Victim speaks out on staff assaults at ECMC psychiatric unit

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BUFFALO, N.Y. (WIVB) — Every day, Korri Spadone relives the beating she suffered at the hands of one of her patients at the Erie County Medical Center’s psychiatric unit.

“He just hauls off and just goes boom,” says Spadone recalling the day last June when she was punched in the head. “He cracked me right here. My head snapped so hard.”

“I have nightmares every single night. And it’s not necessarily about the gentleman who assaulted me. It’s about not being protected.”

Spadone is speaking out now to demand more security in the hospital’s emergency psychiatric unit. “Had we had one more security guard this never would have happened.”

Dr. Michael Cummings heads up the hospital’s psychiatric unit as executive director of Behavioral Health and director of community psychiatry at the University at Buffalo.

“We never have a situation where a hospital is 100% safe,” Cummings said. “It’s just not possible but these are individuals that are part of our team that we really do everything we can to support.”

The man accused of assaulting Spadone last June remains in jail and faces criminal charges.

Spadone has endured two surgeries – one to repair her shoulder and another recently to insert pins and screws in her neck

What really upsets Spadone is that her injuries may have ended her career as a psychiatric nurse — a job she loves.

“I love my patients. They don’t choose this. They don’t choose to have a mental health issue,” says Spadone, a LPN. “They know I genuinely care about them.”

“I can’t do my job. I can’t help these people if I am not being protected.”

Spadone’s incident was one of four last year in which seven staffers were injured in the hospital’s psychiatric emergency room, known as CPEP for Comprehensive Psychiatric Emergency Program.

ECMC dedicated its new expanded Behaviorial Health Center Jan. 16, 2014.

The $25 million building tripled the size of the hospital’s emergency psychiatric unit to 18,000 square feet so it could serve all of Western New York. Last year, the unit saw more than 12,000 patients making it the second busiest psychiatric emergency room in the state.

But some employees, including Spadone, say the new design is too open and leaves them vulnerable in the event of an incident.

“The new CPEP is bad. And the way that it’s designed is horrible,” says Spadone.

But Cummings says the old design was extremely cramped with patients right next to each other.

“The larger space while I think is helpful in a myriad of clinical situations. It does come with an issue that it’s wide open, and so sometimes that can be an issue. But I think by and large it’s greatly improved our ability to treat patients, not worsen it,” says Cummings.

In 2013, under the old design, two incidents led to two staffers injured. In 2014, under the new open design, four incidents led to seven staffers injured.

Cummings says the number of incidents per year varies but he doesn’t consider seven injuries in 2014 high given the volume of patients seen at ECMC psychiatric emergency room.

When asked whether he was comfortable with the unit’s design and whether it was safe for employees, Cummings says: “By and large. But I mean with every new construction I think there’s always room to look, improve, evolve and go on.”

Neither the hospital nor the state Office of Mental Health would release details on the CPEP incidents that resulted in staff injuries.

News 4 Investigates obtained court records on a September incident when a patient is accused of punching a LPN three times in the face. News 4 Investigates also learned of an incident in January when a patient allegedly injured four staffers.

When Spadone was hurt, another female staffer and a male patient safety assistant (PSA) were also injured. News 4 Investigates confirmed Spadone’s account of the incident through police and court records.

Police records say the patient grabbed the woman “by the neck, lifted her up and threw her into a wall.”

Spadone recalled how the incident unfolded.  “He picked her up by her neck. Now she’s a 120 pounds. Picked her up by her neck. Off the ground. Three feet probably. Shook her like a ragdoll.”

“I’m like screaming. I’m like let her go and I’m screaming. Then he throws her. She goes back. Falls back on her bum and slides three feet.”

She credits the assistant who suffered a wound to his abdomen with saving her life.

“I saw the video when we went in front of the grand jury I balled me eyes out. And I looked at him and I said to him, I said you saved my life. I don’t know how I can ever repay you.”

While being arrested, the patient was asked by police why he went after the nurses.

He replied: “I was upset they weren’t discharging me fast enough and felt like I was getting the run around from the staff.” His attorney did not return calls for comment.

The Civil Service Employees Association represents Spadone and the other woman who also suffered injuries to her neck and shoulder.  She declined to talk publicly for fear of retaliation from the hospital.

CSEA issued a statement saying that staff safety was one of its “top priorities” and the union had recently given the hospital suggestions “to reduce the risk of violence at the CPEP unit and management has been very responsive.”

The union also says it does not get any notification when staff are injured by patients. Spadone says she had to call her union to tell them of her assault. She wants the union to do more.

It’s unclear if hospital staffing will change. Cummings said he reviewed the 2014 incidents and increased Patient Safety Assistants in CPEP from 1 to 2. But he stresses that PSAs are not security guards, but trained members of the psychiatric treatment team.

“I don’t think it’s about the numbers nearly as much as it is about the training and how they interact with the rest of the treatment team that’s actively working in that location,” says Cummings. “It’s impossible to have a 0% incident policy but we want to be as close to 0 as humanly possible and we want to do everything that we can to prevent incidents from escalating.”

ECMC’s Behavioral Health unit is licensed by the state Office of Mental Health through May. Staff safety will be one of the issues that the state will review when it conducts its upcoming review.

Emergency room violence in an ongoing concern among worker groups.

“No one should go to work in any occupation with the expectation that violence will be part of the job,” says Nicholas Croce, Jr., executive director, of the American Psychiatric Nurses Association.

“We expect that all institutions will provide staff with appropriate measures, sufficient staffing, sufficient support to deal with whatever situations that they have to deal with.”

Matthew F. Powers, president of the Emergency Nurses Association says while emergency rooms can be very stressful there can not be an assumption that violence is part of a nurse’s job.

“This is a huge problem for emergency nurses being subjected to violence that is not an expectation of our job to come to work and be hit, kicked, punched and spit at. We really need to work all together proactively and not be reactive to the situation.”

Spadone is working on healing physically and emotionally.

She wants the public to know what she and other staffers are facing.

“I got my ass handed to me. And I took it like a champ because I was in a fight or flight. I was holding onto the wall. I was doing everything that I could to get home to my kids.”  She says she’s hopeful that something will come out of her decision to go public.

“I do not want this happening to anybody else because I know what it has done to me.”

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