The new 10-bed section of Bristol Hospital’s emergency department has impact-resistant windows, locked doors and chairs that are weighed down with sand so they’re too heavy to throw.
The first stage of hospital’s multimillion-dollar makeover of its emergency center will open this week and is designed solely for patients who are in psychiatric crisis, high, intoxicated or otherwise potentially dangerous to themselves or staff.
“Substance abuse and mental health issues are by far the greatest health need in Bristol,” hospital President Kurt Barwis said Friday at a ceremony to mark the end of six months of construction. “The design of the unit is more conducive for patients who are undergoing mental health treatment right down to the paint and the artwork on the walls.”
Like hospitals across the country, Bristol’s has seen years of rising violence in the emergency department, with nurses, physicians, technicians and security guards suffering injuries trying to work with thrashing patients suffering severe psychological crises, the effects of powerful drugs or extreme alcohol abuse.
Sometimes those patients hurt themselves, too, and perhaps smash furniture and equipment — forcing the hospital to pull emergency staff away from other cases to regain control of the situation.
So when the hospital began planning a massive modernization of its busy emergency department, the first priority was to create a safer place for treating patients with mental health issues.
“At 2 a.m., if you have a patient in crisis, bright lights and noise may make it worse,” said Dr. Andrew Lim, head of the hospital’s emergency department.
Setting up a separate unit away from the bustle of the main emergency room can help de-escalate the fear or panic that some of those patients suffer, Lim said. The new section is painted indigo, a shade intended to be soothing. The rooms are pointedly free of sharp or breakable medical equipment, and the beds — bolted to the floor — have built-in restraint systems that staff can use quickly in the most extreme cases.
Lim attributes much of the increased violence to the opioid crisis. Nationally, advocates for health care workers cite drug use as well as the decline of psychiatric hospitals as factors. And all agree that violence in emergency departments is on the rise. In a poll last year by the American College of Emergency Physicians, nearly half of emergency doctors reported being physically assaulted at work.
“Violence in emergency departments has reached epidemic levels, and emergency nurses are particularly vulnerable,” according to a statement by the Emergency Nurses Association. “In fact, the health care industry leads all other sectors in the incidence of nonfatal workplace assaults, and the emergency department is a particularly vulnerable setting.”
Lim is optimistic that a more secure and tranquil environment can help defuse confrontations, allowing the medical staff to better focus on treating the patient. That could also reduce cases where patients end up facing criminal charges for the damage they’ve done in the emergency room.
“Sometimes there is the dreaded consequence where a staff member gets injured, and sometimes we need to press (criminal) charges,” Lim said. “It’s not something we like to see. It’s not our role. We’re here to heal and to help.”
Don Stacom can be reached at dstacom@courant.com.