Canadian Occupational Safety

20 Canadian Occupational Safety | www.cos-mag.com that state of mindfulness." If a violent incident does occur, a robust investigation must be con- ducted. All involved parties must be interviewed, including the patient. "The patient may have insight that may help. How did they feel before it happened? Was there a trigger or something that caused them to esca- late? Is there anything we can learn from that event?" says Van hulle. The occupational health and safety manager should look for trends across incident reports and conduct a root cause analysis to really get to the bottom of why the incident occurred. Is it a lack of preparedness? Lack of equipment? Poor communication? Is one particular staff member a trigger for one patient? Is a patient reacting poorly to new medication? Then the OHS team can implement appropri- ate strategies and controls. It's also very important to circle back to the worker who was the victim of violence once action has been taken, says James. "It really validates them. They think 'OK, people took this seriously and they've addressed it.'" Ontario is amending its Occu- pational Health and Safety Act to require employers to inform workers of the results of a workplace violence investigation and of any corrective action being taken. GIVE STIFFER PENALTIES BCNU is calling for harsher sen- tences for individuals who are violent towards nurses. Ryan Stard, the man who attacked the nurse at the Abbots- ford Regional Hospital in 2015, did not serve any jail time for his offence. The judge said there was no defi nitive answer for why Stard snapped, but in the days leading up to the incident, he had not slept or eaten properly and was anxious and depressed after breaking up with his girlfriend. He pleaded guilty to assault causing bodily harm but was given a condi- tional discharge, meaning if he keeps the peace for three years, he will not have a criminal record. Meanwhile, the nurse suffered tremendous mental stress and is still off work, more than two years later. "We have laws in B.C. to protect bus drivers. To assault a bus driver is now a felony, it has been for a while, and yet nurses have no such protec- tion," says Duteil. "Our goal is to change legislation to make assaulting a nurse a felony." Like all workers across Canada, health-care professionals have the right to refuse dangerous work. Unfortunately, it's very hard to tell health-care workers that sometimes they need to back away and not pro- vide care because they truly want to care for their patients, says Van hulle. "We have heard examples of health-care workers who have put themselves at risk in the event of a fi re to save patients. It's the same thing for workplace violence," she says, adding some nurses are worried they will get in trouble with the College of Nurses of Ontario if they refuse work. The Ontario report recommended the government work with the Col- lege of Nurses of Ontario to provide more clarity related to nurses' right to refuse to provide care to patients in hazardous situations, where the hazard is workplace violence. PROVIDE VICTIM SUPPORT Violence takes a toll on health-care workers. Those who have been vic- tims of violence are missing work and suffering from a variety of mental health issues, says Duteil. "They're struggling with P TSD (post-traumatic stress disorder) symptoms, they're struggling finan- cially, they're struggling with not being part of the community that they have been part of for many years," she says. "Nurses become nurses because they love their profes- sion and all of a sudden when you're tossed out of the workforce as a result of a violent incident, it has damning results… and it leads to a myriad of other health-related problems." To help nurses cope, BCNU has launched a 24-7 violence support hotline answered by trained trauma counsellors who offer immediate support. Workplace violence not only affects the health-care workers themselves, it negatively impacts the organization. There are huge costs involved when nurses are off work due to incidents of violence, including workers' compensation claims and sick days. In Canada, out of 34 occupational categories, more workdays are lost among nurses than any other category, according to the PSHSA. Presenteeism — when workers are at work but not performing at their full capacity — also becomes an issue. Incidents of violence negatively affect an organization's reputation and ability to recruit talent. This is especially concerning in provinces facing a nursing shortage, such as B.C, which is experiencing its worse nursing shortage in more than 20 years, says Duteil. But the main repercussion for organizations is that the quality of care suffers if staff members are being exposed to violence, says Van hulle. "Workers who are afraid of their patients can't provide quality care. Workers who are afraid of being hurt at work cannot have a good therapeutic relationship with the people they need to provide service for," she says. "It's going to hit the organization from a quality indicator perspective." It helps to tug on the heartstrings of senior leaders if you're trying to get their buy-in — and more resources — for violence prevention initiatives. Try to mine some stories from your own staff members who have suffered violent incidents and bring these to leadership, says Cripps. "If you can say, 'Here is an example that happened yesterday. This happened last week,' the richness of the story and the currency that brings to the conversation, you can't put a price tag on it," she says. While Cripps is working with partners throughout Saskatchewan on a provincial initiative to address violence in health care, she feels they are "one day ahead of the storm." They have a lot of momentum right now, but they need to put some corrective measures in place before somebody gets seriously hurt, she says. "I know me, personally, I would feel culpable. I would feel, to a degree, responsible because I know I would refl ect and think, 'God, should I have done something sooner or faster or talked to more people or had a strong, fi rm conversation with someone?'" Cripps says. "Are we doing enough? Are we doing it fast enough? That's the pressure on all of us in the system. We all want to do something but we don't want to just put a Band- Aid on this. We want to fi x it." So comfortable, you'll forget you have it on ... ... thanks to advanced comfort technology ® DENTEC - Harnesses Ad - 3.375" x 4.875" 072017.indd 1 7/24/17 9:00 AM

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