A psychiatric nurse says she and her colleagues are being pushed to a breaking point, and she quit her dream job due to violence

• Laura Yeager said she was forced out of her job treating psychiatric patients due to injuries sustained on the job.
• Amid a nurse staffing crisis, more psychiatric nurses are leaving due to violence.

In her five years as a psychiatric nurse in Missouri, Laura Yeager had been bit, kicked, slapped, and spat-on numerous times. Once, Yeager said, a teenage patient put her in a chokehold. Another time a patient kicked her in the head after she attempted to restrain them.

Despite the violence she endured, Yeager said she empathized with her young, vulnerable patients. She understood that, when they lashed out, it was in frustration for being unable to communicate their needs.

"When you work on a behavioral health unit," Yeager told Insider, you have to understand "it runs on chaos. I mean, that's just the nature of it."

In 2021, however, she reached a breaking point. As she mustered all her strength to restrain a violent patient, she felt an awkward twist in her back. Pain shot through her body so intensely that she couldn't push through any longer. Over the next few months, it dawned on Yeager that she would have to quit the job that means so much to her.

Nurses getting injured due to violence on the job isn't a new story. Federal data shows hospitals are among the most dangerous places to work, and nurses get injured at a rate higher than all other occupations.

But abuse against nurses has gotten worse since the start of the pandemic, union leaders say. Now, nurses are quitting in droves, leading to staffing shortages that put the remaining qualified nurses under even more pressure.

Yeager says she was trying to play her part in "an already overloaded part of the medical profession," but for her and many others, it has become untenable.

"I'm a very strong advocate for the behavioral health population, because that's what they need. I'm angry that I got injured, I'm angry that I can't do it," Yeager said. "The fact that more people are getting injured and more people are leaving the bedside of behavioral health... It's a recipe for disaster."

Avoiding violence at work is not really an option, Yeager said

The country's largest nurse union found that, in October 2021, a third of US hospital nurses reported an increase in workplace violence. Just six months later, they ran the survey again, and that figure shot up to 48% — nearly half of hospital nurses across the country.

Yeager says she had been receiving more challenging cases over time, because of her years of experience and talent for dealing with the most difficult patients.

She took a strict yet empathetic approach with her patients, assessing which ones would respond better to verbal deescalation or "responsible restraint."

But, in her 40s, she was among the oldest clinicians on the unit, Yeager said, and she began to worry more about the physicality of dealing with difficult patients.

"I said, 'I am probably one of the oldest nurses here, and I'm being given the worst patient assignments because I have the behavioral health experience," Yeager said. "And lo and behold, three hours later, I got injured."

Under-staffing made it impossible for Yeager to avoid physical work, she said

After her injury, Yeager couldn't work for three months. Her doctors said, no matter how well she progressed in physical therapy, she should be given less physically-straining work when she returned from medical leave.

Under-staffing made that near-impossible. In the months Yeager spent sourcing for remote desk jobs, she was repeatedly assigned to patients with severe psychological conditions who were more likely to become violent.

The nurse said she would do whatever she had to "to get through the day," including relying on pain medication and removing herself from strenuous situations. "I probably ended up doing more damage to my body."

Without intervention, worsening mental health will result in more nurse injuries, Yeager said

The rise in workplace violence against nurses stems directly from short-staffing, National Nurses United president Jean Ross told Insider. Longer wait times can aggrevate patients, and insufficient staff results in fewer people to help deescalate violent situations.

The union has advocated for a bill that would require healthcare facilities to maintain sufficient nurse staffing. The bill passed in the House last year and awaits Senate approval, Ross said.

Yeager believes, from what she saw in the psychiatric ward, the widespread death and isolation during the pandemic has "absolutely" worsened the mental health crisis in the US. Behavioral health patients have become more frustrated and angrier, she said — heightening the risk of violence towards nurses.

Though Yeager does not know the solution, she predicts both patients and clinicians will suffer without more resources devoted to psychiatric health and nurse staffing.