BANGOR, Maine — The Acadia Hospital employee whose beating last summer at the hands of an out-of-control patient helped trigger a federal investigation is hopeful that working conditions will get better at the 100-bed psychiatric hospital.
“I think conditions will improve,” said 55-year-old Robert Patterson of Bucksport, who has worked as a psychiatric technician at Acadia for 10 years.
Last summer, Patterson was jumped at the hospital without warning, he said Wednesday, by an adult patient who had shown no previous sign of emotional escalation. The surprise attack left Patterson with multiple injuries, including a broken bone in his face, and kept him out of work for 2½ months.
He recently returned to work full time, and said some safety improvements — including more visible security in parking areas, improved screening of violent patients and better communication among clinical staff — already are apparent.
It was Patterson’s beating that reportedly prompted a fellow employee to contact the federal Occupational Safety and Health Administration to complain about a worsening pattern of patient assaults and staff injuries after president and CEO David Proffitt instituted a “no restraints” policy at the private, nonprofit hospital.
The policy is endorsed by national mental health agencies and professional groups and supported by the Acadia Hospital board, but employees complained that hospital administrators failed to adequately train clinical staff in alternative ways of dealing safely with violent patients.
After months spent interviewing dozens of administrators and staff and examining staff injury reports the federal agency issued its report and recommendations late Tuesday. OSHA imposed a total fine of $11,700 for the violations at the hospital.
In an interview at his office on Wednesday morning, Proffitt said the OSHA report and recommendations support measures already in place to improve employee safety at The Acadia Hospital. These include improved staff training, more consistent patient screening, better clinical coordination and environmental changes such as the installation of ceiling-height mirrors to improve visibility at hallway corners, he said.
“What we are committed to here is obtaining an injury-free work site for our employees,” Proffitt said. Realistically, he added, it is important to recognize that Acadia’s patients suffer from acute mental illness and psychosis and are prone to becoming violent toward themselves or others.
Proffitt said he was mildly surprised at some of the graphic language used in the report, including a reference to “a smashed face” when the term “facial contusions” would have been more medically correct.
“That doesn’t matter, though,” he said. “Those are all just words but the events are the same. People got hit and injured at work.”
The report calls “serious” the violation of workplace safety standards that has resulted in at least 115 on-the-job assaults since January 2008, including several recent attacks of “particular severity.”
- In April 30, 2010, a psychiatrist was choked and beaten by a patient.
- The next day, the same patient “choked, beat, pulled hair and pounded a nurse’s face into a wall.”
- In July and August, clinical staff were “aggressively assaulted” by different patients, resulting in a severe kick to the groin of one worker and “a smashed face” in the other.
The report also faults the hospital for inadequate record-keeping in the reporting of staff injuries.
Proffitt said the findings of the report will be discussed at an informal “resolution conference” that must be scheduled within 15 working days of the release of the report. At that conference, he said, some elements of the report may be disputed, such as a comparison of injury rates at The Acadia Hospital to those at acute-care hospitals in general, including medical hospitals where psychotic patients are rare.
Proffitt said he has met with board members, administrators and clinical staff to discuss the contents of the report. A routine schedule of “town meetings” for employees will continue, he said, and serve as a forum for frank discussion of workplace safety.
“Generally, our staff is pretty engaged in making this a safer environment,” he said.
Patterson said Acadia administrators appear to be listening to employee concerns and suggestions, many of which he said are “heartfelt.”
“Acadia really does perform a valuable service in our community,” he said. “I see many patients there who get better in a short length of time.”
Newly elected Acadia board chair Rick Lyons said Wednesday that the board is satisfied with Proffitt’s response to the OSHA investigation and report. The board will continue to monitor safety issues at the hospital, he said, and seeks to ensure compliance with the federal recommendations.
Lyons encouraged anyone with concerns about the situation to contact him at 862-3255.