KANEOHE, Hawaii -- A doctor and nurses at Hawaii State Hospital on Monday said that attacks on staff by mental patients are growing more frequent and more serious.

The workers said that managers are not providing enough staff or training to ensure the state's mental facility is safe for patients and employees.

"The first swing I put my feet up, pushed him back in the chest," nurse Terry Evans said.

Evans described the moments when she said mental patient Curtis Panoke assaulted her in January.

Photos of her right after the beating show bruising and swelling.

"He had repeatedly beaten me, crushed my whole bottom orbital, my eye was displaced, fell into my socket," Evans said.

Evans said that two health aides on either side of her froze and did not do anything to stop the man at first. Another patient protected her while the aides pulled him off her, Evans said.

"What is so devastating about that is that those two staff members have not received any additional training," she said.

State hospital officials said that was the most serious assault on a staff member in about six years. Officials held a staff meeting right after and are considering new training because of it, they said.

However, officials said they have not heard all of the details Evans told the media on Monday.

"I'm not aware before this of the specific issues she's raised in terms of the staff aides that were nearby not responding, but it's a continuing challenge to make sure that the staff are well trained," state hospital administrator Mark Fridovich said.

The hospital administrator also said he had not reviewed a surveillance videotape of the incident, but that the nursing director and safety officer have.

"I'm very afraid that another nurse or another patient will be killed out there, because nothing is changing," Evans said.

Dr. Karen Ritchie resigned from the state hospital on Friday, because she said there have been five assaults on doctors in the last two years.

"I'm really concerned that if something doesn't happen, someone's going to get killed," Ritchie said.

"There definitely have been in the past several months more incidents involving doctors, but it isn't clear that overall there's been an increase in assaults in the hospital," Dr. Thomas Hester said.

Assaults on staff are not on the upswing, hospital officials said. They recorded 170 assaults in 2004, 133 the next year, 187 last year and 107 so far this year, they said.

The state said it has the same staff to patient ratio, one employee to every 3.5 mental patients, that it had when it was released from federal oversight in fall 2005.

Kaneohe state Sen. Clayton Hee said he may ask the federal government to consider oversight of the state hospital once again.