Health and Safety ReportVolume 13, Issue 9

Each day you go to work knowing that there is a good chance you could be verbally abused, punched, kicked or assaulted. Shocking as it may seem, this scenario is the regular workday reality of a health care worker and, in particular, nurses. Workplace violence against health care workers is receiving increased attention, and victims are more frequently reporting incidents of violence. Violence has no place in any workplace, and especially not in one that is dedicated to providing care and attention to the health and well-being of patients. The path to a safer workplace starts with the development of a workplace violence prevention policy.

How do we know it's an issue?

Violence in health care is more prevalent than we may realize. Research studies and statistics reveal that health care providers, particularly nurses, face a high risk of on-the-job abuse, both physical and emotional, from both patients and their families. Today, more nurses are filing reports of workplace violence, shining a light on an issue that was previously ignored or accepted as part of a nurse's day-to-day routine. A Statistics Canada survey showed that in 2005, one third of Canadian nurses providing direct care in hospitals or long-term care facilities reported physical assault by a patient in the previous year; close to half reported emotional abuse. In a 2014 U.S. survey conducted by the Bureau of Labor Statistics, almost 80 percent of nurses reported being attacked on the job within the past year. Statistics from the Workplace Safety and Insurance Board (WSIB) in Ontario show that in 2014, lost-time injuries due to workplace violence in the health care sector greatly outnumbered those in other sectors surveyed with 639 injuries compared to manufacturing (77), construction (10), and mining (1).

Underreporting

As significant as these facts and figures may seem, many experts believe they represent only the tip of the iceberg and that most incidents of violence go unreported for one or more of the following reasons:

• perception within the health care industry that workplace violence is 'part of the job'
• poor or non-existent institutional policies, procedures, staff training or supports
• overly complex reporting procedures create a disincentive for reporting
• concern that violence happens so frequently that it's time-consuming to report every event, in addition to a lack of response when time is taken to report
• fear that reporting will reflect poorly on the individual (victim blaming)
• belief that some patients cannot be held accountable for their violent actions
• concern that nothing will be done

Effects of workplace violence

When someone experiences workplace violence it can impair their job performance, decrease productivity, and cause them to make more errors. When the worker is subjected to violence for a prolonged period of time, it can cause them to experience anger, fear, depression, anxiety, sleep disruption, increase sick leave, symptoms of post-traumatic stress disorder, and job dissatisfaction. While not all violent incidents result in devastating consequences, many cause injury and damage worker morale and their sense of safety.

Factors that put nurses at risk

Working conditions and the nature of the job can put nurses at greater risk. Contributing factors include:

• stress created by real, or perceived, inadequate staffing levels and supervision
• unrestricted movement of the public in clinics and hospitals
• interventions that require close physical contact
• close interactions with patients and their families, sometimes under difficult circumstances
• lack of privacy
• long waits in emergency departments or clinics
• the medical condition of the patient or the medication they are taking

Violence prevention program

Health care employers need to establish a specifically targeted violence prevention policy and program as a key part of their organization's occupational health and safety program. The policy should cover all workers, patients, clients, visitors, contractors, and anyone else who may come in contact with workers of the facility. A workplace violence prevention program and policy should be developed by management and employees. The policy should establish clear standards of behaviour and require prompt, appropriate responses. Elements of a policy include providing clear examples of unacceptable behaviour, that all incidents or potential incidents should be reported, the process for reporting (including if the report is confidential), the process by which preventive measures will be developed, the procedures for investigating and resolving the situation, and the education and training that will be provided. Organizations should make a commitment to the prevention of workplace violence, and having a prevention program and policy in place is an important step.

Health care workers do just that - they care for the health and well-being of their patients. Violence isn't, and shouldn't be, part of the job.

Resources

• Preventing Violence in Healthcare, WorkSafeBC
• Healthcare: Workplace Violence, OSHA
• Violence in the Workplace fact sheet, CCOHS
• Violence in the Workplace Prevention Guide, CCOHS
• Violence in the Workplace: Awareness e-course, CCOHS
• Violence in the Workplace: Establish a Prevention Program e-course, CCOHS
• Violence in the Workplace: Recognize the Risk and Take Action e-course, CCOHS
• See Signs of Violence at Your Workplace? poster, CCOHS

Just in time for Global Ergonomics Awareness Month (October), a new app has been released that delivers a basic ergonomic assessment right on your smartphone. It runs you through a series of diagrams and questions to pinpoint musculoskeletal pain, identify possible sources, and discover practical solutions to address work-related hazards that could be contributing to your discomfort. While not a replacement for a professional ergonomic assessment, this app is a first step to help you recognize the signs of musculoskeletal disorders and take action for prevention.

The app is the result of a collaboration combining clinical expertise and ergonomic content from the Occupational Health Clinics for Ontario Workers (OHCOW) with the technological knowledge and communication skills of the Canadian Centre for Occupational Health and Safety (CCOHS).

You can download the app from Google Play, the Apple App store, and BlackBerry World.

Visit the OHCOW website to learn more.

This month’s Health and Safety To Go! podcasts feature a new episode with CCOHS Technical Specialist Anne-Marie Besliu discussing WHMIS 2015 and an encore presentation exploring the impact that psychosocial factors have on musculoskeletal disorders.

Feature Podcast: WHMIS 2015
In this episode, CCOHS Technical Specialist Anne-Marie Besliu discusses WHMIS 2015: what it is, how it affects workers and the workplace, and shares some of the key things we need to know about it.

The podcast runs 6:27 minutes. Listen to the podcast now.

Encore Podcast: How Psychosocial Factors Affect Musculoskeletal Symptoms and Disorders
Dr. Birgitte Blatter, Business Line Manager of Healthy, Vital and Safe Work at TNO in the Netherlands explores the role workplace psychosocial factors play in the development of musculoskeletal symptoms and disorders.

The podcast runs 12:05 minutes. Listen to the podcast now.

CCOHS produces free monthly podcasts on a wide variety of topics designed to keep you current with information, tips, and insights into the health, safety, and well-being of working Canadians. You can download the audio segment to your computer or MP3 player and listen to it at your own convenience... or on the go!

See the complete list of podcast topics. Better yet, subscribe to the series on iTunes and don't miss a single episode

Support your transition to WHMIS 2015 with tools from CCOHS to help you teach your workers about the new system.

The WHMIS 2015 Instructor's Toolkit is designed for individuals responsible for providing WHMIS education in their workplace, and for organizations that need to educate their workforce regarding WHMIS after alignment with GHS. The companion Participant Workbook is strongly recommended for every worker in the course.

The 156-page Toolkit provides an introduction to WHMIS 2015 for workers and provides trainers with tools and guidance, placing emphasis on the common hazard classes and workplace scenarios that are likely to be encountered by most business. Customize the content by using or emphasizing the sections that are most relevant to your audience’s needs.

The Toolkit consists of an instructor's manual in your choice of print or PDF, plus a PDF copy of presentation slides.

The 100-page Participant Workbook, available for purchase separately, provides background about WHMIS and the impact of GHS on WHMIS, with a focus on hazard classes, labels, and safety data sheets. It includes a worksheet for trainees to answer and retain important WHMIS and health and safety information that is specific to their workplace.

Resources from CCOHS

• WHMIS 2015 Instructor's Toolkit
• WHMIS 2015 Participant Workbook
• WHMIS 2015 Labels free poster
• WHMIS 2015: How Canada is Adopting the Globally Harmonized System of Classification and Labelling of Chemicals (GHS) for Workplace Chemicals, free webinar with Health Canada
• Free downloadable WHMIS 2015 Pictograms
• WHMIS 2015 Pictograms poster

The world of work is changing. Join subject experts, workers, employers, and governments from across the country and beyond as we share our knowledge and experience around current and emerging health and safety issues. CCOHS Forum 2016 will take place on February 29 and March 1, 2016, in Vancouver, British Columbia.

Forum is a unique opportunity to explore and understand the health and safety challenges emerging from changes in society, technologies, and work organization. How have shifting demographics, climate change and workplace culture already impacted the way we work, and how can we keep pace and stay head of the changes?

Here are 5 more reasons you need to come to Forum:

1. BALANCED: Perspectives from government, employer and labour – spanning all provinces and territories - will be represented.


2. INTERACTIVE: Intimate event size and small group sessions allow you to connect with like-minded health and safety stakeholders.


3. INNOVATIVE: Gain insight and expertise from our showcase of innovations and best practices.


4. SOLUTIONS-FOCUSED: Emphasis will be placed on identifying solutions centred on the key topic areas.


5. INCREDIBLE VALUE: Registration includes all sessions, networking events, refreshments, lunch, and discounted hotel rates for 2 days.

This will be CCOHS’ fifth national health and safety conference, and if this event is anything like previous forums, the debates will be lively, the questions compelling, and the hallways filled with animated discussion.

Take advantage of the early bird rate.

Register by November 30, 2015, to save $100. Discounts are also offered to CCOHS Members and full-time students. Simultaneous French language interpretation will be available. For more