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Published August 29, 2012, 08:48 PM

Staff injuries on rise at Minnesota Security Hospital

ST. PAUL — Injuries among employees at the Minnesota Security Hospital in St. Peter have risen sharply in 2012, as staffing has dropped and counselors are in closer contact with patients at the state's largest facility for the mentally ill and dangerous.

ST. PAUL — Injuries among employees at the Minnesota Security Hospital in St. Peter have risen sharply in 2012, as staffing has dropped and counselors are in closer contact with patients at the state's largest facility for the mentally ill and dangerous.

Minnesota Public Radio News reported Wednesday that the hospital recorded 40 employee injuries through July 30. That's up from 32 injuries for all of 2011.

At the same time, the number of permanent psychiatrists on the payroll dropped from six to one. One full-time psychiatrist oversees the care of nearly 400 patients at the hospital, with help from a rotating group of part-time and temporary employees. MPR News obtained documents showing the facility lacks enough doctors to provide coverage to all the hospital's units, and that several temporary employees left in recent weeks.

“We recognize the disruption this causes with the unit teams and patient care,” Bruce Hawkinson, administrator of medical services, wrote in an Aug. 21 email to the hospital's nurses. “But until we are back on track again with full time psychiatric coverage we need to (do) the best we can (with) the resources we have available.”

Anne Barry, deputy commissioner of the Minnesota Department of Human Services, which oversees the facility, said a changing policy on the use of restraints contributed to the spike in injuries. Several months ago, she said, the facility stopped using regular handcuffs to restrain violent patients and switched to Velcro restraints. But hospital officials quickly realized that more employees were being injured because the new restraints took longer to fasten.

Officials at the hospital have now switched back to regular handcuffs until they can find a better solution, Barry said.

The increase in injuries comes as the Minnesota Security Hospital tries to recover from the controversial tenure of former administrator David Proffitt, who was forced to resign in March after an independent investigation found he yelled at employees and refused to listen to feedback. The facility is also under scrutiny from licensing officials who have cited it for excessive and inappropriate use of restraints.

Hospital employees have some of the state's most challenging and dangerous jobs. Patients at the facility include people who killed family members, or were kicked out of other hospitals for attacking doctors or fellow patients. Many suffered trauma or abuse as children and are now struggling with severe mental illness. Most stay at the hospital for years.

“We're the end of the line,” said Chuck Carlson, a security counselor at the facility for nearly 25 years and president of the local union that represents many of the employees. “There's nothing we can do except try to deal with them.”

Carlson said another reason for the increase in worker injuries is a change in treatment philosophy. Aggressive patients were once locked in their rooms, but now doctors increasingly ask security counselors to stay within a few feet of a patient at all times, to prevent the patient from attacking anyone.

“But the consequence is that the patient tends to attack the security counselor instead of peers,” Carlson said.

Both Carlson and Barry praised the facility's new medical director, Dr. Steven Pratt, for working long hours to address the facility's problems. Another full-time psychiatrist is scheduled to start in September, but there are no current plans to replace most of the psychiatrists who left earlier this year in protest of Proffitt's management style. Right now, seven psychiatrists from other state-run facilities are helping fill gaps in the schedule.

The hospital also has a current shortage of security counselors. Barry said the agency is trying to speed up its lengthy hiring and training process.

Over the longer term, the hospital will rely on psychiatric nurse practitioners to monitor medications and take over many other duties once handled by doctors. Barry said the perceived importance of psychiatrists has lessened over the years and that many of the same duties can be performed by nurses and psychologists.

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