Public Hearing on

"Proposed Standard for Safety and Security in the Public Sector throughout New York State"

Testimony of Rhonda Bedow, RN

Buffalo Psychiatric Center

New York State Public Employees Federation, AFL-CIO

June 24, 2003

    My name is Rhonda Bedow and I have been a psychiatric nurse for the last 23 years, 18 of which have been at the Buffalo Psychiatric center. Although I had been involved in altercations and had been injured by clients I have never feared for my life as I did that first day of September 1996. What started out as an ordinary Sunday turned into one of the most fearful days of my life. Time stood still. This was one of many Sundays where there were 28 male clients, and three female staff: two therapy aides and myself. This day was different. This was the day a client tried to kill me.

    The client that attacked me did so over a cigarette. The two staff I worked with that day were taking most of the ward to smoke, and client X was not out of bed, and wasn’t ready to go with the group. When he realized that he was not going on the smoking break he began to make verbal and physical threats toward me. As soon as the staff heard him they immediately came back toward the desk to help intervene. As Client X continued to escalate, the code green (emergency response) was activated. He then stated, " If the men are coming, I might as well make the trip worth it." It was then he charged me, his fists flailing, continuing to run toward me, grabbing at me, I was standing near the telephone, unable to go anywhere. The staff with me were trying to stop him by verbal redirection and holding him to no avail. He continued to viciously punch my arm and body. At the same time he was also slamming my head into the butcher block counter. One staff was holding each arm and were unable to stop him. The most amazing thing was as soon as the key turned in the front door and the emergency team appeared he promptly turned and independantly walked to the seclusion room. The next thing he said was, "I don’t want anyone touching me".

    The time between the start and finish of the assault was minimal, but the trauma has been long standing. At first, I could not remember all that happened, but with time some details came back to me. First thing I actually remembered was the hollow sound of my head hitting the butcherblock counter over and over. I also remembered trying to avoid hitting my nose as I had surgery on my nose previously, and didn’t want any more damage. Then I remembered sitting on the floor without my shoes or glasses, and one of the clients giving me my glasses that he had retrieved from the floor 15-20 feet away. A staff gave me my shoes that were still tied, they found them under the desk. Client X was locked in the seclusion room and there were several staff around me, asking if I wanted an ambulance or something. I remember telling them that I just wanted to catch my breath and someone would take me to the hospital. Friends of mine were called and they came immediately to take me to the hospital.

    Arriving at the hospital produced even more trauma when statements were made to me such as, "Don’t you know better than to work there? Didn’t you know that is part of the job when you work at the nut house." There were many other insensitive remarks, which I have continued to hear since my injury. A member of administration was overheard stating, "She only wanted the money (attack insurance), otherwise she wouldn’t have bothered pressing the charges". My response in my head was "I suppose you think I allowed him to assault me just to get time off too."

    After many X-rays, and neurological exams, it was determined to be "only" a concussion with a possible eye abrasion. I was to be released, but I was not to be left alone in case of loss of consciousness or a change in my mental status, @ which time I was to be returned to the hospital.

    By the time I returned home my then teenage children have found out that I was assaulted. They were very anxious to see for themselves what had happened, and that I was alive. The immediate response of my then 15 year old son was "I wish I could go there and tell him not to ever hurt my mother again, but I would probably want to beat him the same way he did her." My then 14 year old daughter, just sat next to me and cried, holding my hand begging me to not go to work at Buffalo Psychiatric Center again. Both of them spent the night in my room on the floor just in case I needed anything and so they could wake me up to make sure I was all right. When they got up the next morning, my daughter began to scream, as the faint bruises of the day before were now a dark purple. My right eye was swollen almost shut and the cornea was bright red. That’s when the bruises on my arm were discovered. I had not even realized he had hit me that many times. The headache from the trauma lasted for days. The pain on the side of my head, jaw continues to this day.

    The effect on my children continues. Every news report of an assault @ a psychiatric center makes them anxious. My son told me a few weeks ago, "I am sure one day I am going to answer the phone or door and they are going tell him I have been injured again or killed. My daughter continues to ask if I couldn’t get a different job and recently has been talking about her fears re: assault, fear that I might go to work and never come home.

&#    The trauma did not only affect my family but also the staff that I had worked with the day I was injured. Each called me, several times, apologizing about not doing more. They were tearful and guilt ridden, wanting to do anything to change what had happened. The feelings of that staff continue to be brought up even now, the trauma is forever present. A few weeks ago one of the staff that witnessed my brutal attack, witnessed another very similar attack on another co-worker. That attack brought back flashbacks, for both of us.

    The trauma stays not only with me, the person who was assaulted and my coworkers but also with the clients who witnessed the assault. Just this week one of the clients approached me stating they wish they could have done more to stop Client X from hurting me. That client had previously been discharged and just recently readmitted.

    On the Tuesday following the assault I went to file charges against Client X. Security had written the original charges for third degree assault a misdemeanor. When I went downtown the officer changed the charges to second degree assault with intent. The officer asked if the man had been arrested but I had to tell him no and that he was an inpatient at BPC, and although the MD on call had deemed him competent, the facility would not have him arrested.

    Tuesday following the assault I was also seen by my regular physician, who was appalled at the trauma on my face, and eye. My doctor immediately called an eye specialist to have my eye evaluated. I was seen that day, and that specialist, diagnosed cornea damage He hoped it was not permanent and thankfully it wasn’t.

    On my next visit to my M.D. about a week later my memory was failing. I knew what an object was used for, but could not name it. My M.D. thought it would be best to go back to my regular routine, including returning to work as soon as possible in hopes of stopping the memory loss, and possibly to restore some of my short-term memory. Because I was fearful of losing even more of my memory, and financially losing ground, I returned to work about 2 weeks later.

    Returning to work was yet another trauma. There was a great deal of discussion re: whether or not the patient or I should be moved, or if we should be left together. Meanwhile the client had continued to make verbal threats to staff in regards to "finishing the job", meaning assaulting me. That made me even more uncomfortable being on the same unit with him. After a great deal of discussion, he was finally moved.

    Again the question asked was whether the client was deemed competent. He had to be declared competent by two psychiatrists, which he was. Even though he was deemed competent, legal charges were not placed on Client X. The day before arraignment he was transferred to Mid-Hudson Forensic PC, a secure facility for one year. His transfer did not take place until the first week of October 1996. I feel that anyone who assaults someone and is deemed competent should face legal charges the same way a person on the street would have to. For example, if someone on the street had assaulted me, they would have been arrested immediately and held for arraignment. Why can’t a mentally competent person, even though they are in an institution be treated the same?

    There was still more physical trauma to deal with. For the next several months I suffered from continuous headaches and ear infections. Due to the constant need for antibiotics my M.D. sent me to an ear, nose, and throat specialist. By then it was December 1996 when this specialist discovered the cause of my ear infections. My jaw had been dislocated on both sides, and the bone was partially blocking the Eustachian tube, not allowing the fluid to drain. Due to the complexity of the required treatment she referred me to another specialist.

    This doctor took several weeks to fit me into his schedule and then I had to have a series of tests to see if the seriousness of the dislocation could be determined. I had an EMG to check the muscles response to the nerves which was not helpful. The doctor ordered a MRI that took several more weeks to be approved by the State Insurance Fund. They sent me to their specialist to make sure that the MRI was necessary. Then the test had to be scheduled, results processed, and there was another doctor’s appointment to receive the results. It was then, Feb. 1997, that I found out that my jaw had been totally displaced and would require surgical repair. My first surgery was scheduled for May 1997. Because both sides were damaged a second surgery was scheduled for several weeks later.

    Both surgeries required an overnight stay in the hospital and extensive specialized physical therapy several days a week. To this day, there are restrictions on the functioning of my jaw. My specialist was amazed at the trauma to the tissues, and spent a great deal of time trying to find the lost disc. The disc that is supposed to be a cushion between the bones was buried in the muscle of my jaw. The damage to the disc was so severe that the surgeon spent an extra hour repairing the disc during each surgery.

    The trauma of that day will be something I will have to live with for the rest of my life. The trauma will have an effect on many of my choices that I make in the future. Physically the trauma will affect me for the rest of my life.

    I have tried to make all work areas safer for everyone by allowing my pictures to be used so that people can see what can happen in your workplace. So that no one can say they didn’t know. Staffing continues to be a problem in most institutions. Dangerous situations continue to occur.

    To this day the client that hurt me continues to threaten me. He has hurt other people, an elderly man who tried to make conversation with him received a broken nose. Then and only then were the charges I filed, found in the judicial system. That incident occurred in January 2003. I was notified 24 hours prior to the arraignment with a subpoena, demanding my appearance. Although I attended the hearing, I was ridiculed and laughed at, " what do you expect, it has been 8 years, no one is going to deal with that now". The patient that was injured in January was claimed to be an inadequate witness. After the two of us were interviewed, we were told to leave and they would contact us with information as they were not sure where Client X was. The D.A. had my cell phone number and stated he would call when the next hearing was arranged. Before my ride came to pick me up I received a call that all charges were dropped, and that he would be returned to the psychiatric center. If that wasn't bad enough, he never reached the psychiatric center and was released to the street. A glitch in the system they said. I was not notified by the courts, but by a concerned staff from my unit. Client X was still should have been sent back to the psychiatric center. Instead he went to his sister’s house and began terrorizing her and her family. The police refused to pick him ups so security and staff from the center returned the client to the center. This put the staff at great risk. This client again injured staff upon his return to the facility.

    Knowledge is the only way to change things. I appreciated that I was asked to be on the violence prevention task force at Buffalo Psychiatric Center. However I am very disappointed that none of our suggestions were followed. We recently started meeting with Buffalo District Attorney Frank Clark, to try to resolve some of these issues, but the Buffalo Psychiatric clients continue to fall through the cracks. This past weekend a few clients were arrested for assaults, but again returned to the center without facing charges. Staff who direct care at the psychiatric center could easily all become victims. We need to all work together to stop violence. I am lucky I still have my life. Not everyone is that lucky. Please act to get the Commissioner of Labor to promulgate an enforceable standard to prevent workplace violence. Thank you.

Rhonda Bedow, RN