WA nurse

Three years after wasting $149 million dollars fighting its nurses in a strike partially based on workplace safety[1], Allina Health and other Minnesota health care systems are repeating history, asking nurses to forfeit raises and other contract proposals as a trade-off for manage­ment support of safety and support in the workplace. But as workplace violence in hospi­tals becomes endemic, nurses across the country are wondering: why is workplace safety negotiable?

According to a 2012 report by the U.S. Govern­ment Account­ability Office (GAO), health care workers in inpatient facil­i­ties experi­enced workplace violence-related injuries requiring days off from work at a rate at least five to 12 times higher than the rate of private-sector workers overall. One study of emergency depart­ment nurses found that 100% had experi­enced verbal assault, and 82.1% had experi­enced physical assault, over the last year. The Depart­ment of Labor in 2011 estimated that health­care workers experi­ence between 22,250 to 80,710 physical assaults each year. Sadly, as many nurses have found, the situa­tion often seems as though nothing changes and nobody cares.”

Bureau of Labor Statistics intentional injuries

Washington nurses are intimately familiar with this issue. One nurse had part of her ear bitten off and experi­enced a spinal fracture from an incident of patient violence. Another nurse was nearly choked to death. A third nurse was pushed down and had her head stomped on.

It’s easy to blame patients for these incidents — but in what other industry does an employer tolerate such levels of workplace violence and injury? Health­care facil­i­ties have the ability and oblig­a­tion to provide a safe work environ­ment, and there are a myriad of evidence-based inter­ven­tions which may be under­taken to support worker safety (see below)

That’s why Minnesota nurses, 4 years after passing a compre­hen­sive workplace violence law and 3 years after obtaining security guards in the ED, are on the picket lines at Children’s, United, Methodist, North Memorial, Health­east, Fairview, and Abbott-North­western hospi­tals. They’re asking their employers for paid time off after incidents of violence occur, and before workers compen­sa­tion coverage (if applic­able) kicks in — up to 3 days. In Anoka, nurses are seeking improved safety condi­tions overall.

Unfor­tu­nately, Minnesota nurses are being told by some of these hospi­tals that if they want to address workplace safety requests, nurses must abandon all other contract proposals. Sadly, this echoes our experi­ence in Washington — all too often, hospi­tals abandon their moral oblig­a­tion to protect their employees by margin­al­izing and ignoring the preva­lence of violent incidents. Indeed, they have a legal oblig­a­tion as well: OSHA’s General Duty Clause states that each employer shall furnish a place of employ­ment free from recog­nized hazards that are causing or are likely to cause death or serious physical harm. 

Minnesota, Washington nurses support you and your fight for a safe workplace.

And across the country, nurses every­where ask: why do we have to negotiate for our safety?

WORKPLACE VIOLENCE INTER­VEN­TIONS: What can health­care facil­i­ties do?

  • Adopt a zero-toler­ance position on workplace violence
  • Develop a plan to proac­tively address violence in the workplace
  • Estab­lish and consis­tently follow workplace violence policies/​procedures
  • Utilize the electronic medical record to flag patients with a history of violence; notify team members/​security to activate height­ened safety proce­dures when on site 
  • Provide compre­hen­sive didactic and hands-on workplace violence training upon hire and annually
  • Imple­ment a trained team for rapid response to incidents
  • Provide staffing at suffi­cient levels to deter incidences of violence 
  • Utilize trained 1:1 sitters as need is identified
  • Discuss workplace violence preven­tion in daily huddles
  • Support incident reporting, analysis, and correc­tion plans that address workplace violence and near misses; devise strate­gies to share learning across the organization
  • Support workplace violence reporting to the police and external agencies
  • Debrief events of workplace violence to identify safety improvements
  • Provide support to victims of workplace violence and near miss events
  • Involve nurses and other disci­plines on safety and/​or workplace violence preven­tion committees
  • Imple­ment environ­mental Control Strate­gies: locked doors with card entry, computers facing patients, secured equip­ment and furni­ture, access to emergency call buttons, wand screening of high risk patients, visitor badging, enclosed triage areas, rooms designed with garage-type doors to secure/​cover equip­ment for high risk situations
  • Imple­ment Personal Safety Strate­gies: proac­tively assess for your safety with each patient encounter, face the patient, ensure access to an exit, avoid items worn around the neck or use break­away lanyards, work in teams, carry an alarm for use when in trouble 
  • Many, many more

[1] Four main sticking points: 1.) transi­tioning to high deductible health plans with no recom­pense; 2.) staffing/​charge nurse workload; 3.) security guards in the ER; and 4.) respect for nurses