RICHARD WALKER / RWALKER@STARBULLETIN.COM
Terry Evans, a former nurse at Hawaii State Hospital who was assaulted on the job, listened yesterday as her injuries were described by state Sen. Clayton Hee, who was holding a photo of her wounds, at a news conference at the state Capitol about working conditions at the hospital. CLICK FOR LARGE
State hospital staff labors in fear
Doctors have been assaulted four times since federal control over the facility ended
The recent resignation of a psychiatrist and a growing number of assaults by patients against staff at the Hawaii State Hospital are indicative of problems that need to be addressed immediately, say critics.
"It's clear to me that if things continue as they have been, we may have a fatality sooner than later," said Sen. Clayton Hee (D, Kahuku-Kaneohe), whose district includes the mental hospital.
Hee held a news conference yesterday with Dr. Karen Ritchie, who resigned Friday as a staff psychiatrist at the hospital; Terry Evans, a nurse who was assaulted at the facility in January and remains on leave; and Lani Tsuneishi, a clinical nurse specialist at the hospital.
"I finally decided I couldn't continue to work there because I don't believe it's a safe environment," Ritchie said.
Dr. Thomas Hester, chief of the state Health Department's Adult Mental Health Division, acknowledged the concerns.
"We agree that there needs to be ongoing effort to continually reduce the risk of assault to patients and staff at the Hawaii State Hospital," he said.
Part of the problem is the increased population at the hospital, officials say.
As of midnight Sunday, there were 195 patients at the hospital, one below the facility's licensed capacity, Hester said.
While the hospital has been able to maintain adequate staff levels, an increase in court-ordered forensic patients in recent months has contributed to crowding and more assaults on patients and staff, administrators have said.
Through the first six months of 2007, there have been 107 assaults by patients against staff members, according to the Department of Health. The numbers have fluctuated over the past few years, with 187 last year, 133 in 2005 and 170 in 2004.
Assaults are classified as anything from a simple shove to the more serious incidents such as the one involving Evans, the nurse, in January.
Evans, who suffered facial injuries, including a broken orbital bone around her left eye, said she plans to sue the hospital, claiming her injuries resulted from an unsafe workplace and that she continues to suffer from post-traumatic stress syndrome.
More disturbing to Hee and the workers is the rise in assaults against staff psychiatrists.
Ritchie said there have been four assaults on doctors since 2006, when there had been none from 1993 to 2006, a time when the Hawaii State Hospital was under federal court supervision.
"I'm really concerned that if something doesn't happen, somebody's going to get killed," she said.
In the short term, the state must do more to train staff and recruit more people to work at the hospital, Ritchie and the others said.
Training and recruitment are among the issues being studied by a task force formed earlier this year to assess the state's mental health needs. The task force is expected to have a report with recommendations ready by this fall.