"I don’t want to go so far, that they are dangerous places, but at the same time, yes. There is still potential for danger when you are dealing with patients who have a variety of issues that can create volatile situations," said Rep. Howard.
A standoff with Austin police in January is an example of the type of dangers healthcare workers can face. A disgruntled doctor went into a private clinic and killed another doctor before killing himself.
On Wednesday morning, members of the House Public Health Committee brought up Howard's workplace protection bill. The legislation does not create any mandates for private clinics but would require larger healthcare providers, like hospitals and nursing facilities, to set up Workplace Violence Prevention Committees.
"They would assess what are potential violent situations that could occur in their facilities, how could they best assess this and then they are required to have a plan that is shared with the staff, they are required to do training update these plans on a yearly basis and so it’s really to ensure there is something there, some forethought to this and some real specific solutions that can be tried," said Howard.
A key part of the bill is the requirement that staff members, like nurses, must be part of the committee.
"So part of it does have to do, what do we have to put into place that will assure we have back up protection when we have identified a situation that may be volatile. How do we physically rearrange things so there is not any furniture in the way when we have to exit a door. Do we have panic buttons we can push, do we ensure there is more staffing available at certain times of day when we know there is more concern about discharging," said Howard.
Howard's previous attempts to get this legislation passed have come up short. She continues to push it because she has lived it. When she was a Brackenridge Hospital nurse, she had her own violent confrontation with a disturbed patient who tried to leave his room.
"Unbeknownst to me, behind his back, he had a urinal, which in those days was metal, not plastic and as I went to get him back to the bed, he swung around and hit me upside the jaw and knocked me to the other side of the room," she said.
Several nurses have testified during hearings, including one nurse who told committee members how a patient bit off her finger. The testimony is not the only reason why state Rep. Stephanie Klick (R-Fort Worth) is already a yes vote. Klick is also a nurse and a workplace violence victim.
"I personally had my wrist broken by a patient. Have been involved in taking care of patients that have been involved in violence outside of the hospital and the family members returned to the hospital to finish off what they started, and there were shots fired," said Rep. Klick.
Howard says she is working with the Texas Hospital Association on any concerns that the group may have with her bill. The Texas Nurses Association has endorsed HB 326, noting that out of all workplace assaults in the U.S., 75% occurred in health care or social service settings.
The legislation could come up for a vote next week. If approved it will move it out of committee and then await a chance for a floor debate in the House Chamber.