Nurse tells committee repeated assaults at Vermont Psychiatric Care Hospital, urges staffing, training and faster access to court-ordered meds

Lisa Tucker, a registered nurse and acting supervisor at Vermont Psychiatric Care Hospital, told the Vermont Health Care Committee on March 22 that repeated violent episodes on acute units have left multiple staff and patients injured and that she came to the committee “to advocate for improved safety.”

Tucker said a single long-stay patient recently led to more than 20 staff injuries, that the patient required teams of staff — “sometimes more than 10 to 12 staff, including 5 or more strong male staff” — to be controlled, and that staff and other patients stayed in their rooms “out of fear.” She said she was assaulted on April 22 while working as a charge nurse, suffered head and shoulder injuries, and remains unable to drive because of continuing treatment appointments.

The testimony came amid committee discussion of H.259, legislation on workplace violence in health care settings. Karen Barber, general counsel for the Vermont Department of Mental Health, told the committee VPCH already maintains a workplace violence prevention program that the hospital developed in 2018 and updates annually. Barber and VPCH leaders described ProAct de‑escalation training, event reporting and root‑cause analyses as central components of the hospital’s approach.

Why it matters: VPCH is a locked, level‑1 facility that treats the state’s most acutely ill involuntary psychiatric patients, a population the hospital says requires different safety and clinical approaches than emergency departments. Committee members said the accounts of injured staff and patients highlight the tension between treating high‑acuity patients and protecting front‑line workers.

Tucker told the panel that staffing shortfalls and high unit acuity regularly leave smaller teams to manage dangerous situations, and that requests for extra staff or for moving a dangerous patient to a separate unit sometimes were not approved until after additional people were hurt. Tucker estimated that roughly 40–50 percent of floor staff on a given day were travel staff (she framed that as her “best educated guess”), and said that turnover and difficulty retaining experienced staff worsened safety problems.

Hospital leadership, including Wendy Shapiro, chief executive officer at VPCH, Grace Winters, interim chief nursing executive, and Nicole Garcia, hospital operations director and safety‑council member, described a set of steps the facility uses to monitor and respond to incidents. They told the committee: VPCH documents emergency involuntary procedures (EIPs) and sends certificate documentation to the Department of Mental Health central office; Disability Rights Vermont receives those reports; the hospital runs debriefs and root‑cause analyses after serious events; and a staff‑run Safety Council vets and pilots changes suggested by front‑line workers.

Nicole Garcia said ProAct is a 16‑hour national training course with an additional 4‑hour restraint module and an annual 4‑hour refresher. She also said some on‑the‑spot trainings previously run by staff were scaled back after the hospital found a technique that had not been vetted under regulation.

Barber and VPCH leaders said Vermont’s “emergency involuntary procedure” administrative rule — which they described as stricter than federal CMS and Joint Commission requirements — constrains what seclusion and restraint options are lawful. They told the committee that the hospital balances those regulatory limits with staff training, facility layout and event documentation.

On numbers: Barber (reporting a quality‑office count) told the committee there were seven employee visits to emergency departments related to incidents at VPCH in 2025. Tucker said more than 20 staff were injured by one patient she described and estimated that one patient had “well over 50 to a hundred EIPs,” language she used to describe the frequency of violent episodes she witnessed.

What the hospital has changed: VPCH leaders described procedural changes in 2025 including increased leadership presence during rounds, adjustments to how staff debriefs and staff meetings are run to gather front‑line input, rollout of an epic committee tied to the hospital’s culture of safety survey, updates to the precaution monitoring form, and that Safety Council is evaluating evidence‑based alternatives to ProAct and exploring whether an “acuity specialist” team used in other state hospitals could be implemented at VPCH.

Committee members asked whether staff could file criminal affidavits after assaults; Barber said staff receive an affidavit packet and can pursue charges independently, but also explained that criminal prosecution is a separate process that can be affected by competency or sanity determinations for patients who were involuntarily hospitalized for mental illness.

No formal committee vote or policy change was recorded at the session. VPCH leaders said they would send the committee assistant a link to the workplace violence program and that they are working on implementation steps tied to the recently discussed legislation.

Tucker closed by urging more staffing, more practical training drills, and faster access to court‑ordered medication when clinically appropriate, saying, “Safety of staff and other patients is always our priority, but we need more tools in our toolbox.”

Looking forward: Committee members signaled interest in following up on implementation of the statutory workplace‑violence requirements and on whether the hospital’s planned changes reduce injury rates and staff turnover.