Health workers dealing with rising on-job violence

Workplace advocate says attitudes toward aggression must change

Sandra Cripps hopes “Code Silver” will be implemented soon in Saskatchewan to address the increasingly severe injuries health-care providers are suffering because of violence.

More than 60,000 work days are lost every year because of injuries in the province’s health-care sector, said Cripps, CEO of the Saskatchewan Association for Safe Workplaces in Health (SASWH).

“What we see escalating in terms of severity of injuries would be those of violence or aggression,” she said.

Violent incidents are “severely under-reported,” she noted.

Figures from the Saskatchewan Workers’ Compensation Board indicate about four per cent of all health-care injuries involve violence or aggression.

“But if you talk to front-line workers or supervisors or managers, they would indicate that the occurrences of violence and aggression is regular,” Cripps said. “I think the normalization that we have going on in the system — that violence is part of the job, that it’s to be expected — that’s the mindset we need to change.”

Violence in health-care facilities includes active assailants entering with weapons. “It could be a firearm or a knife,” Cripps said. “We need to have a better handle on what we do in those occurrences.”

Right now, “Code White” announced on public address systems in health-care facilities indicates a violent event is in progress.

Cripps hopes the next step is establishing “Code Silver” to alert those in health-care facilities that an active assailant is on site and to ensure teams are trained to respond and procedures are in place.

The hot spots for aggressive acts are in emergency rooms and mental health and addictions units.

However, Cripps noted healthcare workers in other areas are also injured because of violent behaviour.

“There is intentional and unintentional violence,” she said. “I would propose that the unintentional violence or aggression would occur in long-term care workplaces. But again, it’s still normalized and while we understand it a little bit better, we do have tools and resources that we can put in the hands of frontline workers and system leaders to mitigate the risk for violence.”

One tool is a team of healthcare professionals performing a violence risk assessment of an individual or area where there’s a high incidence of injuries due to aggression.

“Based on that, we determine the appropriate controls that need to be put in place,” she said.

To achieve that, the SASWH is partnering with Ontario’s health and safety association and using some of their resources.

“We’ve done some of that prework over the past 18 months and we’re quite ready to introduce to the system a new provincial violence prevention strategy framework,” Cripps said.

To have safe patient care, we need a safe workforce, she said.

“You want to protect the patient and protect patient confidentiality, but as a worker, you need to protect yourself,” Cripps said. “It’s not one or the other. “

Shoulders and backs are most the prevalent type of injuries in health care.

“They are our highest-cost injuries, the highest frequency and the most difficult injury to fully recover from,” Cripps said.

Injuries was one of many topics discussed at a conference held by SASWH in Regina on Thursday.

Attended by more than 130 health-care workers from across Saskatchewan, the conference’s theme was Value Safety, Value You.

Allan Kehler, a motivational speaker and author from Saskatoon, talked about mental health and addictions and urged healthcare workers to use their greatest tool — their voice.

“Getting people to report, speak up about what’s working well, what’s not working well and not to be comfortable in the silence,” Cripps said. “Your voice has to be heard.”