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Anger, Aggression on the Rise, as Patients Face Long Waits, Limited Hospital Visits

“It is now unusual to not have at least one employee reported to occupational health because they have been assaulted by patients at every morning rounds across our health system,” said Marna Borgstrum, chief executive officer of Yale-New Haven Health System. 

Borgstrum told CT Examiner that on top of the expected incidents of aggression from patients hospitalized with dementia, every other area of the health system has been coping with public misbehavior rising to the level of assault during the latest wave of the COVID-19 pandemic. 

In the last few weeks Borgstrum said that a fist fight had broken out at a testing center, long wait times at the Emergency Department had led to aggression toward staff, and there were reports of disrespectful behavior by families of admitted patients facing new hospital protocols banning visitors. 

“We understand that families are frustrated…we know that people are feeling overwhelmed by the length of the pandemic,” Borgstrum said. “There is a growing reduction in civility from patients and family members. For our staff, civility and even kindness goes a long way.” 

Ajay Kumar, chief clinical officer at Hartford Healthcare, said their system was also struggling with similar problems.

“The relationship we have in Hartford Healthcare with our colleagues and our patients is different. We have seen incidence of grievance going up. We have seen incidence of impatience going up. We have not, fortunately, seen incidence of direct physical violence so far,” he said. “It has raised the temperature a little bit. Our nurses and our frontline providers are dealing with more of these grievances than before.”

Employees at Backus Hospital in Plainfield also say that there has been an increase in violence, but in their case not directly related to COVID-19.

“It’s been dangerous and it can escalate and it even can lead to assault and has,” said Sherri Dayton, a registered nurse at Backus Hospital.

According to Dayton, the increase in aggression at Backus has had less to do directly with COVID, and more to do with the increase in drug and alcohol addiction and mental health issues they have been seeing in the emergency room. 

“The increase in the amount of addiction that we’re seeing is causing more assaults,” she said. “We frequently have people on drips due to alcohol withdrawal or, you know, give them Narcan. Typically, the addict doesn’t like to get knocked down, because it takes away their high and makes them have a headache and vomit and that kind of stuff. And they get very angry. So, we have had more aggression and injuries because of that kind of stuff.”

Even in average years, workplace injuries are not new to the medical field. In 2018, federal data showed that healthcare workers faced 73 percent of all nonfatal injuries from workplace violence in the United States. 

Staffing shortages aren’t helping matters either.

According to Borgstrum, at Yale-New Haven Health last week more than 700 employees across the health system were out of work due to testing positive for COVID-19 despite being vaccinated. Today, 439 staff are currently out with COVID-19. This has led to exhaustion and frustration on the part of the staff, she said. 

“Our staff have been asked to work and pick up additional shifts during this time,” Borgstrum said. “You can’t cover all the sick individuals and increase in patients without asking people to work overtime.” 

In an effort to prevent more staff shortages, Yale-New Haven Health and Hartford Healthcare both plan to mandate that all staff receive a booster shot. Even with the booster, however, many staff and non-staff are still contracting COVID, but according to Dr. Tom Balcezak, chief medical officer for Yale-New Haven Health, the cases have been relatively mild.

While Hartford Healthcare has decided to continue to allow all visitors in to see admitted friends and family members, Yale-New Haven Health as of last week closed all visitation in an effort to prevent more infections. 

“The visitor restriction is a step that we do not take lightly. We know how important it is for our patients to see their family,” Balcezak said.. “On balance right now, given all the stress that our health system is under, with all of the virus circulating it is the right thing.” 

According to Kumar, part of the reason they have allowed visitors to continue is because it betters the relationship and hopefully prevents aggressive behaviors.

“I think that the operating model we have put in place where we welcome everybody with compassion and have allowed family to visit, it does reduce those infractions to a certain extent,” Kumar said. 

Balcezak said he expects the omicron wave to peak soon and slowly decrease over the next four to six weeks. Currently 738 patients are hospitalized with COVID at Yale.

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