Seattle Nurses Describe Children’s Hospital as ‘Combat Zone’

Police rushed to the psychiatric ward at Seattle Children’s Hospital twice in a two-week period in November. Biting, hitting, chokeholds, and other physical violence against nurses in the Psychiatry and Behavioral Medicine Unit (PBMU) has sent multiple staff members to the emergency room and left nurses demanding support from management.

Staff described conditions as “traumatizing,” “dangerous,” and “detrimental” to staff and patients alike in a Washington State Nurses Association (WSNA) press release. Association officials further likened the ward to a “combat zone” in comments to KOMO News.

“I’m exhausted from constantly reacting to dangerous behaviors and trying to prevent serious harm,” said hospital nurse Henry Jones in the release. “In our current state, I feel like I’m functioning more like a bouncer or a prison guard.”

“We have nurses who had their hair grabbed and head swung around. We’ve had nurses get put in chokeholds and get punched repeatedly. I have scars on my body from being bit, and being punched in the face and kicked,” said Tasha Vederoff, a charge nurse in the PBMU.

Conditions at the pediatric psychiatric ward have declined in recent months.

“I have sustained more serious injuries in the past year than in my first six years of working on the floor,” a Seattle Children’s nurse warned in WSNA’s October report.

Several staff members had to go to the emergency room on November 7 after patients choked and hit staff, including swinging a metal pole at people. Police intervened to break up the attack, which left windows broken in the unit.

On November 25, three injured staff members were forced to stay on the job due to short staffing, creating serious safety issues.

At Seattle Children’s Hospital, the PBMU is intended for short-term crisis stabilization of up to one week. Yet, because of systemic challenges in mental healthcare, some children remain in the unit for up to a year.

“The lack of infrastructure and social supports in the mental healthcare system and lack of funding is the root cause of what’s happening,” said unit charge nurse Amy Lamson in the WSNA release. “These lashing outs are exacerbated by hospital leadership who are not providing resources to handle the current reality.”

Forty-four nurses, representing nearly every staff member in the PBMU, signed a November 17 letter to hospital management deriding conditions in the unit.

“Patient care has been compromised to an extent that our milieu is no longer therapeutic, but rather dangerous and detrimental for all who enter the PBMU, staff and patients alike,” the letter states. “The unfortunate reality of the unit is an exponentially increasing risk of a sentinel event if the PBMU is left to continue operating under its current conditions.”

The nurses requested higher staffing levels for nurses, additional safety officers, and double pay to increase retention.

“The reality is we are forced into this situation,” according to nurse Brayden Schander. “If the state and nation are not going to change, Seattle Children’s needs to build a residential facility to meet long-term care needs.”

The crisis at Seattle Children’s is part of a national problem. And it puts nurses and patients at risk.

“You’re just running from crisis to crisis to crisis, and the hope is that we can be proactive in our care,” said charge nurse Amy Lamson in a KOMO News interview. “We’re seeing more increase in violence and less ability to meet that violence because of our lack of staffing and resources.”

Violence against nurses has made headlines across the country since the pandemic. In October, 600 Seattle nurses picketed after a nurse at Virginia Mason Medical Center was stabbed in the face.

“I’ve never felt more unsafe,” Virginia Mason emergency department nurse Kimberly Travis-Carter said at the time. “A lot of patients come in with weapons on them — homemade weapons — we’ve had instances where we’ve had guns in our ER.”

Bedside nurses are more likely to experience violence. According to a 2023 Premier survey, 40% of healthcare workers said they have experienced workplace violence in the past two years. That number reached 65% for bedside nurses. And a majority of healthcare workers report that violence has increased in recent years.

During a three-month period in 2022, a Press Ganey analysis tracked 5,217 assaults per quarter on nurses –– or more than two assaults per hour.

How can hospitals address the growing problem of workplace violence? The complex problem does not have simple solutions.

“Our country is facing an escalating youth mental and behavioral health crisis and the demand for services remains alarmingly high,” said a statement from Seattle Children’s. “The safety, security and well-being of Seattle Children’s patients and workforce is our top priority and we have intensified efforts over the past several months to address this demand.”

Seattle Children’s is currently hiring nurses to address staffing shortages. Nurses on the unit have requested crisis pay and additional on-site safety officers.

Across the country, nurses have also advocated for legislation to address staffing shortages and workplace violence. In October 2023, Illinois nurses testified at a state legislative hearing to encourage a state law that would set patient-to-staff limits. Massachusetts nurses also testified in May 2023 hearings about state anti-workplace violence legislation.

These long-term solutions still leave many nurses struggling today.

“When I come in and instead of being excited to talk with the kids, I’m scared. I’m scared not only for myself, but the people I’m leading,” said Tasha Vederoff, a charge nurse in Seattle Children’s pediatric psychiatric unit, to KIRO 7 News.

But Vederoff and her colleagues want to make it clear to management and the public that the children are not the problem.

“These kids need us. These kids need us. They have nowhere to go and they’re hurt, and they’re broken and they’re desperate,” Vederoff said. “I don’t want these patients to be seen as the villain. They’re kids. They’re children who are hurting . . . They’re not the bad guys, but they need help and they need support and at this point, we can’t give it to them because we’re trying to keep everyone safe.”