The Roanoker - July/August 2019 - 63

H O S P I TA L S ' DA R K S E C R E T

hospital is a small city ... and it is not
different inside from what we see in
general society. [We are taking care of ]
people during one of the most traumatic
times in their lives."
"People come in at their most vulnerable
times," says Carilion Chief Medical
Officer Patrice Weiss. "We see stress from
family members that results in stress for
the care team."
Nancy May, Vice President of Marketing
and Public Relations at LewisGale
Regional Health System, agrees: "When
people need emergency or hospital care
for a serious or life-threatening illness
or injury, it is one of the most vulnerable
times in their lives," she says via email.
"Understandably, it is an emotional time for
patients and their family members."

"The majority of situations in which
patients become combative or
agitated are due to their health
condition, confusion or anxiety.
Sometimes family members can
also become emotional or angry
when questioning the care of their
loved ones."

May says opioid and other drug use
"has also resulted in events that require
intervention of additional staff or security
personnel. All employees go through
new-employee orientation that includes
a session on security and how to deal with
escalated situations."

Catawba Hospital:
A Safe Bed for All
Catawba Hospital in Roanoke County has special
challenges, since it focuses on mental health and
some of its patients are, by definition, high risk.
"The patient population has changed here since
2014 on the heels of the [Virginia State Senator]
Creigh Deeds incident," says Catawba Facilities
Director Mitch Mitchell. Deeds' son attacked him
with a knife, then committed suicide after being
refused admittance to a mental health facility,
leading to legislation changing commitment laws.
"The goal," says Mitchell, "is that nobody goes
without a bed. The state hospital is a last resort.
We assess. Others may exclude [some patients],
and they come to us."
That means, says Director of Quality and Risk
Management Jarvis Griffin, "They need to be
stabilized; they may not be coherent." And some
may tend toward violence. The patients at Catawba
carry what would generally be considered higher
risk than at other facilities.
"Substance abuse is higher [among those at
Catawba] and rates of violence are high even
when they are not intoxicated," says Mitchell.
"We deal with dementia, delirium and mental
instability. We are robust about human rights; we
are human rights advocates. We have a hotline for
TheRoanoker.com

Catawba Hospital facilities director
Mitch Mitchell (right) with risk
management director Jarvis Griffin
see a lot of high-risk patients at the
mental health facility.

Chief Operating Officer and President
of Carilion Medical Center Steve Arner
points out that Carilion employs 40
security officers and 50 police officers.
There are 500 security cameras covering
two million square feet "to create a safety
environment." There is a lot of one-on-

complaints and we encourage patients to report
concerns. Staff-to-staff violence is not much of
a problem. We have a strong workplace violence
policy."
The policies can be blunt. "If you see something
wrong, you have to say something. In surgery,
we have a 'stand down' policy where we stop and
listen. There is a requirement to report safety
concerns," says Griffin. The goal, he says, is zero
harm, zero violence.
Catawba has a public safety department where
"everybody is trained in therapeutic options,"
says Mitchell. Intervention emphasizes deescalation without physical interference when
possible. Mitchell says hospital professionals in
the Roanoke Valley often train together for the
safety of their facilities, and Blue Ridge Behavioral
Healthcare is "the gatekeeper for the state" in this
area, Mitchell says.
Catawba is "different from most psychiatric
facilities in the state in that we are a geriatric
unit" with 60 geriatric beds and 50 adult beds
with a median stay of 20 days. The goal is to teach
patients to "live in the community."
"We're getting there," says Mitchell. "But I don't
think we will have done enough until there are no
incidents of aggression."
That sentiment seems to be shared throughout
the Roanoke Valley. -DS
JULY/AUGUST 2019 63
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The Roanoker - July/August 2019

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