(Editor’s note: This is the second in a series of five stories about assaults at the Wyoming State Hospital and how local and state officials have attempted to curb violence by patients there.)

EVANSTON — Anxiety and depression were the results Hillary Dunbar said she experienced after she was assaulted by a patient at the Wyoming State Hospital (WSH). She worked as a CNA at the hospital from August of 2012 until just last month. During the eight years Dunbar worked there, she said she had worked on all the halls except Cottonwood Hall.

In August 2018, Dunbar, working on an APS (adult psych services) hall, was in the nurses’ station and the top half of the Dutch door leading into the area was open. She said she noticed a patient getting agitated and suddenly he jumped over the bottom half of the door and started beating her. The other CNA who was also in the area came to her rescue and the patient turned on her and beat her.

Finally, two other staff members out in the hall came and restrained the patient. Both Dunbar and the other CNA were taken to the local hospital. Dunbar said she suffered from a bad headache the rest of the day but the other CNA had a broken nose and was off work for several days.

“I don’t remember what happened after the two controlled the patient,” Dunbar said. “I remember the safety alarm going off, and I think there may have been other people who came to help … I just don’t remember. They took us off the hall and to the hospital.”

When Dunbar went back to work, she was told that the patient who had attacked her had admitted that he did it because he wanted to get moved to Johnson Hall, the forensic area. Dunbar said that the week before the patient attacked her and the other CNA he had assaulted another CNA on another hall in exactly the same way. Dunbar was told that patient had been moved back to Johnson Hall.

“So the patient got what he wanted,” Dunbar said, “and we got hurt. I filed a police report but heard nothing back, which caused me more stress.”

After she was assaulted, Dunbar requested to be moved to the geriatric hall, as she suffered from anxiety and fear and had been diagnosed by her doctor with PTSD. She said the assistant director of nursing approved the move.

During her eight-year tenure at WSH, Dunbar said she witnessed violence and assisted in helping others who were being assaulted many times. She said she thinks the Mandt training is good in theory but isn’t practical. The de-escalation part works with less aggressive patients but when very large and physically powerful patients are assaulting others, it is impossible to do the physical restraint part, Dunbar said. She added that they were often understaffed and didn’t have enough people to restrain patients with a “bear hug” as two people are needed for it to be successful.

“A lot of the employees who are assaulted are women and don’t have the strength to do the bear hugs or defend themselves,” Dunbar said. “I think it is a mistake to allow the patients from Johnson Hall to roam freely on the APS halls. They just wait for an opportunity to attack.”

Recently, when a scheduling position became available, Dunbar asked to apply for it but she said the hospital had already filled it without taking applications. It was never opened for others to apply. Dunbar asked human resources personnel about it and they only said that it had been filled.

“In general, the Wyoming State Hospital is a toxic environment. Lots of back-biting and resentments built up,” Dunbar said. “I feel sorry for the patients. We were understaffed more often than not on the halls and that doesn’t allow us to be able to help patients who aren’t combative. I hope they make changes, as the patients are supposed to be getting treatment and we (the CNAs) were just glorified babysitters.”

Due to her continuing fear for her safety and suffering from PTSD, Dunbar said she resigned from the WSH in January of this year. “I didn’t want to get hurt again,” Dunbar said.

Current employees asked to remain anonymous out of fear of retaliation.

One CNA who has worked at the WSH for several years, Mason Thorpe (not his real name) said that the frontline staff supports each other because they feel little or no support from the nursing supervisors or administration.

The assaults in which Thorpe has been directly involved happened from 2018 to 2019. One of the assaults was when a patient who primarily was restricted to Johnson Hall, the forensic unit, was moved to the hall to which Thorpe was assigned. That patient’s primary guardian threatened to sue the hospital if the patient wasn’t taken off Johnson, so he was moved. However, he said that same patient has been involved in many of the assaults at the hospital.

“I used my Mandt training when he came at me and was able to avoid being hurt,” Thorpe said. “I was sent to work on another hall that day. The next time I was hurt. I was walking into a hall and my hands were full and that same patient came up behind me and grabbed my hair and started hitting at my head with his fist. Other workers that were present restrained the patient and I was sent to another hall to work. The patient was put in the reduced sensory area.”

Thorpe said he witnessed another attack by a patient on Johnson Hall when he was working as an observer that day. The patient was being taken out of his cell block to receive medication and a medical procedure and was showing signs of agitation. The patient suddenly grabbed the nurse and threw her into the wall and broke her glasses, Thorpe said. That patient sent three WSH employees to the emergency room that day, according to Thorpe.

Thorpe said that the de-escalation training and the Mandt Systems training given during orientation is useful and effective in a classroom setting but the actual application of it becomes harder because, on the halls, an employee is taken off guard and it never goes smoothly. Employees are never allowed to use force to control a patient or protect self. They can only use deflective and redirected movements.

They first try to move out of the way but, when a patient is experiencing an adrenalin rush, that becomes nearly impossible, Thorpe said. He added that some of the workers are good at using the techniques, but some are just too inexperienced and afraid. It is impossible to teach someone with little life experience with aggression to be able to stay calm and effective when a patient is coming at them angry and combative.

“When I first started working up there, I was kicked in the groin by a patient,” Thorpe said. “But I have seen patients inflict serious injury on staff: dislocated joints, eye socket surgery, broken jaws and more. One patient kept on beating up staff until he attacked a doctor and then he was put on Johnson; but now he’s back on APS. He will never stop, as he can’t stand noise or other people. When he is in a down cycle, he attacks.”

Thorpe said he thinks that the staff’s opinions are completely written off and that most of the frontline workers are afraid to say anything negative about the hospital. He said that the employees have no advocate and new employees told him that when were hired, they were advised against joining the union, the Wyoming Public Employees Association, because it would only cost them money and the union wouldn’t help them anyway. Thorpe said that a friend who did join the union told him that he was afraid to say anything to the union anyway for fear of retribution from hospital administration.

Another worker told Thorpe that she wanted to press charges against the patient who disabled her for life but was told by administration personnel that it wouldn’t do any good because charges were never followed up on by the county attorney.

“The administration doesn’t seem to know the full situation on the halls,” Thorpe said. “I didn’t even know we had a new superintendent until talking to you. I think administration personnel know the gravity of their own jobs, but if they maintain ignorance of the frontline staff’s problems and avoid the situation, then they are part of the larger problem.”

Another current WSH employee, Jennifer Martinez (not her real name), said she was attacked by a patient who grabbed her hair and beat her. She passed out, and when she woke up, the patient still had hold of her hair. She said that after security came and got the patient under control, a coworker took Martinez to the hospital. She suffered a concussion and said she didn’t even realize what had happened to her until she saw a recording of the incident.

Martinez said she suffers from short-term memory loss and emotional trauma from the assault. She has been diagnosed with the results of a brain injury, delayed stress syndrome and is fearful and isolates herself. She said she is afraid of driving, as the brain injury has affected her eyesight.

“When it happened, I just wanted to stay home with my family and hide,” she said.

The following is CNA Donna Burton’s account of two incidents when two different patients assaulted her in 2014.

“I was sitting down in a chair taking a patient’s vitals and an agitated patient started toward me,” she said. “I broke eye contact with him by putting my clipboard in front of my face and he walked away. He went over to the RN on duty, grabbed her and threw her against the wall, gouged her eyes and knocked her dentures out. He then turned to me and threw me against the wall and beat me badly.”

Burton said she was taken to the hospital and reported the incident to the police who turned it over to the Uinta County Attorney. Burton said the county attorney told her that no charges would be filed, as the patient was a ward of the state and that worker’s compensation is the insurance for the hospital and would take care of her medical expenses. Burton said she suffered from post-traumatic stress after that beating.

Burton said the second serious assault she suffered that same year happened after a female patient weighing over 330 pounds came up behind Burton, who was sitting in a chair.

“She grabbed my hair and literally pulled me up and over the back of the chair by sitting down on the floor,” Burton said. “I suffered whiplash and injury to my neck and back. This time we were short staffed so no one could take me to the hospital, and I hurt too bad to drive myself. So I was made to stay and finish my shift and work one-on-one with another patient. What really hurt me was that in order to calm the woman down, they gave her a teddy bear. It was psychologically demeaning for me as it looked to me that she was rewarded for beating me.”

Burton said she talked to the county attorney at the time about the incident and was told that because she accepted worker’s compensation she couldn’t file a lawsuit. She was told to talk to OSHA, which she did, and OSHA was able to investigate. In 2014, Burton was given medical retirement from the state of Wyoming after completing a psychological exam. She said she has constant pain in her neck and seeks alternative stem cell treatments, which she has to pay for herself.

“When the patients caught on that we could no longer use take-down [methods] they began to get more aggressive and the abuse of the workers got worse,” Burton said, adding that shortly after the Mandt System was implemented, she suffered the first beating. “Mandt training isn’t helping at all. Plus, the hospital is short staffed and the conditions for workers just continue to get worse. Current employees at the state hospital know what happened to me and come to me now with their own stories of getting hurt by patients assaulting them.”