When the security guard at Methodist Hospital San Antonio met the visitor at the door of the children’s emergency room on a Saturday afternoon in early August, the officer’s request was simple: The man needed to get a temperature screening to make sure he showed no early signs of COVID-19 before entering the hospital.
The man refused, became agitated and began angrily shouting, pulling out his camera to record the guard and hospital staff. The scene got so tense that San Antonio police were called, but the man stormed off in anger before the officer could arrive.
Texas hospital workers and health care officials say incidents like it have been rising in both number and intensity this summer as tensions boil during the delta-fueled fourth surge in COVID-19 hospitalizations.
“Our staff have been cursed at, screamed at, threatened with bodily harm and even had knives pulled on them,” said Jane McCurley, chief nursing executive for Methodist Healthcare System.
Nurses and hospital staffers are historically vulnerable to workplace violence due to the nature of their jobs, where they deal with people who are having bad reactions to street drugs or mental breaks and often have to give bad news to patients or family already in extreme pain or emotional distress.
But the pandemic has exacerbated the stress that can escalate into threats and violence, as people are now contending with not just the virus but also job loss and other stresses, said Karen Garvey, vice president of patient safety and clinical risk management at Parkland Health & Hospital System in Dallas.
Garvey said confrontations at Parkland just this year have included “people being punched in the chest, having urine thrown on them and inappropriate sexual innuendos or behaviors in front of staff members. The verbal abuse, the name-calling, racial slurs … we’ve had broken bones, broken noses.”
Visitors and patients assaulting hospital staff “was an epidemic before the pandemic — it was just silent to the public,” she added.
A 2013 Texas law made it a felony to assault an emergency room nurse, but legislation that would have expanded that to include nurses in other areas of a hospital died in the Texas Senate earlier this year.
With hospitals reporting historic nursing shortages as the pandemic drags on, the fear is that the “alarming rate” of escalation will be the last straw for nurses who are physically worn out after fighting a pandemic for 18 months, thin on compassion for people who need care after choosing not to be vaccinated, and afraid for their own personal safety, said Houston pediatrician Dr. Giancarlos Toledanes.
“With the escalation of this violence toward health care workers, we’re going to lose the workers that are deemed essential,” he said.
‘Tempers are high’
The Texas Department of State Health Services doesn’t track incidents of aggression against hospital staff outside of its regular surveys, the next of which will be done next year, a spokesperson said.
But as health officials across Texas watch hospital ICUs and pediatric units overflow with record numbers of mostly unvaccinated people, they say the surge in aggression toward health care workers is obvious.
Many of the problems being reported in recent months include disagreements over masking and screening protocols that people don’t have to follow in other places, particularly after most mandatory protocols were banned in recent months by Gov. Greg Abbott, officials said.
Confrontations are sometimes caused by hours- or dayslong waits in emergency rooms that are so full of COVID-19 patients that there is no room for anyone else, health care workers said.
“Tempers are high,” said Carrie Kroll, director of advocacy for the Texas Hospital Association. “To the point where some systems are putting a security guard at check-in because family members are getting so abusive.”
At the Katy campus of Texas Children’s Hospital west of Houston, Toledanes said some parents get verbally abusive over rules that require them to wait for COVID-19 test results before more than one parent is allowed into a room with a sick child.
“It’s escalated a lot more,” he said, “especially now that we’ve gotten a little bit stricter with our policies” due to the surge.
In mid-August, the escalating reports prompted the Texas Hospital Association to take to social media with an image of an exhausted nurse’s face, mask pulled below her chin. The image reads: “Don’t forget the person behind the mask.”