CT visiting nurses seek protection in wake of brutal slaying. ‘People forget about the dangers’

State Sen. Martha Marx, who is a visiting nurse, said that every nurse she knows could recount a visit where they felt unsafe with a patient and were all alone.

Sherrine Edwards-Gillus, a visiting nurse and supervisor in Hartford, said that she hasn’t been able to stop thinking about the death of fellow visiting nurse Joyce Grayson.

“I can’t get it out of my head,” Edwards-Gillus said

Edwards-Gillus spoke as a number of ideas for change were suggested in the wake of the Grayson’s death, including escorts for home visits, better transparency about patients’ criminal records and a review of the re-entry model for people who have been incarcerated.

Edwards-Gillus also wants to make sure Grayson isn’t forgotten, as she said visiting nurses often feel they are, and that what happened to her doesn’t happen again in Connecticut or anywhere else.

“We don’t get enough support, we’re often forgotten,” she said.

Grayson, a 63-year-old visiting nurse with Elara Caring who had been working in health care for more than 35 years, was found dead in the basement of a Willimantic halfway house last week after going to see her first patient of the day. The early morning appointment, with registered sex offender Michael Reese, was supposed to last less than 10 minutes, but Grayson never left the house.

Reese has not been charged in connection to Grayson’s death but was being held in custody on unrelated charges and for violating his probation. In an affidavit for Reese, his probation officer said that he was a suspect in Grayson’s death after being found in possession of her property at the scene of the death: a transitional house for sex offenders where he had been living since August.

Officials had not yet released any information on how Grayson died, as the matter is sealed, but police and a spokesperson for the Connecticut Hospital Association have called it horrific, violent and deeply troubling.

Not new fears

Just days after Grayson’s death, lawmakers and others gathered in Hartford to echo Edwards-Gillus and the concerns of many other visiting nurses: health care workers who are going into people’s homes need better protection, more support and more information about whose home they are walking into.

The Connecticut Hospital Association said that health care workers “are five times as likely to experience workplace violence as other workers nationwide.”

State Sen. Martha Marx, who is a visiting nurse, said that every nurse she knows could recount a visit where they felt unsafe with a patient and were all alone.

Many, she said, report those feelings and fears to management and are dismissed or shamed.

Marx said she has heard stories of nurses alerting management that they are unsafe in a patient’s home, or that a patient has contacted them outside of work and made then feel uncomfortable.

“And management will say: ‘Just make sure there’s nothing between you and the door,” said Marx.

Marx said nurses who speak up about safety concerns are “shamed a lot” and often, when they raise alarms, agencies will just send another nurse into the same situation, she said.

She said that enough is enough and better procedures need to be in place to protect nurses.

“We just need to make sure our nurses are safe. And our patients are safe,” Marx said.

Information void

Tracy Wodatch, president and CEO of the Connecticut Association for Healthcare at Home, said visiting nurses have been asking for more security for a long time.

“We need help, we need protection, we need safety,” said Wodatch, who has been a nurse 40 years.

“What are we missing? We’re missing the security but we’re also missing good information,” she said at the gathering in Hartford.

She called for a better ability “to collaborate truthfully and honestly across systems” so that nurses know if they are walking into the home of a patient who has a history of sexual crimes or other violence.

She said nurses deserve to know about those behaviors so they can protect themselves properly.

“If we don’t know those issues we can’t mitigate that risk, so must address that upfront,” she said.

Edwards-Gillus, said that she worries for her own safety often in visits, and every day worries for the visiting nurses she supervises.

“There should be bodyguards with us or some sort of protection,” she said, especially when dealing with patients with psychiatric diagnoses.

She said that nurses never want to discriminate: nurses want to make sure every patient receives care, regardless of their history, but nurses also need to be safe.

It is often difficult, she said, to balance their own safety with the patients’ mental health concerns while also administering their medications and following their plan of care. It is a nearly impossible job for one person if they are also tasked with being their own bodyguard.

If that security is lacking, it impacts both the nurse and the patient.

“Multitasking isn’t safe for the patient,” she said, adding that nurses often have to be aware of other potential risks when constantly entering unfamiliar homes and neighborhoods alone.

“People forget about the family members who are home, or the neighbor that’s watching you, people forget about the dangers,” she said.

Wodatch, who handed out white ribbons at the recent meeting in Hartford in memory of Grayson, said that the board of CT Association for Healthcare at Home had an emergency meeting on after the death to discuss how to honor Grayson. She called for wearable security devices for visiting nurses, so they can push a button and call for help in emergencies.

She also said she supports implementing self defense training for nurses.

“Our nurses are fearful of their lives. Our companions, our personal care aids our social workers, they are scared, we need to give them a safe environment,” she said.  “Our hearts for out to Joyce Grayson and the hero and legacy that she is and will leave behind.”

That legacy, advocates hope, is legislative and policy change, including possibly escorts and better transparency about patients’ criminal records.

When Tina Loarte-Rodriguez, a registered nurse with a doctorate of nursing practice who works at Yale Center for Outcomes Research & Evaluation heard about Grayson’s death, was in Washington already lobbying for better protections for healthcare workers, she said.

Loarte-Rodriguez, a member of the government relations committee for the Connecticut Nurses Association, said health care workers are often fearful of raising concerns about safety with patients, whether an incident of workplace violence happens or a healthcare worker just guts “that gut feeling that something isn’t right,” because agencies are hyper focused on productivity, not safety.

“There’s a lack of empathy and really strategizing and prioritizing the workplace safety to even be able to speak up,” said Loarte-Rodriguez, who specializes in infection control, patient safety and  risk management.

Stephanie MCGuire, an APRN who chairs government relations committee for the Connecticut Nurses Association, said that it was already on their radar to push for more protections this month.

“This was a priority on our legislative agenda before this happened, that’s how glaringly evident it was that it was going to happen,” she said.

Kim Sandor, executive director of the association, and Marx, the state senator, both said that they were not surprised about happened to Grayson.

“When we say we weren’t surprised it’s happened, it’s because we’ve been advocating for change for a long time,” said Sandor.

To prevent it from happening again, she said, health care workers and agencies need more transparency about whom they’re providing care.

“We can prevent what we can predict,” she said.

Disclosing patients’ history won’t lead to discrimination, she said, but would increase safety.

“It’s not that you approach them with bias or in an uncaring manner, but you do it with two people in the room until you can assess the situation and see what’s going on,” she said. “And you need to be allowed to do that.”

Nurses, healthcare workers and advocates from multiple state healthcare groups said the dangers don’t only extend to in-home health care workers.

Healthcare advocates are calling for better protections for health care workers in all environments who are working with people with mental health issues and criminal backgrounds.

In an unrelated recent example, a Department of Correction inmate with a criminal background who previously assaulted a correction officer last Wednesday allegedly assaulted a physician and a correction officer.

Joe Baltas allegedly struck a Department of Correction physician in the chest and pinned him up against the wall.

Baltas, who is currently serving a life sentence on a murder conviction, also allegedly stabbed corrections officers at the Garner Correctional Institution in Newtown with a filed-down toothbrush in August, according to state police.

In Grayson’s death, her patient was had been living in transitional housing after graduating from another transitional house for high-risk offenders less than three months ago, records show.

Reese had been released from prison in March and was on probation for a conviction of first-degree sexual assault and first-degree assault causing serious injury, along with another conviction for violating probation, according to the affidavit for his arrest.

Mcguire, who was calling for health care worker protections along with many other advocates even as the physician was assaulted at the MacDougall-Walker Correctional Institution, said that in health care, it is a common to use the phrase “culture of safety” when describing patient care.

But that culture doesn’t seem to extend to those providing the care, she said.