Western State Hospital nurse describes violent attack that left part of her ear missing

Oct 26, 2018

On the evening of September 30, Bernia Garner was working as a nurse on South Hall 7, a ward for non-criminal patients at Washington’s Western State Hospital.

Garner, 63, recalled standing inside the nurse’s station and surveying the ward when a patient who had been placed on one-to-one supervision because of his violent tendencies began to sprint down the hallway.

According to Garner, the patient had done this before and usually ran harmlessly to the other end of the hall. But this time, he turned and leapt over the Plexiglas divider that separates the patient area from the nurse’s station.

“My instinct was I took a chair and put it in between us,” Garner said in an exclusive interview.

After that, Garner said her memory is foggy, but she recalled being on the floor with the patient’s hands around her neck and his teeth grinding into her left ear.

“Choking me and biting me at the same time,” she said.

The attack on Garner that September evening was the third serious patient-on-staff assault at Western State Hospital in a two-month period. In August, two other members of the nursing staff had been pushed to the floor and stomped by patients, according to press reports and hospital administrators. One of the nursing staff who was attacked appeared so bloody that a coworker thought she was dead.

The violent attacks were cause for fresh alarm at the troubled 850-bed hospital that lost federal certification last June after a multi-year turnaround effort that came up short. After the first two assaults, frontline workers rallied outside the hospital and demanded more protections, including better staffing at the hospital, which has struggled to recruit and retain workers. Meanwhile, inside the hospital, administrators began putting together a plan of action.

“Our goal is that no assaults happen,” said Sean Murphy, deputy CEO of Western State Hospital.

Murphy attributed the rise in assaults to a younger, more complex patient population. That population includes some who arrive at the hospital as forensic patients, meaning they’re involved in the criminal justice system, and then over time become civil patients, non-criminal patients who have been civilly committed by a judge because they either pose a threat to themselves or others or are deemed gravely disabled. They are known as “forensic flips.”

“That’s kind of a recent thing where folks come in, aren’t found competent and inevitably get flipped over to a civil commitment … but then end up being violent,” Murphy said.

In recent weeks, Murphy said Western State Hospital has taken a number of steps to improve safety. That included putting more security staff on violence-prone wards and mandating additional training for staff. The hospital has also deployed a psychiatric emergency response team that responds when a patient is starting to escalate. Another team is working directly with the 10 patients at the hospital who have been identified at the most violence prone.

Longer term, the goal is to secure funding from the Legislature to open a new ward called the Specialized Treatment, Assessment and Recovery (STAR) ward, specifically for those 10 highest risk patients. In the new ward, those 10 patients would get intensive, evidence-based therapies. Eventually, the hospital plans to open a second, 20-bed ward to help patients transition from the STAR ward back into the general population.

The hospital has also gotten approval to enclose all nurses’ stations, beginning with the ward with the sickest patients as well as the ward where patients are first admitted. That project will take a couple of years to complete and cost an estimated $1.4 million.

On Friday, Washington’s Department of Labor and Industries confirmed it has begun a workplace safety “inspection” of Western State Hospital. It’s not the first time L&I has investigated safety conditions at the facility.

Murphy, the deputy CEO, said assaults on staff tend to ebb and flow. According to data provided by the Washington Department of Social and Health Services, over the last three years Western State Hospital employees have filed 682 workers’ compensation claims related to assaults on the job. Fifteen of those employees never returned to work at the hospital.

For Garner, who returned to nursing school late in life after moving to the U.S. from the Philippines, the assault was physically and emotionally traumatic. Her injuries included a large contusion on the back of her head from striking the floor, a fractured sacrum, and a missing left earlobe. Her daughter, Danielle, who also works at Western State Hospital, said at first they thought the patient swallowed the piece of ear. But Danielle later found it in her mom’s clothes. Doctors stitched it back on.

Since the assault, Garner said she’s suffered debilitating headaches and dizziness and needs assistance walking. She’s getting care at a rehabilitation facility in Tacoma.

“My goal now is to gain back my strength and set aside what happened to me,” she said.

But in order to move on from the trauma, she said there’s something she desperately wants: reconstructive surgery to repair her re-attached earlobe which doctors have told her is likely to fall off.

“I don’t want that every time I face the mirror, this accident is going to haunt me for my life,” she said.

Garner says she would like to return to work. But she doesn’t know if that will be possible. 

In November, Garner filed a tort claim against the state alleging that Western State Hospital violated her constitutional rights by "creating a dangerous work environment." The tort claim was first reported by the Associated Press. Garner is seeking $5 million in damages. A tort claim is a precursor to a formal lawsuit. The state of Washington typically does not comment on pending litigation. 

The patient who police say attacked Garner has been charged with second degree assault. A declaration for determination of probable cause in the case makes reference to the patient previously assaulting other staff and patients at Western State Hospital.

But Garner said she doesn’t blame him.

“It’s the illness,” she said. “It’s the illness.”

Update: The original version of this story did not identify Bernia Garner by her full name because she requested anonymity as a victim. However, the story was updated on November 9 to include her full name after Garner filed a tort claim against the state seeking damages in connection with her assault. 

Clarification: This story previously said Western State Hospital hoped to open its new STAR ward by January. That was based on comments made by the deputy CEO of the hospital, Sean Murphy, in an interview. The story has been updated to reflect the fact that the Department of Social and Health Services says funding for that new ward has not been secured and the STAR ward won't be open by January. DSHS does not have an estimate for when that new ward will be opened.