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State Sen. Mike Carrell (R–Lakewood) speaks at a union rally at Western State Hospital. Photo by John Ryan.

State Sen. Mike Carrell (R–Lakewood) speaks at a union rally at Western State Hospital. Photo by John Ryan.


Violence On The Rise At Western State Hospital

John Ryan

Three employees at Western State Hospital were attacked by a patient Wednesday morning. Officials say the three were taken to the emergency room but could not provide more details.

Western State Hospital is the state's most violent workplace: 335 assaults were reported there in the past 12 months. That's a slight increase from the year before, but lower than prior years.

One nurse at Western told KUOW's John Ryan what it's like to become a statistic.


Violence strikes lots of health care workers. Patients who are intoxicated, mentally ill, or have dementia can lash out unpredictably. Nowhere is the problem worse than at Western State Hospital, south of Tacoma. The hospital cares for and confines the severely mentally ill.

Rachel Velasquez is a registered nurse at Western. I spoke with her on the grounds of the state's largest psychiatric institution.

Velasquez: "In July, we had a patient who, unprovoked, he just assaulted a staff member. He hit him and kicked him."

Other staffers rushed over to help. When Velasquez got there —

Velasquez: "They had him down already on the floor. We try to, without injury, get them down on the ground so they're not going to continue to hit someone. There was four of us. The one female was caught up underneath the patient who had assaulted this other male staff."

Velasquez says the patient was severely ill mentally. But physically, he was very strong.

Velasquez: "Oh yes. When he was fighting, he was fighting. And when they're fighting, they're fighting with all their might. So it's really hard to contain someone. We were up against the wall, so it made it real difficult. Then we were trying to get other staff member out from underneath, because you can't just try to hold someone down when you got another body underneath. We were holding down his legs because he was fighting us. When he kicked up his feet, I got slammed against the wall."

Eventually, she says hospital staffers were able to calm the patient down. He didn't speak English.

Velasquez: "I told him, 'Calmate. Esta bien, esta bien.' I said, 'It's okay, it's okay.' So maybe he just heard somebody talking to him in his own language that made him feel comfortable, I don't know. But he did calm down. We were able then to stand him up and walk him back up to the ward."

The struggle left Velasquez with her second major back injury at the hands–or feet–of a patient.

Velasquez: "I strained my back, and I had to get a spinal epidural because I was having numbness, tingling, in my thighs and legs and feet. I have the back issue anyways from the '97 assault. But then I got the spinal epidural and, so far, things have calmed down. As long as I don't do too much, I'm okay."

Ryan: "Could this situation have been handled any differently and maybe to avoid you getting injured, or do you think it was unavoidable?"

Velasquez: "It's a dangerous place to work here, there's a lot of people who have been seriously injured. If they provided more staffing, it would make things a lot easier because sometimes, we come onto the ward, like this morning, we had only four staff and we're supposed to have at least a minimum of five."

That's four or five staff for about 27 patients.

Velasquez: "Even though you have four staff, two people take them out to their smoke breaks. One person has to get breakfast. Sometimes, there's only been like, I've been the only one out on the ward by myself. You have to be very aware of where you're at, you know, what patient might be angry. You're totally on alert all the time, watching who might be behind you when you go down the hallways."

Velasquez says she likes working at Western; she finds the work and the patients fascinating.

The unions that represent Western employees have long argued that the violence is made worse by budget cutbacks and under–staffing. Western currently has about 90 vacant positions out of some 1,700 at the hospital.

Legislators had proposed further budget cuts at Western this year, but after last minute negotiations, the budget ax fell elsewhere. Mike Carrell is a Republican state senator from Lakewood.

Carrell: "There will be no more downsizing of Western State Hospital. We've gone too far already."

Western CEO Jess Jamieson says the hospital is short on psychiatrists.

Jamieson: "But it is a difficult marketplace to recruit psychiatrists, so there continues to be a substantial shortage of psychiatrists here at the hospital."

Ryan: "It's not a matter of any vacancies being held open intentionally as a money–saving measure?"

Jamieson: "No. It's all–out effort: Fill all funded, vacant positions in the hospital as quickly as possible."

Two patients suffered violent deaths at Western in April: one suicide and one apparent murder by another patient. Jamieson says the hospital is investigating both incidents.

I'm John Ryan, KUOW News.

© Copyright 2012, KUOW

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