ROCK SPRINGS — Proposed legislation to add protections in the case of workplace violence against healthcare workers will be discussed by the Wyoming Legislature’s Joint Labor, Health and Social Services Committee when it meets Nov. 12-13 in Cheyenne. Several Memorial Hospital of Sweetwater County representatives plan to attend and urge the committee to consider legislation.

When the committee met on this topic in early October, those testifying included MHSC CEO Kari Quickenden; Hospital Trustee Craig Rood; MHSC Emergency Department Director Tiffany Uranker; and Emergency Department Nurses Megan Tozzi, Kaitlyn Ice, and Alexis Lehmann.

It was pointed out that Wyoming and South Carolina are the only two states that don’t have healthcare specific penalties or prevention laws for violence against healthcare workers. 

Committee member Rep. Ken Clouston said peace officers, firefighters, and jail staff are protected by stiffer assault penalties. Judges and jurors have special protections, as well.

“That means our nurses, medical staff, security officers, and support teams walk into situations every day that can turn dangerous, without the backing of state policy affirming their right to safety,” Quickenden told the committee.

Being grabbed, kicked, or hit has become so common that they see it as part of the job, not an event that warrants documentation or reporting.

Kari Quickenden, CEO of Memorial Hospital of Sweetwater County

“In the last two fiscal years, our hospital recorded 84 incidents of workplace violence via our safety event reporting system,” she said. “I want it to be very clear that workplace violence events, including those that occur at Memorial Hospital of Sweetwater County, are underreported. I know this because I have spoken directly with staff. They tell me about events that never make it into a report. They tell me that violence is part of the job. They tell me they expect to be hit, kicked, threatened, spit on, bit, or physically assaulted.

“And when I ask staff why they don’t report, they tell me: ‘It happens all the time.’”

Violence has become so routine that many staff do not see the point in reporting it. Some staff do not recognize that what happened to them qualifies as workplace violence.

“Being grabbed, kicked, or hit has become so common that they see it as part of the job, not an event that warrants documentation or reporting,” Quickenden said. “This is one of the most concerning realities we face. Underreporting is not evidence of safety. Underreporting shows normalization and a lack of protection.”

A Cowboy State Daily article published earlier this year highlighted this same issue statewide: violence against healthcare workers is increasing, and Wyoming has no protection in place. The data is clear:

According to the U.S. Bureau of Labor Statistics, healthcare workers account for 73% of all workplace injuries due to violence.

The Emergency Nurses Association reports that one in four emergency nurses is assaulted every single week.

The Joint Commission and AHA safety briefs show that behavioral‑health conditions are involved in more than half of violent incidents in hospitals.

OSHA estimates that only 30% of workplace‑violence incidents in hospitals are ever reported.

Mental Health Crisis

“I want to be very clear: I am not here to criminalize behavioral health conditions,” Quickenden said. “Many individuals who assault a healthcare worker may be experiencing some form of behavioral‑health crisis. That is a reality we acknowledge, but even when violence stems from behavioral‑health conditions, the impact on our staff is real. The injuries are real. The fear is real, and the need for protection is real.”

“Other states have found balanced approaches, policies that protect staff while recognizing the complexity of behavioral‑health‑related violence. Wyoming must do the same,” she said. “We have strong workplace‑violence programs in place. We provide de‑escalation training. We have security protocols. We have reporting systems. We conduct after‑action reviews. We invest in staff education. We work every day to improve.”

Rood told the committee Wyoming has a mental health crisis, “and rural hospitals are absorbing it. Rural hospitals are not a psychiatric facility. Patients may wait for days before they are admitted into the few beds available in Wyoming.”

After a recent attack on an MHSC nurse, Rood said a legislator told him the hospital should hire more security.

“Security is not the answer,” Rood told the committee. “Guards can respond to the crisis, but they can’t treat a psychiatric emergency. They can’t provide a bed in a facility that doesn’t exist.”

The capacity problem must be addressed at the root, he said. Wyoming needs more inpatient psychiatric beds regionally, spread out across the state. He asked the committee to examine where those facilities are needed and how the state can support them.

What Nurses See

Uranker, an MHSC ER nurse for nearly 17 years, said she’s been kicked, spit at, bitten, and threatened.

“It happens all the time,” Uranker said. “It’s not normal, but it’s kind of normal for us. We don’t feel like we’re being protected and would love for the State of Wyoming to back us.”

Tozzi, an ER nurse of 15 years and house supervisor for the past two years, said she’s seen a lot of nurses come and go.

“They come in and they’re excited,” Tozzi said. “They have a sparkle. They’re like ‘Yes. Let’s make a change. Let’s be good.’ Then things happen to them. They get hit, they get kicked. They get yelled at. Passing this (legislation) would help. They would feel protected and feel like they have something to back them.”

Ice, an MHSC ER nurse of 15 years, said she did report an incident.

“I had a patient hit me in the face,” she said. “I cut my lip. I had braces on at the time. My tooth was loose. I had the officer come in. I made a report. The patient made a report, as well. And that was it. It didn’t go anywhere from there. There was nothing that was done at that time.  And I think that’s why we’re seeing nurses last maybe five years at bedside. And then they’re leaving and now our nursing shortages are at a crisis.”

Stronger Laws

Wyoming Hospital Association Director Eric Boley pointed out that if the person in custody strikes a law enforcement officer, there are extra protections and extra charges the person can face. There are not extra protections if the person in custody strikes a nurse or doctor.

Boley said states that have implemented stronger laws are showing a decrease in incidents.

“This has been a priority for close to a decade now,” Boley said. “We’ve brought bill after bill to try to send a message to them that it matters and that we care.

“If we can do anything to protect even one healthcare worker, we’ve accomplished something,” he said.  “We do have penalties in place that are not enforced. This would send a message to law enforcement and the judicial system that we’re serious about protecting people.”