May 18, 2013

Understaffed, undersized and under siege: Riverview hospital struggles with safety

'We have major concerns about health and safety at Riverview, and we're trying to address them long-term,' union representative says

By Betty Adams
Staff Writer

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This aerial photo, taken on April 30, shows The Riverview Psychiatric Center on banks of Kennbec River in Augusta.

Staff photo by Joe Phelan

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Augusta police responded to more than 100 Riverview emergencies in 2009 and 2010. That number dropped to 77 in 2011 and to 47 last year, but it's not clear whether that decline by the city's police department represents fewer total emergencies.

If something serious happens, Riverview staff call 911, according to McEwen. She said those who attack fellow patients and employees face criminal charges.

"Some people are purposeful in their intent to hurt staff," she said. "Staff are forgiving when they know it's related to the illness, but (not) when they see someone who says, 'I'm going to hurt you,' and they make good on their threat."

Another union that represents about 100 Riverview employees, mostly nurses and medical professionals, echoed Perry's concerns about staff safety.

"The work can be dangerous; people realize that," said Rod Hiltz, director of field mobilization for Maine State Employees Association Local 1989.

Hiltz said the jobs there are difficult to fill.

"There is a huge recruitment and retention issue around getting nurses to work there. It's not just a freeze on wages — they haven't had an increase in four years — also the governor proposed a freeze on merit, longevity and health plan," Hiltz said. "They end up running short-staffed, and you have a lot of overtime cost. That, in itself, can create a dangerous condition."

Perry also said employees need training and tools as well as support "to carry out their jobs with pride and confidence."

Riverview workers are hit, stabbed and strangled. The chaplain at Riverview is still recovering from injuries he suffered when he was attacked in December 2009 by patient Anthony P. Reed, now 37. Reed went to prison for that assault. He was back at Riverview in April 2012 when he was charged with injuring four employees, including a woman who had to be treated at the hospital for her injuries. Four assault charges are pending against Reed in connection with those attacks.

In February 2006, Murphy, who reportedly suffered a brain injury in an automobile accident years ago, attacked a mental health worker, leaving him with a crushed windpipe and broken teeth.

That attack triggered legislative inquiries as well as an evaluation of hospital security by a national expert.

Caring for clients

Maloney, newly elected as district attorney last fall, thinks there may be better ways of caring for Riverview patients who are deemed dangerous.

"I believe there needs to be a small facility to exclusively house these individuals," Maloney said.

That's the case in two nearby states. Massachusetts uses Bridgewater State Hospital, inside the Bridgewater Correctional Complex, to evaluate and treat people committed by the courts. It is a medium-level security hospital that is part of the Executive Office of Public Safety and Security.

New Hampshire has an equivalent service offered inside its prisons.

Manchester forensic psychologist Charles Robinson said the way that different states treat those found not criminally responsible or mentally ill has evolved both culturally and politically.

Robinson, who has performed mental health evaluations on more than 12,000 patients, doesn't think the different models in Maine or in New Hampshire or Massachusetts offer clear-cut safety benefits.

"People with significant persistent psychological difficulties who are treated in prison settings are not any less likely to assault staff than those in hospital settings," Robinson said. "I would suspect that the likelihood of another patient coming to aid is probably better in a hospital than an integrated facility in a prison."

Injury rates in geriatric residences — where patients might have dementia and where they use walkers and canes — are typically higher than in forensic units such as Riverview, Robinson said.

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