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Nurses in contract talks with Twin Cities hospitals are asking for protections from being hit, spit on, shoved and yanked by confused or agitated patients.

While pay and other benefits are key issues, negotiators for the Minnesota Nurses Association said that workplace safety has emerged as a priority because nurses are fed up with the risk of violent injuries and want their labor contracts to hold hospitals accountable for their safety.

Nurse Mary McGibbon wore a sling to contract talks with Methodist Hospital in St. Louis Park on Monday, saying she had suffered an elbow injury when a panicked, breathless patient pulled on her arm. Such accidents can be difficult, but deliberate assaults by patients also can be traumatic, she said.

“These can be life-changing attacks,” McGibbon said. “Some [nurses] can’t go back to the bedside.”

The nurses have been negotiating since late March with the Allina, Children’s, Fairview, HealthEast and North Memorial Medical Center systems, as well as Methodist. With current contracts expiring on May 31 and no deals so far, the union is preparing plans to picket the hospitals.

The talks are the first since 2016, when a dispute over health insurance benefits prompted Allina hospital nurses to go on two strikes for 44 days.

Addressing workplace violence has been a shared concern for nurses and hospitals, which are seeing more complicated cases and an increase in patients with mental health conditions.

Workers’ compensation claims for nurses who were seriously injured by intentional assaults in hospitals increased from 31 in 2013 to 70 in 2014, and have remained at or above 65 every year since, according to the Minnesota Department of Labor and Industry. Those claims count only the most severe cases involving indemnity payouts to nurses who were disabled three or more days due to the attacks.

However, the union and the hospitals differ on whether the issue should be part of labor contracts.

On Monday, Methodist negotiators tentatively agreed to give assaulted nurses time off before workers’ compensation determinations are made and to switch nurses off caring for patients who harmed them. The talks have stalled due to differences over pay hikes, though.

“We’re proud of the work we’ve accomplished with the MNA at the bargaining table,” said Ashley Burt, a spokeswoman for Methodist. “Together, we acknowledge that workplace violence is an important topic.”

On Tuesday, Children’s and union negotiators discussed but did not agree to terms for addressing violent injuries. Final scheduled talks with other hospital systems are set for later this week.

Patient swings a metal bar

Legislative efforts to improve hospital safety accelerated after a 2014 incident in which a confused patient charged through St. John’s Hospital in Maplewood, swinging a metal bar and striking and injuring four nurses. The patient died as police struggled to subdue him outside the hospital.

A 2015 law requires hospitals to train their staffs on de-escalating stressful situations and preventing violence. It also required that the hospitals track and review their safety plans and violent incident reports each year.

A summary of injuries at Allina Hospitals in 2018 was provided to union negotiators, as also required by state law, and it underscored the breadth of the problem.

One nurse at Allina’s Abbott Northwestern Hospital was bitten while holding down a patient for several minutes until security officers arrived. A Mercy Hospital nurse was struck in the eye while trying to give injectable medication to a patient. Another Mercy nurse suffered a fractured rib when he tried to remove a bracelet from a patient who kneed him in the chest.

Abbott nurse Michelle Smith is still undergoing vision exercises as she recovers from a concussion she suffered nearly two years ago when a patient “sucker punched” her and also broke her nose. Smith has returned to patient care in the surgical recovery unit, but said she would welcome more prevention and support efforts to make sure she doesn’t get hurt again.

“There’s that fear,” she said. “You still treat your patients the way you’re going to treat your patients, but there’s that thing in the back of your head — ‘could this happen again?’ ”

Jeremy Olson • 612-673-7744