By Marti Webb Slay
As workplace violence becomes a growing issue in healthcare, many hospitals are beginning to develop programs to keep employees safe.
“We’ve had workplace violence as long as I’ve been in healthcare, but it has increased,” said Kelli Powers, president of Decatur Morgan Hospital. “I’m a flagbearer for it in a way, to protect my employees. We all have a shortage of employees everywhere, and I want to make sure we have as little violence as possible. Of course, I’d like to have none, so I’m a constant advocate for how we can minimize workplace violence.”
According to the American Nurses Association, one in four nurses is assaulted, but only an estimated 20 to 60 percent of incidents are reported. The organization has launched A Nurse’s Call to Action, encouraging nurses to pledge to share the program, support zero tolerance policies and report abuse. Nurses can take the pledge at Nursingworld.org/Pledge.
It’s not always easy for healthcare workers to take such a pledge and follow through. “Healthcare workers are there to care for people, so it’s not in their nature to move forward with actions like this, but it’s important,” said Amy Shelton, MSN, RN, chief nursing officer of St. Vincent’s Ascension. “It’s a felony in the state of Alabama to assault a healthcare worker. As leaders of healthcare organizations, we have to support our associates and have an environment that’s safe for them and for our patients, so our providers are able to deliver care.
“We support our associates with a no tolerance policy. We will stand behind them in the event an incident may occur. We’ve seen a rise in healthcare violence towards workers, and it’s important that our associates know they have our support. We have a prevention plan in place, but if some unfortunate event should occur, they are totally, 100 percent supported by us.”
lnspirien, manager of the Healthcare Workers’ Compensation Fund (HWCF) as well as Inspirien Insurance Company, a medical malpractice carrier in the state, has developed classes for its insureds and members focusing on this issue. “We are doing our own initiatives to bring awareness to workplace violence. We see it every day when the claims come in, so we are gathering that data and seeking opportunities to support our healthcare partners,” said Cindy Sawyer, Marketing Manager. lnspirien is highlighting Violence Against Healthcare Workers by making it one of the featured topics in their annual Risk Seminar this year. Participation is open to all healthcare workers in Alabama. Find out more information on their website, inspirien.net.
Decatur Morgan’s Powers said it’s important to acknowledge that workplace violence is an increasing problem in many industries beyond healthcare. “I don’t want healthcare to get the total blame,” she said. “We see this everywhere. You want to be honest with people, but you don’t want them to be afraid to work at a healthcare provider.
“A key first step is to talk about it and heighten awareness. If we can minimize a situation ahead of time, it doesn’t lead to violence. All our employees are taking a computer-based learning module, based on MOAB (Management of Aggressive Behavior). Some of that is online, and there are four-hour and eight-hour classes.”
Since the emergency department is often a target for violence, the Decatur Morgan ED staff is taking the eight-hour MOAB class module in person. “You can’t do it all on the computer,” Powers said. “A lot of it is body language.
“It’s also important to be aware that violence doesn’t always come from the patient. It can be family too. Some of it comes with family members to each other. You can get a family here that doesn’t always get along, and they are stressed out with a short time to make decisions that aren’t always easy to make. Disagreements can escalate quickly in that situation. Also, violence doesn’t have to be physical. It can be mental and verbal as well.”
In addition to the training, Decatur Morgan has added more security staff, and they now have a safety officer, a nurse by training whose responsibility is to stay focused on security. They are also meeting with local law enforcement, their district attorney, and mental health officers to work on solutions.
Powers emphasized the importance of recognizing a potentially violent situation and taking steps early to de-escalate. She cites a recent case, when a homeless patient, irritated with the emergency department staff, came to the administration offices. Concerned that the patient was likely high on illegal drugs, the staff offered him a meal, which calmed him down and kept him from escalating to violence. “We try to be as accommodating as possible, but we aren’t going to tolerate aggressive behavior,” Powers said.
She believes it is reassuring to the employees to know violence is being addressed. “People are glad to talk about it, and they are glad to see that as president, it’s on my radar to do something about it,” she said. “We are addressing it and have options for them. And again, if you can get ahead of it, you can minimize so much of it. Be proactive instead of reactive.”
Powers encouraged other hospital administrators around the state to work together and share ideas. “Don’t ignore that it’s an issue,” she said. “Let’s work together to come up with solutions to help each other. I think your employees deserve that, to know we are all working together to make a safer environment for everybody.”