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Hospitals have plans in place if a patient, family become unruly

Eric Benson, an alarm and communications officer, monitors safety and dispatches security officers from the Security Operations Center of Sanford Hospital, as seen Tuesday, July 22, 2014, in Fargo, N.D. Michael Vosburg / Forum Photo Editor

FARGO – Hospital workers sign up to deal with a lot of life or death situations – one patient’s terminal cancer diagnosis, another’s sudden drop in blood pressure during surgery, or a sudden outbreak of communicable disease from a third.

But sometimes the life or death situation involves the medical professionals’ lives – such as in a series of bomb threat phone calls two weeks ago threatening Sanford Medical Center.

“Unfortunately, we do have situations sometimes where people can be violent,” said Susan Jarvis, Sanford’s vice president of emergency services.

The hospital doesn’t track the number of incidents that involve violence or threats of violence from patients or their family members, Jarvis said.

But Sanford does have specific plans in place for when those incidents happen, which Jarvis said is not an unusual occurrence, particularly in the emergency room and in the inpatient psychiatry department.

Essentia Health also has procedures and precautions in place for dealing with confrontations at its Fargo hospital, spokeswoman Jennifer McLaughlin said. No Essentia personnel were available this week to talk about their security efforts, she said.

Alcohol and drug use are sometimes at the root of what sets a patient off in a violent, confrontational direction, Jarvis said.

In one case, a new father was arrested at the birth unit and charged with possession of a controlled substance after he allegedly became violent during a confrontation with his child’s mother, who had just delivered.

Even dementia patients can be violent because they often don’t understand what’s happening to them.

“Lots of times security is our best friend in the ER,” Jarvis said.

Nurses, in particular, are exposed to violent behavior from patients in the emergency room, said Tim Vangerud, Sanford’s security and safety director.

“It affects each one differently, depending on their size, level of life experience,” he said.

Security guards also often bear the brunt of a patient’s ire, as alleged in the case of Peter Jonathan Rovang, 53.

Rovang, of Moorhead, was recently charged in Cass County District Court after allegedly getting into a fight with Sanford security guards.

Two days later, prosecutors say, he called the hospital and threatened to blow it up if Sanford didn’t release the guards’ names.

All Sanford employees go through a training program that helps them identify and deal with developing confrontations before they erupt into violence.

Hospital staff members who work in higher-risk areas like the ER, inpatient psychiatry and security go through a more intensive training program, Vangerud said.

Both programs help hospital workers identify the signs of someone who may be headed toward a violent meltdown: pacing, clenching fists, not listening to what the worker is telling them.

Then the workers can take steps to defuse the situation and to protect themselves, Jarvis said.

“You can usually tell when a situation is going to escalate,” she said. 

Sanford has also developed a workplace violence taskforce, Jarvis said.

And Sanford has panic buttons and “constant watchers” on every floor who keep an eye out for escalating situations with patients.

Vangerud said part of the workplace training for staff members establishes that no matter how sick a patient is, kicking, biting or scratching hospital staff is a crime.

“Staff are made aware it’s not okay,” he said.