Montpelier, Vt. – Just over a year after Central Vermont Medical Center made changes to improve safety in its Emergency Department, staff and patients report feeling safer.
In April 2024, amid rising incidents of aggression and violence against health care staff in Vermont and nationwide – and a particularly terrifying incident for one triage nurse in close quarters with a patient and a four-inch switchblade knife – staff rallied senior leaders to act. The hospital installed a metal detector outside its ED and launched a clear bag policy for patients and visitors entering the department.
“That was a really big moment, because if things had been a little different, the nurse could have been stabbed to death before anyone could have gotten to her,” said ED Nurse Manager Kristen Schieman, RN, of the incident. “We always knew violence was a reality in emergency medicine, but that moment was a tipping point.”
Keeping dangerous items out of the hospital
“Workplace violence is a serious threat to the wellbeing of our staff and patients,” said Anna Noonan, MS, BSN, RN, president and chief operating officer at CVMC. “This is about creating a culture of safety and respect where our teams can focus on healing without fear.”
Since launching, the hospital’s metal detector has identified thousands of weapons and unsafe items, including:
- 3,940 knives
- 191 tasers
- 27 guns
- 223 canisters of mace
- 759 flammable items
- 458 pieces of paraphernalia or contraband
Each item made it to the doors of the hospital’s emergency department, despite parking lot signage informing visitors that such items are not permitted in the hospital. After a prohibited item is identified, individuals have the option of returning items to their vehicle or placing them in a secure locker. The lockers, located next to the hospital’s security checkpoint, allow individuals to create unique codes and store their items in a space only they can access.
Take the pocketknife back to your car
“These changes make me feel safer,” said Burt Heath, an ED technician. “Assaults on health care workers happen far too frequently as it is, so any prevention is a step in the right direction. I feel safer knowing that this helps prevent injury by means of a weapon. Being assaulted is bad enough without the added fear that it could be even more severe.”
In surveys that track CVMC’s performance and contribute to public ratings of the hospital’s quality, patients also say efforts to reduce workplace violence and prevent weapons and paraphernalia from entering the hospital improve their experience when seeking emergency care or visiting loved ones.
Since the detector was installed, the percentage of ED patients who reported feeling safe and secure rose nearly 10 points, from 75.49% to 83.43%, in surveys conducted by Press Ganey, the nation’s leading health care performance improvement solutions company.
"We recognize this can be seen as an inconvenience," said ED Medical Director Benjamin Smith, MD. "But if taking a pocketknife back to your car gives our nurses even one more second to feel safe on the job, that trade-off is worth it."
Statewide action
Efforts go beyond the installation of protective hardware. Hospital leaders reached out to the Washington County State Attorney’s Office in Barre, as well as victim advocates, to build a relationship and share information. Now, hospital employees who experience violence have a direct line of communication and support, and state prosecutors have greater insight into the violence health care workers face on the job.
"We realized that the normalization of violence had left many of our staff feeling isolated — and our state attorneys didn’t fully understand what was happening on the ground," said Dr. Smith. "This relationship gave both sides context.”
That direction aligns with recent efforts by the Vermont Legislature to formalize and expand protections and resources for health care workers. In late April Gov. Phil Scott signed H259, which UVM Health Network clinical staff advocated for, and aims to prevent workplace violence in hospitals.
"The bill isn’t perfect, but it’s a step forward,” said Schieman. “It shows this issue matters."
Shining a light on violence against health care workers
These are the latest steps in UVM Health Network’s workplace violence awareness and prevention efforts, although there is much more work to be done at partner organizations in Vermont and New York.
A 2023 video produced by the health system, in which staff told their own stories of workplace violence, was picked up by The New York Times and brought national attention to the issue.
University of Vermont Medical Center in Burlington also has metal detectors and a clear bag policy. During a time when hospital resources are being stretched, not all hospitals and sites in Vermont – or within the health system – have been able to install metal detectors, but patients should be aware that certain items such as guns and knives should never come in to any hospital or health care setting with them.
Champlain Valley Physicians Hospital in Plattsburgh, N.Y., has made progress in enhancing a safer work environment for staff, patients and visitors including secured access to the Plattsburgh facility, improved communication technology, staff education and the hiring of additional staff. A trauma support team, Critical Incident Stress Management (CISM), is also available to help staff who have suffered trauma to recover and build resiliency.
"This is one of the last places in our society where everyone mixes," said Dr. Smith. "People from every background, in crisis, in pain, in fear. We have to make that environment safe again."