At some point in all of our lives ourselves, a family member, a close friend, or someone else that we care about requires medical care. During this time, one of the saving graces throughout such a stressful period is the amazing nurses that dedicate their lives to the care of others. Sadly, statistics state that a large percentage of these devoted individuals face both verbal and physical abuse within their jobs on a regular basis.
Tracy Zambory, President of the Saskatchewan Union of Nurses (SUN), spoke to the Martensville Messenger regarding these surprising statistics. “It is starting to seem that it should be the norm that if you work in healthcare, in mental health, home care, long term care, emergency room, etc. that being hit is just the price of business. We are saying that there is absolutely no way that anyone should come to work and expect to get hurt,” Zambory said. According to the International Council of Nurses, it is estimated that 70 to 80 percent of assaults do not get reported. The incidents that do get reported have led to healthcare being among the top sectors in which violence is a leading cause of injury. In 2016, the Saskatchewan Worker’s Compensation Board (WCB) provided statistics stating that registered nurses were among the top five occupations with injuries by violence, even coming in ahead of police officers. The report also stated that patients and residents of healthcare facilities were the most frequent inflictors of violence. For 2016, 8.84% of time loss injuries within the healthcare industry were caused by assaults, violent acts, attacks and harassment.
Alarmingly, these numbers also showed that 61% of surveyed nurses had experienced abuse, harassment or assault that year and that 1 in 3 registered nurses within the province had been physically assaulted by a patient, and more than half experienced emotional abuse.
These statistics are not something that SUN wants to see continue, and they are working hard to ensure steps are taken to prevent incidents such as these from taking place. “We want to ensure that through a collaboration with the new Saskatchewan Health Authority that we can start having open and honest dialogue about what is happening in the workplace, what we can do together to actually ensure that these kinds of attacks are a thing of the past, and we really think that we have some good recommendations about how we can prevent this from continuing,” Zambory added.
Recently, there was a violent incident that took place at the Dube Centre in Saskatoon, which many people heard about via social media. This incident sparked interest into the violence that nurses face on a day to day basis, but unfortunately, occurrences such as that one are not isolated. If a violent situation does take place, SUN currently has language within their collective agreement that triggers actions that take place immediately to ensure that those involved are properly taken care of. In addition to what is already in place, SUN is looking to implement long term strategies to help avoid the situations from happening entirely. “We are finding that some members are being instructed not to say anything if an incident does happen, and that if they are going to work in a certain area, that this is what can be expected. We have seen job postings that actually state that violence should be expected. We say absolutely not. Nobody should expect to get hurt when they go to work. We cannot tolerate that as SUN and we shouldn’t tolerate it as a public either. That is no way to think that a vibrant, well run health care system in this province should run,” added Zambory.
One of the recommendations that SUN has included is ensuring there are appropriate staffing levels and staff mix on all shifts within units. “This does not necessarily mean there needs to be more staff hired, we just mean that there needs to be a really strong look at the patient needs on that unit for us to decide what the appropriate number of staffing is and we need to be able to look at the ‘junior/senior mix’, so that we have enough senior staff who are well acquainted with the patient population and who understand what it means if there is a potential for violence. That doesn’t mean because there is a potential for violence, you should automatically assume you are going to get hit, that means that we are smart as workers and as management to realize that the potential is there and that we have all the proper checks and balances in place,” Zambory said.
Another recommendation is ensuring that all staff that comes into these units are properly oriented, educated and that they have a supportive environment that they can work in. Part of this is working to ensure that there are proper protocols in place, being prepared for the situations that could transpire and how to work together to stop it before it can actually occur.
“We need to make sure that there is the appropriate care plans put in place so that when a patient is admitted into the ward or into homecare, that we have been able to take the time to prepare a plan so that we can understand this persons background, that we have had the time to sit down and create a holistic plan for someone, whether they have the potential for violence or not. This will help to understand what it is they need, what it is they may want and how they may react to certain situations. That is what a proper care plan does,” explained Zambory. She also stated that the province is currently running 20% over capacity in health care facilities, which can lead to the potential for some issues.
The Canadian Federation of Nurses Unions implemented a Plan to Stop Violence in the Health Care Sector for 2017-2018 and within this plan they highlight various steps that can be taken to help provide a safer environment for both workers and patients. Some of these steps include;
– Identifying barriers, enablers, and potential police and legislative levers.
– Working with member organization to strengthen and improve OH&S legislation so as to create safe workplace standards for health care workplaces.
– Develop and deliver a communications strategy to bring national attention to the issue of violence against nurses.
– Host a national roundtable on violence in healthcare.
– Conduct a national survey to obtain data on workplace violence from all provinces.
– Develop and Work with member organizations to ensure meaningful and consistent enforcement of OH&S legislation and consistent reporting, as well as strong language around the prevention of violence & bullying in health care workplaces, through risk assessments, education, training and emergency preparedness.
– Lobby for memorandums of agreement (with the Crown and police) to improve the process of investigating workplace safety incidents and the subsequent laying of criminal charges against patients who assault nurses.
– Lobby for charges to be laid under the federal Bill C-45 (The “Westray Bill”) for organizations and individuals who fail to ensure the safety of workers and the public.
– Lobby for amendments to the federal Criminal Code (section 269.01) to require a court to consider the fact that the victim of an assault is a health care worker to be an aggravating circumstance for the purposes of sentencing.
– Lobby to include health care workers and physicians in the PTSD presumptive legislation framework federally.
– Develop a national violence toolkit highlighting best practices in health care sectors.
This issue is not something that is occurring just within our province, or even within our country, violence within healthcare is a worldwide issue that is taking place. In the CFNU ‘Enough is Enough: Safe Workplaces for All’ report, they state that physical violence was most prevalent in emergency departments, geriatric and psychiatric units. They also note that this kind of violence has a cascading effect, impacting the psychological and physical wellbeing of health care staff, their job motivation, compromising the quality of care, and leading to health care sector financial losses.
Currently, Saskatchewan has a Provincial Violence Prevention Framework strategy in place through the Saskatchewan Association of Safe Workplaces and Health that is looking into developing strategies on how to avoid violent occurrences. One of these methods includes a tick sheet that describes potential violent situations, and by filling in the sheet, you can see that there is a patient that may perhaps require additional focus to ensure that people are kept safe. “The whole idea behind this is to be able to circumvent something at the front end, rather than trying to clean up at the back end, which is kind of where we are now, and hopefully we can get this turned around and we can start working in a collaborative, proactive way to ensure that people are safe. At the end of the day, this is all about how we can best serve the patients of this province and when we have the proper protocols in place, when we have appropriate staffing levels, proper orientation, this can benefit not just the worker, but the patient as well, and that’s truly what is important.”