‘Steady stream of resignations’: Health care workers testify about workplace violence

AUGUSTA — The legislative task force studying violence against health care workers heard public testimony Tuesday for the first time since convening nearly two months ago.

The 13-member panel heard from several health care workers who said the escalating frequency and severity of physical and verbal abuse they face at work is “unsustainable” and is likely the number one reason driving people to leave the profession.

Miranda Chadbourne, a critical care nurse who is program manager for workplace violence prevention at Maine Medical Center in Portland, said she has worked with 2,400 health care workers across the MMC network who have experienced violence.

She said she, too, has been assaulted by patients and one experience a few years ago was so traumatic that she decided to step away from bedside nursing.

“We need your help … to make sure no other care team members leave the profession,” Chadbourne said.

Nanci Goudey, the nursing director for MMC’s emergency and urgent care departments, said three nurses had resigned from the emergency department, continuing a “steady stream of resignations” in her department over the past year.

“Initially when we were losing people it was specifically due to COVID and older staff choosing to retire,” she said. “The overarching resignation reason for the last year, year and a half, and accelerating over the last several months has absolutely been stress, burnout, PTSD, anxiety.”

Goudey said the story is “always the same” when someone resigns: “I was assaulted by a patient … and I simply cannot take it anymore.”

The health care workers who spoke Tuesday reiterated a frustration expressed by many others in the profession that their perpetrators are not held accountable and the prosecutorial process lacks transparency.

“All we do is our job to provide care and to help others,” Kelly Smith, a nurse at Eastern Maine Medical Center in Bangor, said in a written testimony read to the panel by a proxy.

She said she’s heard patients state that if they assault a worker, their charges will ultimately be downgraded or dropped.

“The fact that we have to accept the assailant’s charges (are) dropped sends the message that the actions are OK. It’s not listed anywhere in my job description that it’s OK for me to be assaulted,” Smith said.

While Co-chairman Sen. Ned Claxton, D-Auburn, said previously that the task force will only focus on perpetrators whose mental capacity at the time of an incident does not preclude them from prosecution, the task force was again confronted with the question of how mental and psychiatric disorders play into this conversation and if and how they should be considered within the criminal process.

The president and CEO of Northern Light Acadia Hospital, an acute psychiatric hospital in Bangor, said the “significant increase in violence” against staff has led the hospital to reach out to local police.

“Unfortunately, law enforcement is limited in their ability to respond. Issuing a summons to court or arrest patients with mental illness who assault hospital personnel is not the pathway forward to resolve this extremely challenging situation,” Scott Oxley said in written testimony.

“Regardless, we cannot, and should not, expect mental health care providers to endure this type of abuse.,” he said. “It is clear to our behavioral health professionals that Maine needs a new model to safely care for violent individuals in need of acute behavioral health services.”

Carly Mahaffey, writing on behalf of members of the Intentional Peer Support Advisory Committee, said the task force’s focus should be on examining the overreliance on Maine’s emergency departments to provide psychiatric care or to house individuals while awaiting appropriate services and on “how people can be supported in the community so they do not have to go to an emergency department.”

The Intentional Peer Support Advisory Committee advises the Department of Health and Human Services on Maine’s intentional peer support program, which trains individuals with lived experiences to serve as patient advocates in emergency departments.

The voices of people with lived experience in these conversations are “invaluable,” Mahaffey said.

“It is puzzling to us then why the voices of those who will be directly impacted by what this task force recommends are not being included in these conversations and meetings,” she wrote. “They can offer a perspective to this issue that is lacking, and the exclusion of which will lead to the creation of more and larger problems down the road, especially for those in the community and for those who work in hospitals.”

The task force only heard testimony from those who joined the meeting in-person or virtually and because the Intentional Peer Support Advisory Committee’s testimony was among those submitted in writing, it was not acknowledged during Tuesday’s meeting.

The fourth and possibly final meeting of the task force will be held in-person and remotely at 9 a.m. Oct. 13. For more information, visit the Maine Legislature’s website.