About Richard Nugent

I'm an old guy with lots of children, partners of children, grandchildren and their partners. I hope this blog will be fun for us all, a way to stay in touch.

They’ll Let Women Drive !

A woman behind the wheel in Saudi Arabia in 2013. . CreditFaisal Al Nasser/Reuters

By Abdullah Al-Shihri and Aya Batrawy Associated Press Chicago Tribune 9.27.17

RIYADH, Saudi Arabia —

Saudi Arabia on Tuesday announced that women will be allowed to drive for the first time in the ultra-conservative kingdom next summer, fulfilling a key demand of women’s rights activists who faced detention for defying the ban.
The kingdom was the only the country in the world to bar women from driving and for years had garnered negative publicity internationally for detaining women who defied the ban.
The move, which has been welcomed by the United States, represents a significant opening for women in Saudi Arabia, where women’s rights have slowly gained ground over the years. Saudi women remain largely under the whim of male relatives due to guardianship laws.
King Salman and his young son and heir, Crown Prince Mohammed bin Salman, have tested the waters though, allowing women into the country’s main stadium in the capital, Riyadh, for national day celebrations this month. The stadium had previously been reserved for all-male crowds to watch sporting events. The king and his son have also opened the country to more entertainment and fun.
Women’s rights activists since the 1990s have been pushing for the right to drive, saying it represents their larger struggle for equal rights under the law.
Some ultraconservative clerics in Saudi Arabia, who wield power and influence in the judiciary and education sectors, had warned against allowing women to drive. They argued it would corrupt society and lead to sin.
Women will not be allowed to obtain licenses immediately. A committee will be formed to look into how to implement the order, which is scheduled to begin in June 2018.

Deafening mystery grows in Cuba

Physics of injuries, methods don’t add up, officials say
Secretary of State Rex Tillerson said Sunday the Trump administration is considering closing the U.S. embassy in Havana. (Desmond Boylan/AP 2015)
By Josh Lederman, Michael Weissenstein and Matthew Lee Associated Press
WASHINGTON — The blaring, grinding noise jolted the American diplomat from his bed in a Havana hotel. He moved just a few feet, and there was silence. He climbed back into bed. Inexplicably, the agonizing sound hit him again. It was as if he’d walked through some invisible wall cutting straight through his room.
Soon came the hearing loss, and the speech problems, symptoms both similar and altogether different from others among at least 21 U.S. victims in an astonishing international mystery still unfolding in Cuba.

The top U.S. diplomat has called them “health attacks.” New details learned by The Associated Press indicate at least some of the incidents were confined to specific rooms or even parts of rooms with laser-like specificity, baffling U.S. officials who say the facts and the physics don’t add up.
“None of this has a reasonable explanation,” said Fulton Armstrong, a former CIA official who served in Havana long before America re-opened an embassy there. “It’s just mystery after mystery after mystery.”
Suspicion initially focused on a sonic weapon, and on the Cubans. Yet the diagnosis of mild brain injury, considered unlikely to result from sound, has confounded the FBI, the State Department and U.S. intelligence agencies involved in the investigation.
Some victims now have problems concentrating or recalling specific words, several officials said, the latest signs of more serious damage than the U.S. government initially realized. The United States first acknowledged the attacks in August — nine months after symptoms were first reported.
It may seem the stuff of sci-fi novels, of the cloak-and-dagger rivalries that haven’t fully dissipated despite the historic U.S.-Cuban rapprochement two years ago that seemed to bury the weight of the two nations’ Cold War enmity.

But this is Cuba, the land of poisoned cigars, exploding seashells and covert subterfuge by Washington and Havana, where the unimaginable in espionage has often been all too real.
The Trump administration still hasn’t identified a culprit or a device to explain the attacks, according to interviews with more than a dozen current and former U.S. officials, Cuban officials and others briefed on the investigation. Most weren’t authorized to discuss the probe and demanded anonymity.
“The investigation into all of this is still under way. It is an aggressive investigation,” State Department spokeswoman Heather Nauert said last week. “We will continue doing this until we find out who or what is responsible for this.”
On Sunday, Secretary of State Rex Tillerson said the Trump administration is considering closing down the U.S. embassy in Havana. Tillerson’s comments were the strongest indication to date that the United States might mount a major diplomatic response, potentially jeopardizing the historic restart of relations between the U.S. and Cuba.
“We have it under evaluation,” Tillerson said of a possible embassy closure. “It’s a very serious issue with respect to the harm that certain individuals have suffered.”
Investigators have tested several theories about an intentional attack — by Cuba’s government, a rogue faction of its security forces, a third country like Russia, or some combination thereof.

Yet they’ve left open the possibility an advanced espionage operation went horribly awry, or that some other, less nefarious explanation is to blame.
Aside from their homes, officials said Americans were attacked in at least one hotel, a fact not previously disclosed. An incident occurred on an upper floor of the recently renovated Hotel Capri, a 60-year-old concrete tower steps from the Malecon, Havana’s iconic, waterside promenade.
The cases vary deeply: different symptoms, different recollections of what happened. That’s what makes the puzzle so difficult to crack.
In several episodes recounted by U.S. officials, victims knew it was happening in real time, and there were strong indications of a sonic attack.
Some felt vibrations, and heard sounds — loud ringing or a high-pitched chirping similar to crickets or cicadas. Others heard the grinding noise. Some victims awoke with ringing in their ears and fumbled for their alarm clocks, only to discover the ringing stopped when they moved away from their beds.
The attacks seemed to come at night. Several victims reported they came in minute-long bursts.
Yet others heard nothing, felt nothing. Their symptoms came later.
The scope keeps widening. Last week, the State Department disclosed that doctors had confirmed another two cases, bringing the total American victims to 21. Some have mild traumatic brain injury, known as a concussion, and others permanent hearing loss.
Even the potential motive is unclear. Investigators are at a loss to explain why Canadians were harmed. Fewer than 10 Canadian diplomatic households in Cuba were affected, a Canadian official said. Unlike the U.S., Canada has maintained warm ties to Cuba for decades.
Sound and health experts are equally baffled. Targeted, localized beams of sound are possible, but the laws of acoustics suggest such a device would probably be large and not easily concealed. Officials said it’s unclear whether the device’s effects were localized by design or due to some other technical factor.
And no single, sonic gadget seems to explain such an odd, inconsistent array of physical responses.
“Brain damage and concussions, it’s not possible,” said Joseph Pompei, a former MIT researcher and psychoacoustics expert. “Somebody would have to submerge their head into a pool lined with very powerful ultrasound transducers.”
Other symptoms have included brain swelling, dizziness, nausea, severe headaches, balance problems and tinnitus, or prolonged ringing in the ears. Many victims have shown improvement since leaving Cuba and some suffered only minor or temporary symptoms.
After the U.S. complained to Cuba’s government earlier this year and Canada detected its own cases, the FBI and the Royal Canadian Mounted Police traveled to Havana to investigate.
FBI investigators swept the rooms, looking for devices. They found nothing, several officials briefed on the investigation said.
In May, Washington expelled two Cuban diplomats to protest the communist government’s failure to protect Americans serving there. But the U.S. has taken pains not to accuse Havana of perpetrating the attacks.
Cuba’s government declined to answer specific questions about the incidents, pointing to a previous Foreign Affairs Ministry statement denying any involvement, vowing full cooperation and saying it was treating the situation “with utmost importance.”
“Cuba has never, nor would it ever, allow that the Cuban territory be used for any action against accredited diplomatic agents or their families, without exception,” the Cuban statement said.

Airline Women Forbidden to Marry!

 

At one time a major US airline had a rule that stewardesses may not marry!

I learned about that while I was Grievance Officer for our local teachers’ union.

Preparing to argue a grievance against our school board in arbitration, I conferred with our lawyer who suggested the tactic of estoppel.

He said his firm had represented the stewardesses of a major airline where many had been fired for  violating the no-marriage rule.  At one point their union reps had come away from a bargaining session with the understanding that the airline had agreed to rescind the rule and they posted a notice of that on bulletin boards on appropriate airline property.

Happy stewardesses promptly started wearing their wedding rings to work and were promptly fired.

The union objected, arguing that the airline had to know what the union’s understanding was and so was estopped from the firings.

A funny thing:  I and the board had agreed to save money by substituting a sound recording for a court reporter so that a typist would have to work from the tape.  When she came to the unfamiliar term estoppel, she wrote gestapo! That amused everyone, and I didn’t bother to have the transcript corrected.

RJN

 

Women Too Big to Fly?

e

Flight attendant wins discrimination case against Aeroflot  source


FILE – In this file photo taken on Thursday, Aug. 3, 2017, Aeroflot flight attendant Yevgeniya Magurina shows her uniform during an interview with the Associated Press in Lobnya, outside Moscow, Russia. A Moscow court has ruled in favor of Magurina who claimed that Russia’s flagship airline Aeroflot discriminated against her based on appearance.. (Alexander Zemlianichenko, FILE/Associated Press)
 September 6 at 12:27 PM
MOSCOW — A Moscow court on Wednesday ruled in favor of a flight attendant who said Russia’s flagship airline stopped assigning her to work long-haul international flights because of her weight.The Moscow City Court overturned a ruling by a district court that had rejected Yevgeniya Magurina’s contention that she was sidelined as part of Aeroflot’s drive to make its cabin crews younger and more physically attractive.The flight attendant’s lawsuit put a spotlight on how women in Russia are still often judged by their looks, not their skills.The 42-year-old Magurina had submitted pay slips showing that she had stopped receiving bonus pay, which comprised roughly 20 percent of her income, after she asked for a larger-sized uniform. She also says she no longer was assigned the role of senior steward after asking for a bigger uniform.
(NOTE) I heard on BBC that that Aeroflot had defended its policy against  large women by asserting that 1–they took up too much cabin space 2–their weight raised costly fuel consumption.  I laughed out loud.  RJN)
Magurina had requested 500,000 rubles ($8,700) in damages and for the court to rule that Aeroflot’s regulations on clothing sizes is discriminatory. The court on Wednesday upheld Magurina’s discrimination claim, ordered Aeroflot to pay her the missing bonus pay but awarded her just 5,000 rubles ($87) in damages.

Her attorney welcomed the ruling, calling it “definitely a victory.”

“We were not suing for money. We wanted the court to acknowledge that you cannot treat people like that,” lawyer Ksenia Michaylichenko said.

Flood–pets and great people

Notes on radio reports for which I haven’t found stories  to include here (RJN).

Suppose you were offered rescue in a flood but would have to leave your dogs, cats, birds behind.  So hard!  Some people have refused rescue and died with their pets.  That’s why the Texas legislature is considering a law requiring rescuers to take animals.  Think of all the problems in the arenas and other rescue centers!

–A family whose house was safe from flooding looked at their snorkel-equipped jeep with their inflatable kayak and said, “Why not?”  With this special equipment, they went to a village for the elderly. At a house their jeep could not approach, they took the kayak in and brought out a couple.  The man had had recent heart surgery.  They went on to make 14 more pick-ups.

Nurse Arrested

Nurse dragged out of hospital, arrested for doing her job

A nurse in Utah was forcibly arrested after she refused to draw blood from an unconscious patient, screaming “I’ve done nothing wrong” as an officer dragged her out of a hospital.Video footage of the interaction between nurse Alex Wubbels and Salt Lake City police Detective Jeff Payne on July 26 at University Hospital in Salt Lake City shows the nurse calmly explaining to the detective that blood cannot be taken without a warrant from an unconscious patient unless he or she consents or that individual has been arrested.

“This is something that you guys agreed to with this hospital,” Wubbels says while showing Payne the policy in writing. “The three things that allow us to do that are if you have electronic warrant, patient consent or patient under arrest … and neither of those things … the patient can’t consent, he told me repeatedly that he doesn’t have a warrant and the patient is not under arrest. So, I’m just trying to do what I’m supposed to do, that’s all.”

A 2-minute video of the interaction then cuts to Wubbels holding a phone, as a man’s voice warns that a “huge mistake” is being made by threatening a nurse. That sets off Payne, who then places Wubbels in handcuffs and leads her out of the hospital as the woman shrieks in agony.

“OK, no, we’re done, we’re done — you’re under arrest,” Payne says. “We’re going, we’re done, we’re done, I said we’re done!”

“You can’t put me under arrest, this is not OK,” Wubbels says while backpedaling before being led out of the hospital. “Somebody help me. Stop! You’re assaulting me, stop! Stop — I’ve done nothing wrong!”

Two hospital officials then try to intervene, but Payne warns them not to interfere or they will be arrested as well.

“I’m leaving now — with her — anybody who wants to prevent that, that’s your option,” Payne says. “So, take your hand off her, please.”

Payne then leads Wubbels to a waiting police vehicle as the woman claims the officer is hurting her.

“Then walk!” the officer responds.

“What is going on?” Wubbels tearfully asks another employee at the hospital.

Parts of the footage were shown Thursday during a news conference held by attorney Karra Porter, who is representing Wubbels, the Salt Lake Tribune reports. Wubbels, who was not charged, told the newspaper that she’s watched the footage about five times.

“It hurts to relive it,” she said.

Hospital officials, meanwhile, said they supported Wubbels’ actions.

“She followed procedures and protocols in this matter and was acting in her patient’s best interest,” according to a statement obtained by The Post. “We have worked with our law enforcement partners on this issue to ensure an appropriate process for moving forward.“

No notice of claim or lawsuit had been filed as of Thursday, but Porter had discussions with the department, which will provide better training to its officers, she said.

Payne, meanwhile, has been suspended from the department’s blood-draw program, but remains on duty as an investigation is conducted, Salt Lake City police Sgt. Brandon Shearer told the Salt Lake Tribune.

Solar Eclipse in Libya

Total solar eclipse in the Libyan desert. People are spread out over the stony sand, many with telescopes and cameras on tripods, ready for “1st contact” at 11:17. Twenty busloads of people from our ship stop milling around, quiet down . As the moon takes its first bite of sun, there is some cheering. Then people return to visiting, checking on the eclipse from time to time.

We watch through welder’s glass . As the eclipse approaches TOTAL, people become very quiet. There is noticeable dimming of light. A cool breeze comes up. The planet Venus comes out in the darkening sky. The circle of horizon around all around us glows orange, like sunset.

 

 

Story image for total eclipse photos from Ars Technica

Totality comes at 12:35.Some people cheer–we are too moved to talk. It’s fairly dark, as just after normal sundown. White streamers blaze out all around the black disk. It has a red rim on one side, blue rim on other. We see “Bailey’s beads” of several colors on the edge of the disk. We do not see the “shadow bands” expected to slide across the ground.

As totality ends after 4 minutes, we see the “diamond ring” effect– a brilliant blossom of white with a white rim on the opening edge of the moon.

Media image for total eclipse photos from CNBC

As the moon slides away, people resume chatting, pack their equipment.  Everyone has a slightly different memory of this experience, but no one leaves unmoved.

 

RJN

 

 

 

 

 

 

 

 

 

Inside German Bomber

 

An Inside Look at the Germans’ Deadly Bomber

Cutaway diagram shows a German Gotha bomber.CreditB. Corvinus/The New York Times Mid-Week Pictorial, Aug. 9, 1917

Awful though it was, some good came of a German air raid on London in July 1917. Twenty-two Gotha bombers had flown in for the attack, but only 19 returned, Prime Minister David Lloyd George told a secret session of the House of Commons a few days later. The incursion had not been made with impunity, he said.

“A stalwart American fighter now in active service at the American camp ‘somewhere in France.’” (Censors would permit no more specific identification.)CreditThe New York Times Mid-Week Pictorial, Aug. 9, 1917

The downing of the bombers allowed an artist working for The Times Mid-Week Pictorial to render the airplanes’ general structure and arrangements in a cutaway diagram, including the racks and chutes in which 14 60-pound bombs were carried over the target, and the bombardier’s sighting window on the underside of the fuselage. The diagram also showed the biplane’s 260-horsepower Mercedes engines, manufactured by Daimler Motors.

(This was the month in which King George V restyled the British royal family as the House of Windsor, and dropped the names Saxe-Coburg and Gotha, for fairly obvious reasons.)

More at Source

Violence to Nurses

 

 

Note–Through my many surgeries, starting at age 4 (1939), I’ve gained a lot of respect for nurses, men and women.  We’ve had nurses in the family: my mother Marjorie, my sister Carol, my sister-in-law Jenny and her son Chris, and my daughter Laura.

When I had an appendectomy at age 12, I  fell in love with a student nurse from Indiana who was kind to me but I sensed  did not reciprocate my passion.

Before colleges entered nursing education, girls trained in hospital programs. Mom and Carol had tuition, room and board free at St. Francis Hospital in Evanston and worked long hours at such tasks as cleaning beds as well as nursing duties. They wore white dresses, stockings, and shoes.  At graduation they received their white caps to which they added a stripe after a period of service.  Laura trained at Lutheran General Hospital in Niles, Illinois, and worked there  in the cancer unit.

Now we have highly trained advanced practice nurses who do much of the work of a primary care doctor.  Rachel Foote treated patients in Spanish at a clinic in Boston. Nurses can earn master and doctor degrees in nursing.  Some physicians don’t like to have nurses addressed as doctor.

RJN

 

______________________________________________________________________

On the front line of hospital violence, nurses seek reform  Chicago Tribune 8/11/17

‘Part of the job’ culture in health care must change, advocates say

Carina Johannessen, 40, said being a nurse is rather like “being in an abusive relationship.”

By Kate Thayer and Hannah Leone Chicago Tribune

One woman describes getting slapped and groped on the job. Another was punched in the head repeatedly. A third was bitten so hard that a spike in blood pressure burst an aneurysm in her brain, altering her life forever.

All three are nurses, who say their jobs place them in harm’s way as the rate of violent incidents at hospitals appears to be growing.

U.S. Bureau of Labor Statistics data show that the rate of hospital employees intentionally injured on the job at the hands of another person is significantly higher than the rate across all private industries. In 2015, the most recent year available, there were 8.5 cases of injuries per 10,000 full-time hospital workers, versus 1.7 cases for all private industries.

The data also show that injury number for hospital workers steadily rose from 2011 to 2014 but dropped slightly the following year.

According to an Occupational Safety and Health Administration guide on addressing violence in hospitals, 70 to 74 percent of workplace assaults between 2011 and 2013 happened in health care settings.

And hospitals in the Chicago area have not been immune to such violence in recent years.

In May, two nurses at Northwestern Medicine Delnor Hospital in Geneva were taken hostage by a Kane County jail inmate after he got hold of the gun of a corrections officer guarding him. One of the nurses was sexually assaulted, according to a lawsuit filed in the case, before the inmate was fatally shot by police, authorities said.

Less than a month later at Presence St. Joseph Medical Center in Joliet, a convicted murderer who was there for treatment used a makeshift weapon to hold a corrections officer and a nursing assistant hostage.

In 2014, a man who had been taken to NorthShore Highland Park Hospital after a car crash was shot and killed by police after removing a gun from his waistband, according to police accounts.

Experts say facilities across the country have been affected. In June, a disgruntled doctor opened fire at a New York City hospital, killing another doctor and injuring several other people before taking his own life. In 2015, at a Boston hospital, a man shot and killed the surgeon who’d operated on his mother before she died.

While such extreme examples are rarer, many health care workers — especially nurses — say they deal with more minor incidents of physical aggression or verbal abuse on an almost daily basis. Many have stories of intoxicated or delusional patients who spit, claw and hit, or angry family members who threaten lawsuits or even lives.

For too long, nursing advocates say, aggression toward hospital workers has been chalked up to just an unfortunate part of the job, and patients are rarely held accountable.

Yet a movement to change this culture seems to be gaining momentum, with nurses groups speaking out at protests and on social media, and lobbying for legislation that aims to curtail violence against health care workers.

The Delnor attack seems to have been the tipping point for many activists locally, and in response to it, a nonprofit group called Show Me Your Stethoscope plans to gather nurses at a rally Friday in front of the Kane County sheriff’s office to shed light on their efforts.

Nurses point out that they’re the ones with the most contact with patients and their families, often during times of crisis and intense stress. Heartbreak over a serious diagnosis, anger over a long emergency room wait or even a general disdain for the health care and insurance fields — all can translate into hostility toward nurses, experts say.

“Just going into work is a high-risk endeavor,” said Lisa Wolf, director at the Institute for Emergency Nursing Research at the Emergency Nurses Association and a registered nurse who has studied emergency room violence. “You’re going to work and people are in some ways feeling like they can kill you.”

Nurses groups generally would like to see more staffing and more training. Other observers say there’s no single solution that would work for all hospitals — an industry struggling to do more with fewer resources.

While many states, including Illinois, have enhanced penalties for offenders who attack nurses, there’s also a push for federal legislation or an OSHA standard that would regulate hospital staffing levels and install other violence prevention measures.

Some who’ve studied the problem say it’s even worse than the statistics suggest. Verbal abuse is not included in government reporting, and while many hospitals have a system for employees to report acts of violence, nurses say they often don’t have or take the time to take advantage of them.

‘Part of the job’

Trauma nurse Carina Johannessen said her job is somewhat like “being in an abusive relationship.”

Nurses get hurt, but they keep going back to work, said Johannessen, 40, who is employed by an RN placement firm and has worked in several Illinois hospitals.

While on a shift at the emergency room at St. Joseph in Joliet, she said, a large male patient punched her in the head five times after he attacked someone else and she tried to intervene.

Johannessen, of Joliet, said she didn’t suffer severe injuries and felt she had to finish her shift, despite a “raging headache.” No one suggested she file a police report, she said, or even go home for the day. And if she had left, she said there wouldn’t have been enough nurses to cover the rest of her shift.

“This just seems to be the culture. It’s part of the job,” Johannessen said, adding her “greatest fear” is that violence against nurses will only escalate.

On May 13, Tywon Salters, a Kane County jail inmate admitted to Delnor for medical treatment, was left unshackled by a corrections officer, according to a lawsuit filed by Delnor nurses.

Salters, 21 and in jail for alleged car theft, got hold of the officer’s 9 mm handgun, and while the officer ran down the hall and hid, Salters found a nurse in a nearby office, threatened her with the gun and made her remove her clothes, the complaint states. When another nurse entered, he led her to another room, where he held her captive for hours in the dark, raping her and beating her at gunpoint, according to the lawsuit.

A SWAT team officer eventually shot and killed Salters. The fatal bullet also struck the nurse in the arm, according to the lawsuit.

Johannessen said the Delnor incident was partly what prompted her to speak out. She said she sometimes struggles to remember why she chose to be a nurse in the first place.

“It is so incredibly rewarding,” she said, “but it’s sad because it’s becoming more and more infrequent that you get the patient who reminds you why you wanted to be a nurse.”

ER nurse Valerie Zage said she’s been subjected to regular verbal abuse in her 10-year career.

“People scream at you, they swear at you. I’ve been called so many names,” she said. “It seems the culture of hospitals in general is, you kind of have to just take it.”

Zage, 33, of Bensenville, said two incidents prompted her to file official reports, not just with her employer but also with police.

The first occurred a few years ago at Advocate Condell Medical Center in Libertyville, where Zage said a patient charged at her and slapped her across the face after being denied a pain pill prescription.

Zage was shaken and called police. She said the patient received a minor ordinance violation ticket but never appeared in court so the matter went unresolved.

More recently, while working at Advocate Lutheran General Hospital in Park Ridge, Zage said an intoxicated patient grabbed her breast while she was setting up an IV. Zage also went to police but said she found it “frustrating” that he, too, merely received a ticket and was fined $100.

“You go through nursing school and you think, ‘Wow, I’m going to help people and save lives,’ ” she said. “No one really warns you in school that people are as mean and horrible as they’re going to be.”

Sally Griepentrog, 52, of downstate Eureka, is an educator trying to prepare nurses for those realities of the profession. A workplace violence course she teaches to employees at OSF St. Francis Medical Center in Peoria includes techniques for recognizing cues for possible violence and de-escalation methods.

Griepentrog said she’s uniquely suited for the job, as an act of workplace violence changed her life.

In 2015, Griepentrog was staffing a medical tent at a summer music festival. A young woman came in, topless, saying she had been taking drugs all day and was dehydrated. When Griepentrog tried to start an IV, she said, the woman clamped her teeth down hard into the nurse’s shoulder and would not let go.

It took the intervention of multiple staff members to eventually wrestle the woman away.

Griepentrog was treated for the gash in her shoulder, but a lingering headache led to further testing. Days later, doctors learned the pain from the bite caused her blood pressure to spike, bursting an undiagnosed aneurysm in her brain.

She underwent surgery and spent weeks in the ICU. She was left with short-term memory loss and said she can no longer read more than a sentence at a time.

“I’ve been swatted at, hit, spit on, puked on, you name it,” Griepentrog said. “But this was the first time it almost cost me my life.”

It might have cost her career, too, had Griepentrog not already had a master’s degree and experience teaching. She can no longer treat patients but now works solely as an educator, using computer software that reads aloud to her.

The woman who attacked Griepentrog was eventually convicted of a misdemeanor and sentenced to six months in jail, court records show.

“Now that this has happened, I think, no more. This can’t be considered part of our jobs anymore. I think too many of us are being hurt,” Griepentrog said.

Alice Johnson, executive director of the Illinois Nurses Association, said it’s time for hospitals to make nurses’ safety a priority and dedicate resources accordingly.

“Nurses are taking action on their own as part of a grass-roots efforts to address this issue,” she said.

Hospitals and other employers, on the other hand, “have a long way to go,” Johnson said, adding they seem focused on the bottom line but not enough on the care of the workforce.

Adequate staffing is one key way to improve hospital safety, she said.

Pam Cipriano, American Nurses Association president, said mandatory staff training and better record-keeping should be done at all hospitals — whether voluntary or through federal legislation.

“We need to be able to reverse the culture to make sure no nurse should … be exposed to violence on the job,” she said.

More research needed

Emergency medicine physician James Phillips started studying hospital violence after the surgeon was killed at the Boston hospital. At the time, he was working at nearby Harvard University, writing about mass shootings.

But when he turned his attention to medical settings, “I came across a plethora of nursing literature of violence in hospitals,” he said. Last year, he published an article in the New England Journal of Medicine arguing that hospital violence is under-reported, tolerated and ignored.

Phillips notes that government statistics on workplace violence only track incidents that result in injuries and time off of work. He said more accurate tracking is important to persuade hospitals to put more resources toward security and violence prevention methods.

During Phillips’ residency in Chicago with the University of Illinois hospital system, he was working a shift at a suburban hospital and was trying to calm an agitated, intoxicated patient when the man “spit a mouthful of blood right into my eye.” Phillips soon learned the man was infected with hepatitis C.

The doctor never contracted the virus but had to undergo testing multiple times for months.

“I blew it off at the time. I thought it was part of the job,” he said. “No one ever said, ‘Did you file a police report? You were a victim of a violent crime.’ ”

Later, Phillips was working in Massachusetts when a patient spit in his face and threw a cellphone at him. In that case, he said he did call police, and the man was charged and served community service.

“I’m so sick and tired of being yelled at, screamed at and threatened,” he said. “I finally thought it was time to stand up for myself.”

Phillips said nursing and medical schools “should be the first place future doctors and nurses learn about the fact that they are entering into a violent industry and have a significant chance of being verbally and physically assaulted in their careers.”

Active shooters in hospitals are rare, he stressed, but assaults on staff by patients and visitors are much more common.

Wolf, of the Emergency Nurses Association, said hospitals need to assess risk factors, down to things like poor lighting, and should implement detailed reporting systems and encourage staff members to use them. Hospitals also need adequate staffing and should take “a firmer stance on patients who start acting out.”

Wolf said it’s a challenge for hospitals to acknowledge any risks because “everyone wants to feel like the community is safe.”

Wolf’s group surveyed thousands of nurses across the country, and the results, published in 2009, showed more than half were physically assaulted at work. “This is a very, very common, deeply disturbing aspect (of the job),” she said.

No single solution

Several Chicago-area hospitals contacted by the Tribune declined to comment on security measures and staff training relating to workplace violence.

Advocate, Presence and Northwestern health systems issued statements, noting security is a priority and they take precautions, including de-escalation techniques and drills, and continue to study the issue.

“Unfortunately, this is something that continues to be seen more and more, and we continually have to talk about it,” said Melissa Granato, associate vice president of security for Amita Health.

In 2015 at Alexian Brothers Medical Center in Elk Grove Village, one of the hospitals under the Amita banner, a man locked his estranged wife in a bathroom and stabbed her to death with a screwdriver.

Granato said the case prompted the security team to review and improve its procedures. Those approaches vary by location, she said, but can include drills and simulation training with staff. She also said they work closely with local law enforcement.

At the Chicago-based American Hospital Association and the Illinois Health and Hospital Association, the issue of workplace violence is taken seriously, officials said. Members can access resources on how to address security at their facilities.

But every facility is different, said Dr. Jay Bhatt, AHA president. That’s why he and others question whether a national standard on staffing levels or violence prevention for hospitals would work.

“Nurses aren’t widgets, neither are patients,” said Cathy Grossi, a vice president at the IHA. “One size fits all rarely ever works.”

However, California recently enacted legislation that many nurse advocates say is groundbreaking and a potential model for a national standard. The law addresses the reporting of violent acts, staff training and correcting any violence hazards, including staffing levels. The union that lobbied for it is also pushing for OSHA to come up with a standard.

The Joint Commission, the Oakbrook Terrace-based nonprofit that accredits hospitals across the country, does not have a uniform standard related to workplace violence. But the commission does address safety and security when accrediting hospitals, and offers violence prevention resources, said Dr. Ana Pujols McKee, the commission’s chief medical officer.

“We expect our organizations to understand security risks and respond in a proactive way,” she said.

McKee said one challenge is finding a uniform way to gather data and use it to set guidelines. She uses the example of a nurse being hit by a patient with a brain tumor that has altered the patient’s behavior. “Is that violent? To me, it is, but it may be perceived as a patient who has uncontrollable behaviors.”

McKee said she’s watching California as a “test site,” to see if the new law leads to a decrease in hospital violence.

Are hospitals secure?

Security experts also agree more study is needed to determine the best way to keep hospitals safe.

“The historic feeling that places like … hospitals (are) sacred ground is gone,” said Kevin Tuohey, president-elect of the International Association for Healthcare Security and Safety.

The Glendale Heights-based group researches and offers guidelines for the security industry, including hospital guards.

Another association official, Tom Smith, who runs a health care security consulting company, said hospitals are typically subjected to few regulations dealing with security, and some don’t place enough emphasis on it.

“Family-friendly and patient-centered doesn’t mean it shouldn’t be secure,” he said.

The association has provided feedback to OSHA as the workplace safety agency contemplates hospital security regulations. Some local law enforcement agencies, though, have already made changes in how they handle inmates who need outside medical care.

Within weeks of the Delnor attack, Kendall County updated their policies, including requiring detainees to remain handcuffed or shackled at all times unless medical staff specifically orders restraints removed or the detainee is giving birth.

Deputies who are guarding inmates at hospitals are also barred from using the phone unless there’s an emergency and may not use social media or the internet or play games. According to the lawsuit filed by the Delnor nurses, corrections officers assigned to guard Salters were seen sleeping or on the computer.

Sheriff offices in Cook and McHenry counties also listed several guidelines for transporting and guarding inmates who need outside medical attention.

The Illinois Department of Corrections, as well as DuPage, Kane, Lake and Will counties, declined to provide their policies, citing security concerns.

Kate Thayer is a Chicago Tribune reporter; Hannah Leone is an Aurora Beacon-News reporter. kthayer@chicagotribune.com