Since my arrival at St. Joseph’s Healthcare Hamilton as president one year ago, I have made it a point to start each day by reading through the details of every safety incident report submitted by staff. What I read concerns me.
Every day, nurses, physicians, personal support workers and students document a spectrum of abusive behaviour they experience in providing care. They are kicked, punched and subjected to sexual harassment. This violence is not only physical. It often takes the form of verbal aggression and abuse, as well as racism toward Black, Indigenous and people of colour (BIPOC). It also is not only violence resulting from mental illness. Incidents occur in all types of care areas and are on the rise.
This is not only a challenge for St. Joe’s in Hamilton. Across Canada, health-care workers are assaulted on the job every day by the very patients and family members they are trying to help. In 2019, the House of Commons Standing Committee on Health reported that 61 per cent of nurses, 74 per cent of paramedics and 89 per cent of personal support workers are subject to harassment and physical abuse annually. The committee also reported that nearly 50 per cent of all hospital-based violence occurs in emergency departments. Violence toward health-care workers is not only a Canadian problem. According to the World Health Organization, it is estimated that between eight and 38 per cent of health-care workers suffer physical violence during their careers.
In 2017, based on work of the Ontario Hospital Association (OHA), Ontario’s Ministry of Health (MOH) made a series of workplace safety recommendations, including the requirement for hospitals to include violence prevention as part of annual quality improvement plans. As a result, St. Joe’s, like most other hospitals, implemented several strategies to combat incidents of violence and abuse, including the introduction of additional security personnel, cameras, panic alarms and enhanced safety training.
Anger, a lack of civility, violence and abuse have become part of a larger societal problem. You can see it underscored by signs and warnings in retail stores, customer service departments and public offices asking people to be nice to the staff who work there. The challenge we face on the front lines of health care is that even in the face of abuse, we must contend with the moral and ethical framework that puts care of the patient first. We simply can’t refuse service to an abusive client like a private business.
It is impacting morale, staff turnover and clinical outcomes.
Still, it is impacting morale, staff turnover and clinical outcomes. More needs to be done. Legislatively, some nursing leaders have called for nurses to be designated as public safety personnel and be included in presumptive care legislation that is afforded to paramedics, firefighters and police officers. This idea has merit and has been extended to nurses in Ontario. But we must also ensure our allied health and non-clinical support staff who interact with patients and families are also included. New hospital building designs must also incorporate workplace safety including things like more technology, more windows and double entry and exits. And if all else fails, we must not be afraid to utilize protections we all have under the criminal and human rights code to protect our physicians and staff from harm.
Despite the challenges, we must remember that the vast majority of patients and families treat our staff with dignity and respect. I hear many stories from patients who are incredibly grateful to the health-care workers who have been part of their circle of care.
But it is simply not right that every year, hundreds of staff members experience violence, aggression, assault and abuse on the job. No one should feel unsafe in their place of work, and it’s time to do more to protect our health-care workers. At St. Joe’s we do not have all the answers, and we know we won’t solve this alone overnight, but we can commit to trying and we do.
Security presence in uniform is a huge deterrent to fear of all, rapid intervention in the ED when the behavioral norm is in question. Aggressive outbursts with vulgarity and physical assault are all too common in ED’s across America. Medical staff are exposed to situational violence in the ED daily,
Solution
High visibility officer in those areas.
A well-trained officer in de-escalation, crisis intervention along with a firm supported code of conduct is the answer to the issue, no nonsense proactive approaches will resolve these issues drastically decreasing these events and.
72 percent of hospital employees arrive to work in fear either emotionally or physically every day in America. What does this do to productivity, retaining needed medical and ancillary staff, the produictivity dips up to 10 percent when these conditions exist in your facilities. it can change and change fast. the building of a worki9ng relationship with law enforcement, the implementation of trespass orders as we4ll as strict adherent to the code of conduct are some of the components that need to be cemented down in order for this to work., I know it works, we do it and it works.
Jim Yeaman
BMC safety and security Manager.
What about for the staff who are exhibiting these behaviours against other staff in isolated circumstances? How do you suggest human rights are preserved behind closed doors? The workplace violence in this hospital’s operating room is alarming.
I was paid to leave my job after reporting sexual harassment, assault & workplace violence in this operating room. All radio silence from Mike, the president of this hospital’s operating room. All behaviours from another nurse. All cameras spun around to face the walls. This hospital is in court for similar behaviours as we speak against other staff. As well, dozens of concerned community members and nurses have reached out to Mike the past two weeks without a response. Finally, this blog post is half of an email Mike sent to all staff in the summer, where he shared he was saddened that we are punched, kicked and spit on. Mike doesn’t care about his nurses, he cares about his hospital’s image. Hope this helps!
This article sounds like you’re trying to address the abuse healthcare workers face from patients, which is definitely a major problem. You fail to address the abuse alleged in your own hospital from other healthcare worker into their peers. When are you going to grow a pair and talk openly about the abuse your hospital has worked to cover up?