By DALE SINGER
Having a baby is stressful. Having a baby in the neonatal intensive care unit multiplies that stress exponentially, sometimes to the point where it threatens the peace and security of a hospital floor.
Bob Boehmer, a veteran security guard at SSM Health Cardinal Glennon Children's Hospital in St. Louis makes regular rounds as part of the patient care team. He is shown here in the neonatal intensive care unit with NICU nursing team leaders Kimmie Pacatte, left, and Kate Madden.
By having a security officer rounding as part of the care team in the NICU, SSM Health Cardinal Glennon Children's Hospital in St. Louis has installed a pressure valve to help ensure that the stress doesn't boil over and put staff, patients or others at risk.
The approach gives security officers, who go through communication and verbal de-escalation training, the opportunity to build rapport with parents and family members early in a child's hospitalization and to do so as members of care teams rather than authoritarian figures. SSM Health is rolling out the enhanced security program known as purposeful patient rounding across its four-state system.
In hospitals that care for adults, the officers round in intensive care units, emergency rooms and behavioral health units — places where anxiety runs high and tempers may fray. The concept of purposeful rounding is akin to community policing, where officers get to know a neighborhood's residents to identify and solve problems proactively. To explain how the approach works in a health care setting, Bob Boehmer, a veteran security guard at SSM Health Cardinal Glennon recalled a situation from last year, not long after the hospital started purposeful patient rounding.
The NICU nursing staff called security because the distraught mother of a NICU patient was verbally abusive to staff. At Cardinal Glennon as at other SSM Health hospitals using the security rounding format, the officers work closely with nursing staff to identify potential security concerns.
"She was having a very hard time," Boehmer said of the mother. "She was pretty worked up, crying and hysterical. She felt like that was how she had to get her point across." Security officers listened to her concerns and frustrations, calming her as they did so.
After that, during their regular rounds in the NICU, Boehmer and other the security officers made it a point to engage the mother in conversations. Since NICU babies frequently have long hospital stays, security officers often get to know families.
"Once she had somebody to talk to, I think she learned that (verbal aggression) was not necessarily the way to go about things," Boehmer said.
Kate Madden, the nurse leader on the NICU floor, said the mother was a night owl, and once she got comfortable with the security officers, she opened up to them in late night chats. "It's no different for our security guards than it is for a nurse," she said, "It's a presence." Respectful, authentic communication eases anxiety. "The security guards understand they're in a Catholic hospital, and they are deeply invested in our mission, to reveal the healing presence of God," Madden said.
The mother shared that she felt hopeless. "We were able to change the services we were giving to her," Madden said. Hospital spokesperson Denise Nazzaro explained that the pediatric hospital provides a wide range of treatments and services for families with sick newborns. "Each situation is unique," she said.
Boehmer said the woman "comes back and talks to us." Nazzaro said it's not unusual for NICU alumni families to update staff about their well-being.
It is no surprise that tension can run high for NICU families and Madden said that can fuel arguments between family members and incite outbursts toward staff. Just having the security officers as a regular, visible presence on the floor can head off confrontations, especially when the officers have established a cordial relationship with patients or families, who come to accept them as part of the care team.
Boehmer has worked at Glennon for 28 years. He said that purposeful rounding helps prevent extreme, aggressive confrontational behavior that can lead to a parent or other visitor having their visiting privileges restricted. (On rare occasion, a parent may be told that he or she can visit their child at set hours and then only with a security guard escort).
Todd Miller, the regional public safety and security specialist for St. Louis-based SSM Health, said the purposeful patient rounding program grew out of concerns over the increased frequency of violence in health care workplaces in the U.S. "There has been a growing trend nationally that's been identified by OSHA," he said, "and it's been going upward at an alarming rate. We could see some of those trends, and we wanted to get ahead of the curve."
Miller, who is a former FBI task force officer and St. Louis police detective, said the individuals assigned to the purposeful patient rounding program have crisis prevention and people skills.
With the early intervention and the rapport that the security officers have built with patients as part of their daily routine, what had been an average of 34 calls per month to handle disruptions at one particular SSM Health hospital has dropped to under 16.
Boehmer said security officers view the approach quite positively. "It makes us much closer to the situations that we're involved in." Nurses and other clinical staff "include us in everything — they actually call us and ask questions about the parents or specific patients. It's very nice to be involved like that, instead of just being called up to the floor when there's a problem." Being a part of the care team is "one of the most enjoyable things we do."