Brenda Maynard, RN

ORAL TESTIMONY
For the Subcommittee on Appropriate Supply and Utilization of Michigan's Health Care Workforce of the Standing Committee on HEALTH POLICY

Monday, August 27, 2001

Submitted by Brenda Maynard

My name is Brenda Maynard. I am the mother of three adult children and the wife of a supportive and devoted husband. I am a Registered nurse and licensed with the State of Michigan. I received my Associate Degree in Nursing in 1990 and completed my Bachelor of Science of Nursing this month.

I have worked for the same hospital the last ten years.

On June 28, 2001 I reported to work for my routine PM tour of duty that starts at 3:30 PM. I was assigned by my head nurse to cover the psychiatric NEST. The NEST is a unit that is set up to care for patients who pose a threat to themselves or to others. The acuity rating of patients in the NEST are number 4, which is the highest rating and classifies the amount of care the patient needs. The NEST was at maximum level, three patients' that evening. When assigned to the NEST, nursing staff is not to leave the area unless a nurse can cover you for lunch and bathroom breaks. The nurse working down team II is your primary relief.

After receiving report from the daytime nurse I started my nursing duties. The patient in bed one was a right hip replacement with short-term memory loss, with no reported history of violence. Bed two was a dialysis patient, legally blind, a total care patient, and a full code. Bed three was delirious, in restraints, and a total care patient.

The milieu was extremely busy that evening, total patient census was 15. Two RN's were down team two for seven patients and three RN's and a nursing assistant were down team one for eight patients. Early in the evening our nursing coordinator informed our charge nurse that a staff RN on our floor was getting pulled to another floor. Both my charge nurse and the nursing coordinator were aware of the high acuity of the patients in the NEST, yet our staff was pulled and I was not given any staff to assist me in this high acuity area.

The patient in bed one had his daughter and grandson to visit in the evening, but after they left he became more fidgety and wanting to get out of bed. I was very concerned he would injure his hip replacement and instructed him he could not get up without assistance. While assisting the patient in bed two with a diaper change due to loose stools, I looked over and saw that the patient in bed one was out of bed and stating "I am going to leave the hospital". I went over to this patient and encouraged him to get back in bed, but he would not get in bed. I had my hands on his arm to support him to keep him from falling, but he jerked away from me, grabbed his duffle bag and started to run down the hall attempting to leave against medical advice.

With the assistance of two maintance workers and myself this patient was brought back to the NEST, placed in bed and a poesy restraint vest was placed to his chest area. All four siderailes were up. I notified the orthopedic doctor, the nursing coordinator, and my charge nurse. Both my charge nurse and the nursing coordinator was in the NEST and seen this patient at this time. In fact my charge nurse helped to restrain him. He was medicated to help decrease the anxiety per another RN as I secured his hand and arm. He settled down and appeared to be resting. This patient did not speak another word to me until the attack.

Approximately 45 minutes later while hanging an antibiotic intravenously on the patient in bed two I was attacked from behind. I felt hands grasping my neck and soon learned that it was the restrained patient in bed one that was attacking me. I heard no sound of siderailes being released and heard no footsteps. I heard no sound at all. He used sexual and racial overtones the entire time of this attack "Woman you will never put me to bed again, you will never put me down again. I'm going to kill you White Bitch, I'm going to kill you now." I was finally able to break his neck grasp by flexing my knees using all forces of energy and the weight of my body and jumped as high as I could, while at the same time using the full force of my hands, arms, and elbows to bring them backward while I was jumping upward. I tried to get away from him many times, but each time he would grab my shirt and pull me back trying to get his hands back to my neck and throw me to the floor hitting the table and the wheel chair. I was fighting for my life; I was blocking his punches and watching every move he made for I knew my life depended on it. I was screaming and praying for help, but no one came to assist me. The last time I broke free from him I made it to the door when he grabbed my shirt again and threw me across the room and I hit the wheelchair and table very hard this time. At this point I was unconscious for a few seconds and was not able to physically get back on my feet. He then picked up a metal air pump used to inflate an air mattresses and was swinging the pump at my head. He had my right hand trying to pull me to my feet and I kept resisting. At this point I knew I was facing death if someone didn't hear me soon; I was terrified. I was crying and praying for help and for my life. The entire time he kept saying he would kill me lying on the floor or standing, but he was going to kill the bitch that had put him to bed.

At this time my charge nurse and a staff RN appeared in the doorway; I will never forget the fear in their eyes. My charge nurse did not speak, but the staff RN said don't you kill her Mr. ----. He kept saying, "I will kill you too, bitch, I'm going to kill you both." The staff RN stepped forward and handed me her hand and pulled me loose from his grasp and threw me across the room out into the hallway and I hit the med cart and the computer terminal. She told me to get up and start running and I did. We were all running in a single file, me first, the staff RN, and the patient with the metal pump was running after us shouting he was going to kill us. I made it to the first set of elevators, but the doors were not opening fast enough, so I ran to the thoracic intensive care unit (TICU) and pushed the big silver button to make it in the unit. I kept running toward the nurse's station shouting he's going to kill me when everything got black and I couldn't see. The next thing I remember was being on the floor in TICU being placed into a neck collar and onto a backboard. I was treated in ER and transferred to the University of Michigan for trauma and further evaluation.

This patient tried to get into TICU but was unsuccessful, he continued on down the hall attempting to attack a visitor in the waiting area, and then continued on to break window panels near the elevator.

I believe on the night of my attack if adequate staffing had been provided in the NEST this attack could have been prevented or not escalated to this level. I believe if only one staff person had been available in the hall and heard me screaming the attack could have been minimized. My unit supervisor told me that the two patients across the hall heard my death screams, but were unable to assist me. Both of these patients verbalized feelings of quilt because they were unable to help me.

Inadequate staff and the use of mandatory overtime that is used in this facility places both the nurse and the patient in unsafe conditions. Just two weeks prior to this attack I was mandated to work a midnight shift after working my scheduled PM shift. I would be responsible for 19 patients with one scheduled LPN and one Nursing Assistant. Being in an unsafe work environment nearly took my life that night and the life of others. I believe other nurses would be here with me today to give testimony if they were not afraid of reporting unsafe work conditions. I believe violence is not acceptable at any level, and no human being deserves what I went through that night. Thank you for listening.

----- Back to top ---