Tougher penalties sought for patients who assault health workers

  • Nurse Nelson Vo talks about when he witnessed a fellow nurse get physically attacked by a patient while working at Hilo Medical Center. (HOLLYN JOHNSON/Tribune-Herald)

The work environment is becoming increasingly dangerous for health providers.

“I have been spit on, hit, kicked and abused verbally by patients when my only goal is to provide a safe environment and medical interventions as appropriate to each case,” a member of the Hilo Medical Center ER staff said in testimony to the state Legislature.


Hawaii lawmakers are seeking tougher criminal penalties for people who assault health workers.

There were 1,075 assaults against health workers in Hawaii hospitals, nursing homes and in patients’ homes — during in-home health care — in 2017, legislators were told.

And according to testimony from the Hawaii Nurses Association, 84 percent of nurses who have served 21-plus years have been physically threatened by patients.

“There are rising rates of assault and violence against health care workers in Hawaii,” Dan Brinkman, CEO at Hilo Medical Center, said in his testimony to the Legislature. “At Hilo Medical Center, the largest hospital on Hawaii Island, we experienced 20 incidents of assault against our employees in the last year.”

About 95 percent were perpetrated by patients. The associated costs to the hospital in 2017 were $400,000, Brinkman said.

Currently, if a patient is found guilty of assaulting a lab tech, nurse or physician in a Hawaii ER, the crime is classified, by law, as a felony.

But if the assault happens instead in a patient’s hospital room, at a nurses’ station, in a hallway or during in-home health care, the crime is just a misdemeanor.

Senate Bill 2491 and House Bill 1906, if passed, will instead classify assault against a health worker in a patient’s home, private clinic or anywhere in a hospital as a felony.

A hearing by the House Health and Human Services Committee was held Tuesday morning, and the committee recommended unanimously that HB 1906 should pass.

“I had one of the patients not just attempt to harm me but also my pregnant belly at the time,” says testimony from a Hilo Medical Center behavioral health nurse, who was six months pregnant during the assault.

Assaulting an EMT, educator or correctional facility staff member is already a felony under Hawaii state law.

Proponents of the new legislation said assault victims must relive the assault when they testify in court.

But they also must often witness perpetrators of a misdemeanor set free after the court hearing, because, by then, the perpetrators have already served enough time to cover the relatively short sentence — in some cases, about 30 days. A Class C felony is punishable by up to five years of incarceration.

Dan Busheme, nurse manager of the Hilo Medical Center Behavioral Health Unit, said administrators, volunteers and students would all be covered under the new law.

Busheme, who retired from the Air Force as a lieutenant colonel, said he has been assaulted “multiple times” by patients during his 30-year career as a nurse.

The new legislation does not apply to patients with conditions such as dementia, exacerbation of schizophrenia or acute traumatic brain injury, Busheme said. Those conditions can result in behaviors that patients who are cognitively aware don’t exhibit.

Only people “capable of forming an intent to cause substantial bodily injury” to a health worker could be charged with a felony under the new legislation, according to the bills.

Busheme said medical crews are affected emotionally by the trauma of an assault, which can make returning to work difficult. And it’s not just the direct victim affected.

Registered Nurse Nelson Vo, during a break in his duties Tuesday at the Hilo Medical Center ER, said he once witnessed a man assault a coworker.

“He grabbed one of my coworkers and started swinging her around,” Vo said, noting it took multiple health and security personnel to intervene.

The perpetrator was “young, he had no history of psychiatric issues — and it came out of nowhere,” Vo said.


Supporters of the legislation to address assaults at locations outside the ER include unions representing health workers, the Hawaii Medical Association, the Hawaii Primary Care Association, and insurers Kaiser Permanente and the Hawaii Medical Service Association.

Email Jeff Hansel at

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