Washington nurses support MNA as it pickets for safety

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.”

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