From left, Nursing Supervisor Colleen McKinney, Chief Nursing Officer Patti Ludwig-Beymer, Service Line Director Cindy Rentsch and Public Safety Manager Dave Hoffman discuss ways to improve safety for employees and patients at Edward Hospital. (Edward Hospital)
The news hitting the public that second week in May was awful enough: A hostage situation at Northwestern Medicine Delnor Hospital in Geneva involved nurses and a patient with a gun.
Hours later, that patient, a 21-year-old prison inmate, had been shot dead by a SWAT team member and the victims released.
But the information that came out almost two weeks later in a lawsuit filed by several nurses was even more horrifying: Contrary to earlier reports that there were no injuries, the suit claims one of the nurses was held hostage in the dark for hours with a gun to her head, and was not only beaten, tortured and raped during the ordeal, she was hit in the arm by the bullet that killed prisoner Tywon Salters on May 13.
Certainly I wasn’t surprised when the headlines prompted an immediate call from my daughter-in-law, a nurse in the Dallas area who will never forget the time a prisoner she was attending in the ER all but destroyed his hospital bed, despite having one hand in handcuffs. The Delnor story, she said, has everyone in the profession talking, especially those who work in emergency rooms where you never know who is going to come through the door in an often high-stress and at times volatile situation.
Closer to home, there’s no question that what happened in Geneva had a chilling effect on hospital employees across the Fox Valley.
Officials from Delnor declined to be interviewed, but the hospital issued a statement noting that safety "is our highest priority" and that the "professionalism and bravery demonstrated by our staff during the May 13 incident likely saved many lives."
The statement continued, "We are now focused on supporting our employees, implementing procedures to prevent this from happening again and caring for the patients who trust us for their care."
Likewise, Presence Healthcare, which includes Presence Mercy Medical Center in Aurora, Presence St. Joseph Hospital in Elgin and Presence St. Joseph Medical Center in Joliet, where a convicted murderer transported from Stateville Correctional Center earlier this month briefly held a corrections officer and caregiver hostage with a makeshift weapon, declined an interview. But Regional Chief Nursing Officer Grace McBride said in a statement that Presence Health follows "tested emergency protocols and procedures" and regularly participates in drills and in coordination with other organizations in the region.
As it turned out, four months before the Delnor incident, Rush Copley Medical Center began working with the Aurora Police Department to implement security enhancements as a response to an increase in violence that seems to be permeating society. New policies and procedures put in place at that time included more access restrictions as well as upgrades in badge and surveillance camera technology.
But even as the Delnor situation was playing out, Rush Copley officials "were talking to staff," said Chief Operating Officer John Diederich. And in the immediate aftermath of that hostage crisis, there was no question, he added, that nurses and other employees felt the need to revisit the policies and procedures that had just been upgraded a few months prior.
"It shook them up," he said, creating a sense of "vulnerability among staff and administration."
For that reason, officials have tried to check up more often on those working in the ER "just to make sure they are comfortable," Diederich noted. Also in response, Rush Copley held a series of employee forums that offered nurses and other employees a chance to voice their concerns and offer ideas.
"There are always gaps in policies, and since then, we have taken a hard look at this employee input," he said. "How do we work together with the APD or any other law enforcement group that brings prisoners to the hospital? How do we work together to keep our employee safe?"
Some of those discussions have led to changes in code policy. For example, they have designated a word to signal when there’s a combative patient, and security is notified of the need to deescalate the situation.
"We already had a good response in place," said Diederich. "But the staff told us we needed to form a perimeter around that area … to ensure the public remains outside and certain hallways are blocked off.
"We took it up a notch," he said, "to improve what we already had in place."
In part because of its close relationship with Linden Oaks Behavioral Health, Edward Hospital in Naperville began aggressively tackling the issues of violence in the workplace two years ago, officials said. All 8,000 employees, including those at its 60-plus off-campus sites, have gone through safety training, noted Edward Public Safety Manager Dave Hoffman. And security measures, including better camera coverage and more panic buttons, have been added.
In addition to more face-to-face time between nursing supervisors and those on the front line, Edward has also been holding forums and discussions on ways to promote a culture of safety. Since March of 2016, representatives from all hospital departments converge once a day Monday through Friday to discuss any safety issues — no concern is too small —— that have arisen in the last 24 hours.
"It does not have to be pulling a gun," noted Chief Nursing Officer Patti Ludwig-Beymer, to constitute a threat to an employee.
Also, in the last nine months, there have been three major "active shooter" drills, including a full-scale drill in April that involved Naperville police and fire personnel. And a zero-tolerance policy in place encourages all staff to report when visitors display any type of violence toward them.
"Over the years, we just thought the abuse was part of the job," noted Cindy Rentsch, service line director for Edward. "Now we convey to the patient that we will not tolerate it."
There’s no question, these health professionals say, there’s been a breakdown in civility that has made their work more difficult.
"For the past five years there has been an escalation in patients acting out, verbally and physically," Rentsch said, and not just in the ER but in many departments.
"As a population, people are angrier," she said. "The world is moving at a faster pace and social media is providing a stage for people to act out."
Adding to the problem is that some of the mental health infrastructure in the state has disappeared, said Rentsch. With institutions closing and state funding drying up, emergency rooms have become ground zero for treating these patients who are not getting the help they need. And while inner cities have always had stronger safety protocols in place, these experts said, suburbia has been lulled into a sense of security now being challenged by recent events.
Hospital officials agree that, no matter how good the security measures are, they will always need to be re-evaluated.
"We will never be able to eliminate the risk," said Rush Copley’s Diederich, "but we can minimize it."
Ludwig-Beymer agreed. "We look at vulnerabilities and see where we can get better," she said. "This is a journey that will continue forever."