O.C. Nurse Offers Cure for Violence : Legislation: Emergency room veteran drafted state bill to tighten hospital security. She says L.A. shooting was no surprise.

Violence inside hospitals was never included in any recruitment brochure of the nursing profession, says Vicki Sweet. Yet, during Sweet’s 11-year career as an emergency room nurse, the subject was always on her mind.

“We experience different levels of violence almost on a daily basis,” Sweet said of emergency room staff members.

On Monday suspect Damacio Ybarra Torres, a 40-year-old Skid Row hotel resident, allegedly shot three doctors at Los Angeles County-USC Medical Center and took two hostages during a five-hour siege. The ordeal began when the gunman entered the hospital’s emergency room and started firing. He later surrendered to police.

In the aftermath, the California Emergency Nurses Assn., which has an Orange County chapter, is stepping up its push for legislation to help provide a safe working environment in hospitals.

Under proposal is state legislation that will make it mandatory for every hospital in California to assess its security, adopt standards for hospital guards and train nurses and other emergency room employees how to identify problem patients and defuse situations.

The bill will be sponsored by Assemblywoman Jackie Speier (D-Burlingame). Its genesis was a 1990 resolution drafted by Sweet, which won endorsement by the Emergency Nurses Assn. at a national convention.

“We’re excited about this bill,” said Elise Thurau, a spokeswoman in Speier’s Sacramento office. “It looks like the California chapter of the American College of Emergency Physicians may co-sponsor the bill.”

The proposed bill is being drafted by the legislative counsel and could be introduced as early as next week, Thurau said.

The bill would require every hospital in the state to conduct a security review, and require minimum standards for security guards. Also, it provides for training of nurses and other emergency room staff to identify patients with aggressive behavior and restraining techniques.

“We also want to enhance current penalties for assaults on emergency room personnel, possibly using the same standards applied to police officers and firefighters,” Thurau said.

David Langness, a spokesman with the Hospital Council of Southern California, said that he doubts the proposed bill will get through Sacramento intact because the new Joint Commission on the Accreditation of Healthcare Organizations implemented new security provisions as of Jan. 1.

“All hospitals from now on will be asked to document these things, especially reporting of violence. This means that the legislation just may duplicate these other approaches,” Langness said.

Deborah Boucher, an emergency room nurse who chairs the governmental relations committee for the association, said a 1992 survey of 103 hospitals in Los Angeles and four other California metropolitan areas by the association found that 58% of the hospitals reported violence-related injuries suffered by staff members, visitors or patients, and that guns and knives were the most common weapons.

The study concluded that prolonged waits were a major trigger of violent episodes. Besides patients angered by delays in care, the study found that drunk or drug-intoxicated patients were violence-prone, as were those with psychiatric illnesses.

“This wasn’t the first time in California that emergency department staff members were shot by a gunman inside a hospital,” Sweet said of Monday’s attack.

In 1990, San Diego emergency department nurse Debbie Burke and Edward Rooney, an emergency medical technician student, were shot and killed at Mission Bay Memorial Hospital by a patient’s distraught relative.

“Debbie Burke’s death was the reason I wrote the resolution because something needed to be done,” Sweet said.

The resolution was eventually endorsed by the national 20,000-member Emergency Nurses Assn.

For Sweet and her colleagues, news of the tragedy was disheartening but not surprising.

“The media and so many people are treating it as if this is a new problem when it’s not,” she said. “We have nurses that get kicked or struck by patients all the time. We get patients that come in with police and they’re on drugs. Or they’re victims of violence like the drive-by shootings. You walk out late at night and are confronted by gang members in the parking lot asking if you gave aid to the shooting victim.”

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