CHARLOTTE, N.C. - The emergency room is a place where people come in a crisis.
"This is really not the first place that they'd want to go -- they come here often as a last resort," said Dr. John Santopietro with Carolinas Medical Center-Main.
Sometimes, it's a result of violence, drugs, alcohol or mental illness. Regardless, it's high stress.
In some cases, it can lead to assaults on doctors and nurses.
"There's been hitting, slapping, punching, spitting, verbal abuse," said Angie Alexander, a nurse with CMC-Main.
Alexander has been a nurse for more than 20 years.
She's had coworkers injured by patients or their families. She has been verbally assaulted.
"We understand it's a crisis situation. A loved one is ill or injured. Sometimes it hard for them to cope," Alexander said.
Alexander said the attitude used to be that was all just part of the job. Now, there's a growing effort to change that.
"The number one topic I've been asked to talk about is workplace violence," said Joann Lazarus, president of the Emergency Nurses Association. "The nurses have to be able to focus on the care of the patient and not worrying about if they are going to be safe in the environment in which they work."
From 2009 to 2011, the Emergency Nurses Association surveyed more than 7,100 emergency nurses.
Twelve percent reported experiencing physical violence during the previous week and more than 42 percent reported verbal abuse.
"Nurses have to feel safe because if nurses aren't safe, then our patients aren't safe," Lazarus said. "There are more hospitals that are trying to put things in place. It's just not consistent across the country."
A class at CMC-Main is one way the hospital is working to cut down on those cases.
It's mandatory for all emergency department staff.
"We are trained to identify signs people are having a hard time coping," said Jenna Koebel with CMC-Main Emergency Services.
CMC-Main tracks assaults that result in injury to an emergency department employee.
In 2011, it says four were reported. Last year, there were eight. So far this year, there's been six.
Hospital officials said only a few verbal assaults have been reported, but historically that is under-reported because some nurses feel it's just part of the job.
"We are concerned with the under-reporting -- the reason being we can put in more policies, more guidelines, more technology and new things if we know what's happening day to day," Koebel said.
Lazarus said CMC is using some of the best safety methods from the de-escalation classes to video monitoring and secret panic buttons for nurses.
Channel 9 was told security guards work closely with emergency staff, and while Eyewitness News was there, Channel 9 experienced first-hand the badge controlled access in place.
Alexander said nurses have a right to feel safe and their job depends on it.
"We want our patients to feel safe and give the best care we can. In order to do that, we need a safe environment," Alexander said.
Eyewitness News has reached out to other local hospitals asking for assault numbers that are recorded and for procedures in place to keep nurses and doctors safe.
A spokesperson for Piedmont Medical Center in Rock Hill told Eyewitness News that injury data is tracked, and there have been assaults on staff this year. It wasn’t able to give Eyewitness News number specific to the Emergency Department. The hospital said it has increased the number of security guards and has increased the number of staff members who receive aggression recognition and safe intervention training. The spokesperson said the hospital has also improved its psych assessment and interventions.
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