A joint Senate health and judiciary committee hearing drew a handful of hospital workers and their doctor, who gave lawmakers an earful about the growing problems on the job at the Hawaii State Hospital in Kaneohe.
Their concerns ranged from staff and patient safety to fears about a hostile workplace.
“I got knocked out a couple of times. One of the patients said he was actually going to break my neck,” said psychiatric technician Ryan Oyama.
One by one workers told their horror stories.
Their doctor, who said he treated six hospital workers during an eight-month period, felt he had to say something before someone died.
“Something has to be done because we are going to a have a death, whether its a death of an injured worker or a patient, this goes beyond a simple assault," said Dr. Scott Miscovitch.
The state labor department has also launched a probe into workplace safety but it may be months before it determines if it will issue any citations.
Health officials laid out the challenges of a growing, and more violent and psychotic population of patients.
Lawmakers also grilled them about short-staffing and training programs.
But there are new claims of nepotism and promotion of untrained staff, as well as letters written by workers who shared their concerns because they are too afraid to speak publically.
Others said they fear retaliation from mid-level bosses.
"I did my job, but I got reprimanded and I got moved off my unit," said psychiatric technician Kalford Keanu Jr.
"There are so many people who are silently suffering because they failed to reach out or who are suffering because they are being threatened. So I think there should be some screening mechanism for those who are suffering," said Miscovitch.
"This thing is a can of worms that is going to be very difficult to unravel. It is multifaceted. Everything is in writing and that's why I think a subpoena is necessary," said Sen. Clayton Hee.
There is also a growing concern about a disconnect with how violent patients are treated in prison and at the hospital. They are in shackles and under heavy security one day, and then let loose at the hospital with little for hospital staff to protect themselves against violent outbursts.
“I think the discussion we are going to have is to the treatment of these patients and the laws that govern the two departments,” said Public Safety Director Ted Sakai.
But there will not be a quick and easy fix.
"Whether or not we have to build a forensic hospital to both... to put the people who are the greatest threat to society in there, while we protect some of these workers," said Sen. Josh Green.
Lawmakers plan to ask for subpoena powers on the first day of the legislative session.
The hearings could last several months.