, but not all of them. The association is working to get legislation passed that would require hospitals to work with unions or with front-line staff to evaluate workplace safety risks and develop a plan to address them.

“We have a violent society and hospitals for years of all types have treated violence as a natural result of working in health care and it’s not,” he said.  “Violence is never acceptable no matter what the condition.”