Years ago, when nurse Danielle Bubeck was working a shift in the emergency room, she revived a patient from a drug overdose. The woman responded by shaking Bubek’s hand, causing a bee.
“Then she threatened to come after me and my family.” Bubeck noted.
It’s one of many violent incidents Bobek said she’s experienced in her decades-long career. She saw her colleagues suffering from injuries and bruises after being attacked while working at the hospital.
Patients are sometimes angry, frustrated or scared. Some may distrust the medical system. Others are facing a mental health crisis. But with violent incidents on the rise, doctors and nurses like Bobek are calling for stronger protections — and tougher penalties for those who deliberately attack them.
“Right now, health care workers don’t feel supported,” said Bobek, associate director of nursing at the Cambridge Health Alliance. “I shouldn’t have to fear for my personal safety when I’m protecting someone. It’s not part of the job, and it’s not right.”
After years of inaction, the Massachusetts House of Representatives passed legislation aimed at addressing this last November. The bill is awaiting a vote in the Senate.
The legislation — which has support from hospital CEOs, labor unions and physician groups — would bring Massachusetts in line with 30 other states that classify assault on a health care worker as a felony rather than a misdemeanor. The change would allow police to arrest people for assaulting healthcare workers, even if the officers did not witness the assault, and would impose stiffer penalties on those convicted.
The law would also allow workers who are under attack time to recover from their injuries and pursue charges in court. And it will require hospitals to improve their preventive measures.
Violence sometimes occurs when patients are in crisis and cannot fully control their actions. They may experience confusion or other mental health symptoms that affect their behavior.
Deanna Mach, president of the Massachusetts Association for Mental Health, said she is concerned that people in these circumstances could be unfairly punished for their mental health conditions. The bill would allow a prison sentence of up to five years for assault – and 10 years if the assault causes serious injury.
“It’s a very harsh sentence,” Mach said.
Supporters of the law say its goal is to hold accountable people who knowingly and happily assault — not humiliate — patients with mental health conditions.
“There are a lot of attacks that are not related to mental health, that are out of anger and aggression,” said Dr. Benjamin Milligan, director of emergency medicine at Cambridge Health Alliance.
Milligan said the bill would hold hospitals accountable by requiring them to study risks and strengthen policies to keep employees safe.
“It has to be an ongoing process,” he said, “not something that’s just done once, and the box is checked, and everyone moves on.”
Health care workers have long been targets of violence, but the problem appears to have worsened in the years following the COVID-19 pandemic, according to state and national surveys, federal workforce data and interviews with employees.
The Massachusetts Health and Hospital Association estimates that a health care worker is verbally or physically assaulted in the state every 36 minutes, with violence typically occurring in emergency departments.
In interviews, doctors and nurses said that patients sometimes hit them, threw things at them, insulted them, or threatened to follow them with guns. Visitors can also become warriors.
“It happens every day in our emergency departments here in Massachusetts, someone is assaulted,” said Dr. Melissa Lay Baker, director of emergency medicine at Mass General Brigham Community Hospitals.
Each incident adds trauma to an already burned-out workforce, she said: “Every time this happens all the employees are mentally traumatized.”
“I’m a nurse, and I’ve learned that I’m a human finger bag for society.”
Olivia Smith, emergency department nurse
Under current state law, police generally do not arrest someone for assaulting a health care worker unless the officers witnessed the incident. So employees must continue to care for the person they assaulted. And if they want to press charges, health care workers usually have to go to court and have their case heard.
“I can’t tell you how many times I’ve heard of colleagues I work with being physically assaulted, and it doesn’t go anywhere,” said Olivia Smith, a nurse who has worked in the emergency department at Brigham and Women’s Hospital for 10 years. “We just go ahead and take it in.”
Smith said a patient once threw a can of ginger at her head, but luckily missed it. Another time, Smith said she saw a patient attack an emergency medical technician and had to call the police for help.
Verbal abuse, Smith said, happens every day.
“I’m a nurse, and I’ve learned that I’m a human punching bag for society,” she said.
Smith and other health care workers explained the steps they take to protect themselves: never turn your back on a patient, stand near an exit, bring a colleague with you when the situation looks dire. But she said that’s not enough – bigger changes are needed.
“If there were more significant repercussions for the person who attacked, that would be in our favor,” Smith said.
Two years ago, the state hospital union, the Massachusetts Nurses Association and SEIU — the largest union representing health care workers — reached an agreement on legislation to protect workers. These organizations often disagree on important workplace issues, so their cooperation was significant. But state lawmakers did not act on the proposal.
The bill was later reintroduced, and lawmakers now have until July 31 to act before the formal session ends.
Sen. John Lully, a Salem Democrat who sponsored the bill, said he was optimistic it would pass before that deadline.
“I don’t think we’ll ever eliminate assaults in the medical setting, but we definitely want to reduce them,” Lively said. “And that’s what this bill aims to do.”
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