Healthcare workers are under attack. We must do more to ensure their safety

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, healthcare 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% of nurses, 74% of paramedics and 89% of personal support workers are subject to harassment and physical abuse annually. The committee also reported that nearly 50% 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% 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 healthcare 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.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.Allied health workersBut 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 healthcare 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.Michael Heenan, PhD, is president of St. Joseph’s Healthcare in Hamilton.This article is republished from from Healthy Debate under a Creative Commons licence.

Healthcare workers are under attack. We must do more to ensure their safety

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