Workplace violence occurring in all sectors: OPSEU
The Ontario Nurses Association (ONA) is asking Ontario’s premier and the Ministry of Health to meet with the union to develop strategies to keep nurses safe on the job.
The decision to appeal to the highest level of government was spurred by an incident at Southlake Regional Health Centre in Newmarket, Ont., when a nurse was attacked by a patient who also injured three others.
“Our members have reported being verbally harassed, pinched, scratched, having feces thrown at them, being physically beaten, sexually assaulted, having their hair pulled out of their head, their necks wrenched in violent attacks,” says Erna Bujna, occupational health and safety expert at the ONA in Toronto.
There has been an escalation of violent incident reports from members and a lack of response from the Ministry of Labour (MOL), according to the ONA.
“We see lots of MOL orders to write policies and to do a risk assessment, but these are paper-pushing exercises that do little to protect our nurses,” Bujna says. “The MOL needs to fully enforce the OHSA (Occupational Health and Safety Act) when employers and supervisors are not compliant with legislation. They need to set deterrence and start laying charges.”
There were no criminal charges laid against the individual in the Southlake attack, according to the ONA.
Training must also be improved, Bujna says.
“At a training session of approximately 300 ONA health and safety reps in May, I asked participants if they are consulted on training and only a few hands went up,” she says. “Our members tell us that, more often than not, they get some e-learning on the violence policy, but few are getting real training and education on the types of measures and procedures that should be contained in the workplace violence program.”
Violence at the workplace is a universal problem, according to Lisa McCaskell, senior health and safety officer with the Ontario Public Service Employees Union (OPSEU) in Toronto.
“There’s workplace violence all the time in every sector,” she says, noting the frequency of incidents leads to under-reporting. “In health care and developmental services, such as group homes, we know people don’t report as they should. And, if they don’t report, then there’s no cause for action and then we don’t know what’s going on.”
McCaskell works with members from across the province serving on joint health and safety committees. She provides guidance on the appropriate protocol when a safety incidence occurs.
“Let’s say there’s been a unit in a health-care facility where there have been a number of serious assaults over time,” she says. “(Employers are) supposed to have done a risk assessment for the hazard of workplace violence. Then, on the basis of the risk assessment, they’re supposed to put in place measures and procedures to address the risk they’ve identified.”
If it’s a reoccurring problem, then something isn’t being done the way it should be, McCaskell says.
“If somebody held up a liquor store with a gun and some people ended up with post-traumatic stress, it’s possible (the employer will) do a reassessment,” she says. “What about our hours? What about working alone? What about taking breaks? What could we have done differently?”
Unfortunately, this type of reflection doesn’t always take place in environments with reoccurring violence, says McCaskell.
“I’m coaching our members to go back to the employer, point out any gap and what’s going on,” she says. “If they still won’t do anything, then I’m advising them to call the Ministry of Labour.”
Best practices
Employers have an obligation under the OHSA to advise workers about a person who has a history of violence, but it can be a difficult obligation to comply with, McCaskell says.
“Employers in many places are quite reluctant to put in place an effective flagging system,” she says, adding that employers don’t want to draw public attention to the individuals. “There are ways of doing discrete flagging, whether it’s on the front of a patient’s chart or a little mark beside the person’s name in the nursing unit. Or maybe their armband has another colour on it.”
Toronto East General Hospital has implemented a procedure so patients who have a history of violence are flagged in the hospital’s system. The system also defines what may trigger violent behaviour from the individual, according to Bujna.
“When nurses are made aware of a person who has a history of violent behaviour and their triggers, they can then adjust the care plan to take measures to protect themselves while providing tailored care,” she says. “When I get calls about workplace violence and I ask if the employer has a flagging procedure, the answer is almost always no, despite occupational health and safety legislation which requires (it).”
McCaskell suggests employers look on the MOL website for the toolbox developed to provide safe practices depending on which sector the business is in.
Nova Scotia
Nova Scotia developed a workplace violence prevention strategy in 2007 after a convenience store attendant was killed during a robbery.
“We adopted the regulations because violence is, unfortunately, becoming a risk in many workplaces,” says Scott Nauss, a regional manager with the Nova Scotia Department of Labour.
The plan requires employers in high-risk industries to complete a workplace risk survey that helps identify risks, prioritize those risks and develop mitigative measures to minimize the effects of these risks, according to Nauss.
“There is a requirement that employees are made aware of the survey and trained on any preventative measures put in place,” he says. “There is a requirement under the regulations and it is audited by (safety) officers.”
Employers are welcome to complete their own survey of the workplace, but Nova Scotia Labour and Advanced Education also provides employers with a sample assessment forms on its website at http://novascotia.ca/lae/healthandsafety/violenceriskassessment.asp.
Employer resources
Sample workplace assessment
Nova Scotia Labour and Advanced Education suggests employers consider the following when the potential for violence in the workplace is identified:
• What activity or feature of the workplace or task may trigger violence?
• Describe the predicted type of violence (such as assault, robbery, threats).
• Describe the frequency with which the predictors of violence occur (For example, the threat occurs every Monday).
• State who is at risk from this violence — use job titles as opposed to personal names.
• After completing the assessment, decide on ways to control the risk of violence at the workplace.
