After completing medical school in Salt Lake City, Golomb relocated to San Francisco for her residency at California Pacific Medical Center, part of Sutter Health.
She harbored ambitions of practicing psychiatry in the Bay Area and hoped to establish her own private practice in the future.
“That’s why I went to medical school. Most people go in because they are passionate about medicine,” she recounted.
“I went in because I was passionate about working with individuals in therapy.”
However, her vision was drastically altered following a violent attack that occurred shortly after she began her residency.
The incident left Golomb’s life and career in turmoil, leading her to commit herself to enhancing safety protections for her colleagues in the healthcare field.
In her pursuit of change, Golomb shared her traumatic experience with KQED, which prompted the California Division of Occupational Safety and Health, also known as Cal/OSHA, to initiate an investigation into the hospital’s psych unit where the attack occurred.
This investigation, which concluded last fall, revealed significant concerns regarding workplace violence regulations within California’s healthcare sector.
“I put so much work into providing investigators with as much information as I could, sending them documents, talking to nurses about the importance of reporting incidents,” Golomb explained.
Her efforts highlighted the deficiencies in the safety protections that were supposed to be in place for healthcare workers at the facility.
The investigation uncovered multiple instances of attacks on staff at California Pacific Medical Center’s inpatient psych unit.
One shocking case revealed that a nurse had suffered broken bones after being assaulted by a patient, an attack that ultimately led her to never return to her position.
In another incident, an occupational therapist described a harrowing experience in which a patient physically lifted them off the ground during a group exercise.
The therapist recounted the threatening words the patient used, stating, “He said if I don’t get to talk to the judge, ‘I am going to kill her.’”
Fortunately, a security guard intervened to de-escalate the dangerous situation.
In 2022, two years post-attack, Sutter Health made a notable change by relocating the inpatient psych unit to their Davies Campus.
Reportedly, the hospital invested roughly $40 million to enhance safety, including installing cameras, panic buttons, and secured doors.
Additionally, staff members gained direct access to security personnel via phones and voice-operated devices, thus fostering a safer environment within the unit.
However, despite these improvements, Cal/OSHA’s report detailed several failings on the hospital’s part regarding security training, staffing levels, and the communication of incident responses.
The report identified concerns about inadequate physical barriers between patients and clinicians and even highlighted areas where staff members were at risk due to broken elevators and insufficient emergency exits.
Golomb found the details in the inspection report validating, affirming her concerns about safety.
Yet, she was disheartened to learn that her specific case fell outside the statute of limitations for enforcement action.
“I was like, ‘Wait a second, this is off the table?’ That was the impetus for this investigation,” she expressed.
In the wake of the inspection—prompted by KQED’s reporting—Cal/OSHA issued two minor citations against the hospital, totaling $1,575.
This fine included $525 for not maintaining proper emergency exits and $1,050 for failing to implement their workplace violence prevention plan.
According to labor code regulations, citations must be issued by Cal/OSHA within six months after a violation occurs, but Golomb’s assault seemed to have gone unnoticed by regulators until she publicly shared her story.
Although the hospital was legally required to report Golomb’s violent incident within a specified window, Cal/OSHA had no record of it.
While Sutter Health acknowledged some shortcomings regarding the initial reporting of the assault, they maintained they recorded the incident in an injury log submitted to the state.
Garrett Brown, a former Cal/OSHA inspector, voiced his frustration over how regulators could handle such cases, emphasizing that the statute of limitations should extend based on when Cal/OSHA became aware of a violent incident.
Brown illustrated that it was “outrageous” and personally upsetting that the organization overlooked Golomb’s assault.
In response to Cal/OSHA’s findings, Sutter Health maintains that their safety measures met state requirements and the hospital is contesting the issued citations.
A spokesperson for the hospital stated, “Providing a safe place for employees to work and patients to receive care is our top priority.
We continually reevaluate our procedures and facilities to ensure we are providing the safest possible environment.”
Golomb, however, felt that the citations were far too minimal and referred to Sutter’s appeal as a personal affront.
“Seeing this was just like, ‘Oh, right, nobody cares about enforcement,’” she lamented.
She emphasized that her concerns were not just about her case but about the overall safety conditions for workers in healthcare settings.
Adding to the challenges facing Cal/OSHA, Brown pointed to significant understaffing issues, citing that only two inspectors are responsible for overseeing all workplaces in San Francisco.
This has resulted in enormous pressure on the district manager to manage an overwhelming workload of inspections, complaints, and accidents that continue to pile up daily.
Despite the challenges, Cal/OSHA’s communications deputy director, Daniel Lopez, contended that the number of inspectors does not solely dictate the pace of investigations.
He emphasized that Cal/OSHA prioritizes inspections based on imminent hazards and serious complaints, asserting that they were actively recruiting to fill vacancies.
California has some of the strictest workplace violence regulations in the country, having implemented them in healthcare settings since 2014.
Senator Alex Padilla, while serving as a state lawmaker, crafted legislation to ensure safer workplace environments for healthcare providers but later acknowledged that further improvements are needed.
At the same time, the California Nurses Association expressed its concerns about state enforcement capabilities and hospitals’ underreporting of violent incidents.
Motivated by her experiences, Golomb took on an organizing role alongside her colleagues to advocate for better protections.
Together with her fellow residents, she joined the Committee of Interns and Residents, part of the Service Employees International Union, where they engaged in challenging negotiations with Sutter Health.
Their efforts included an appeal for round-the-clock security in the inpatient psych unit—an essential demand following Golomb’s assault.
Members of the San Francisco Board of Supervisors expressed their support for the cause in a letter to Sutter Health, emphasizing that healthcare workers deserved safety in their work environments.
Ultimately, the residents and Sutter Health reached a contract agreement in October, securing increased salaries, housing stipends, and support for professional development.
However, the key demand for around-the-clock security was not included in the final agreement.
Reflecting on the outcomes of her advocacy, Golomb felt a deep sense of disappointment, questioning whether she had fought hard enough for the necessary changes.
She wrestled with the circumstances, recognizing how drastically her experience altered her residency journey.
“One that could have ended my career in medicine. Then to have a brain that has changed because of it,” she acknowledged.
Despite the struggles, Golomb has made significant strides in her recovery and continues to focus on her medical career aspirations.
As she looks forward to graduating at the end of June, she expresses excitement about taking the next steps in her career, including planning to start her private practice in the San Francisco area, close to California Pacific Medical Center.
“It’s very exciting,” she admitted.
“But it’s very much like being a senior in high school and you’re just like, ‘Come on, let’s go.’”
image source from：https://www.kqed.org/science/1996726/a-brutal-attack-upended-her-life-it-also-exposed-gaps-in-californias-hospital-safety-laws
