Published on: March 28, 2017 | Last Updated: March 28, 2017 5:35 PM EDT
Windsor Regional Hospital Ouellette CampusNick Brancaccio / Windsor Star
A month after a patient choked her in a brutal attack a registered
practical nurse is looking forward to returning to work at Windsor
Regional Hospital.
Hospital CEO David Musyj described the choking as the worst level of
violence at the hospital since he’s been there — close to 20 years — and
is reflective of an alarming rise in violence in hospitals and other
health-care institutions, here and across the country.
He said in the last year there have been 20 staff physically harmed
at Windsor Regional — from scratches and bruises to more serious
injuries. There were another 200 incidents in which staff have been
threatened. Some of those threats may well have progressed to violence
except for anti-violence measures put in place, he said. He described
the response by staff to the choking incident as “amazing, really
amazing.”
“It was a horrible thing to happen to our member,” Chris Sutton, a
national health and safety representative for the Canadian Union of
Public Employees, said of the attack. He praised the hospital for its
handling of the incident and its quick followup to ensure nothing
similar happens again.
“We are grateful the outcome for our member was not worse than what
occurred and that she is recovering and looking forward to going back to
work.”
Two co-workers ran to her aid within a few seconds and hospital
security was on the scene in under a minute, according to Sutton,
who said the system the hospital has in place to ensure staff safety
worked.
The registered practical nurse activated her personal alarm system,
which all staff at the hospital’s Ouellette campus began wearing
following the 2005 murder of Hotel-Dieu Grace Hospital nurse Lori Dupont
by co-worker Dr. Marc Daniel, who subsequently killed himself. The
program was continued after the building changed hands in 2013, from
Hotel-Dieu Grace to Windsor Regional.
When the alarm sounds, or when “code white” is called, it’s an all-hands-on-deck scenario, with staff running to assist.
Union and hospital officials were reluctant to provide details of the
attack, citing patient and employee confidentiality and concerns about
jeopardizing a case that might end up in court. But Sutton said police
and the Ministry of Labour were notified and that police are
investigating. He also said the hospital held a forum Friday to discuss
the incident and its aftermath, and tweak its policies and procedures.
“There is a good outcome,” Sutton said. “And the (RPN) has said what
happened to her was bad, but she came in and participated in the forum
because she wanted to make sure everything reasonable that could be done
would be done to ensure it doesn’t happen to anyone else.”
Health-care unions including CUPE have been campaigning against a
rising level of violence in health-care institutions, whether it be
against staff or patient-on-patient.
Donna MacInnes, the Ontario Nurses Association bargaining unit
president for Windsor Regional, said the incident is an example of the
violence nurses contend with. “It does happen on a daily basis. Whether
they’re spit on or name calling or hitting, it happens every day,” she
said.
“But this one here, in my opinion, was dealt with properly.”
ONA has launched a campaign to end workplace violence “because of the
rising and daily occurrence of violence in our health care
institutions,” said ONA first vice-president Vicki McKenna, whose union
cites a 6.4 per cent increase in lost-time injuries due to workplace
violence in health care in 2014 compared to 2013. There were 680
violence-caused injuries in the health-care sector in Ontario in 2014,
compared to just 80 violence injuries in manufacturing, 11 in
construction and zero in mining.
And research shows that there are many more of these attacks that
people aren’t reporting, said McKenna, whose union has been working with
the province’s labour and health ministries on an action plan.
“The reports we are hearing from the field are daily,” she said.
Musyj cited two factors in the rising number and severity of violent
acts: patients coping with mental health and the drug epidemic. Patients
on drugs or in withdrawal can have violent and unexpected outbursts.
Even while in the hospital, addicts are continually seeking and
acquiring drugs. People sometimes bring street drugs in for patients.
ONA’s McKenna said in many cases, the increase in violence is caused
by understaffing, and failing to appreciate that your staff numbers
shouldn’t always be based on simple patient-to-staff ratios. “You have
to staff based on what patients need, not the mathematical equation,”
she said.
She said the violence often happens when patients are in altered
states, from illegal drugs or medications, or from dementia or head
injuries.
“This doesn’t mean people shouldn’t receive care,” she said. “It just
means you have to have the adequate staff and support so you can care
for people properly.”
The
Ontario Council of Hospital Unions is urging the ministry of labour to
do more to protect health-care workers who face daily threats of
violence on the job.
Mourners
exit St. John The Baptist church passing an honour guard of nurses in
Amherstburg, Ont., in 2005, where funeral services were held for slain
nurse Lori Dupont, who was stabbed to death at a Windsor hospital by a
doctor she had ended a relationship with. In the wake of Dupont's death
the province introduced legislation requiring employers to have programs
in place to deal with workplace violence and harassment. (Dan Janisse / THE CANADIAN PRESS FILE PHOTO)
Ontario’s
nurses and personal support workers are facing an “epidemic of
violence” caused by government and hospitals’ failure to safeguard them
from abuse, assault and sexual harassment, according to the body
representing health-care providers.
In a
letter sent Monday to Minister of Labour Kevin Flynn, Ontario Council of
Hospital Unions president Michael Hurley expressed dismay at the
“daily” threats health-care workers confront on the job, which he calls
“unacknowledged, dismissed, or tolerated by administrators and
regulators.”
“In no other occupation or walk of life would such abuse be tolerated,” Hurley said.
Health-care
workers have the second highest number of reported injuries in the
province — behind the service sector, but ahead of such industries as
construction, mining and manufacturing, according to the latest
available statistics from the workers’ compensation board. In 2014, a
study by the Canadian Institute for Health Information found at least
half of all registered practical nurses were assaulted by patients, the
letter obtained by the Star says.
Ontario
Council of Hospital Unions president Michael Hurley has written a
letter to Minister of Labour Kevin Flynn expressing alarm over the
"daily" threats health-care workers face on the job. (Michael Stuparyk/Toronto Star File Photo)
New
research commissioned by OCHU, which will be published this year, also
has documented “widespread and systemically accepted violence” among
health-care staff in seven Ontario communities, according to the letter.
All but one of the 54 workers interviewed
in that study said they directly experienced violence at work,
according to Jim Brophy, who conducted the research with fellow
occupational health expert Margaret Keith.
“It’s
become so normalized, so accepted, that now it’s really viewed as part
of the job. You might as well put it in as part of the job description,”
Brophy told the Star.
“I was scandalized
by how much it was replicating all the features of domestic violence.
Blaming the victims, keeping the dirty little secret quiet, really
internalizing all of this.”
Dianne
Paulin, a registered practical nurse from North Bay with 25 years of
job experience, says she would have been spared her life-changing
injures if the psychiatric ward she worked on had implemented common
sense policies like bolting down furniture.
Instead,
she was assaulted by a patient who pinned her against his room door
with a chair and repeatedly punched her, leaving her with a bulging neck
disc, post-traumatic stress disorder and panic attacks.
Dianne
Paulin, a registered practical nurse from North Bay, was brutally
assaulted by a patient in the psychiatric ward where she worked in an
attack that left her with post-traumatic stress disorder and panic
attacks.
(Supplied Photo)
“You
don’t go to work and think you’re going to die. I went to work because I
loved my job and the clients liked me,” she said. “It wasn’t that I
didn’t know what I was doing. It was the environment.”
Workers
identified underfunding and understaffing as “significant contributors”
to workplace violence, often perpetrated by patients or their family
members against employees who are sometimes forced to work alone because
of shortages. Brophy said the abuse often took on a sexual and racial
hue because many health-care workers are women of colour. But fear of
reprisal from hospital managers discouraged nurses and other staff from
raising the issue, he said.
“Nobody is
allowed to talk about it. Health-care workers are frightened. We had to
conduct these interviews pretty close to secretly.”
In
2010, the Ontario government introduced legislation requiring employers
to have programs in place to deal with workplace violence and
harassment. Those reforms were prompted by the 2005 slaying of Windsor
nurse Lori Dupont, who was stabbed multiple times in the chest at work
by a physician she had ended a relationship with.
In
a statement to the Star, the minister of labour’s spokesperson, Michael
Speers, said the government is “committed to addressing workplace
violence in the health-care sector and is developing a plan to make
hospitals safer. A progress report on that initiative is expected to be
released in the coming weeks.
“No one
should feel unsafe at work, and concrete steps are needed to ensure the
safety of our health-sector workers,” Speers said.
Last year, the Centre for Addiction and Mental Health was slapped with an $80,000 fine
under workplace safety laws in relation to a 2014 beating of a nurse by
a patient who reportedly left the victim “beyond recognition.”
Brophy
said his research found workers often had little awareness about what
policies were in place to protect them at their hospitals.
“The
problem is widespread, it’s pervasive, it’s unreported. But when you go
to the workplace, you find it’s not being taken seriously by the
employers.”
The letter makes several
recommendations to government, including that the ministry of labour
launches a program of “comprehensive inspections and audits of all of
Ontario’s health-care facilities” to ensure effective protections are in
place, and that every workplace has safeguards like personal monitors,
alarms, and identification of violent patients. It also calls for
co-operation with the ministry of health to ensure adequate staffing
levels, and the presence of trained security personnel where needed.
Government
should “immediately enact” whistleblower protection for workers who
speak out about workplace violence, the letter adds.
Nurses at the
Centre for Addiction and Mental Health protest against workplace
violence in December 2014, shortly after charges were laid by the labour
ministry over the brutal beating of a nurse. Back row, left to right:
Holly Williams, Andy Summers and David Tennant. Front row, left to
right: Danielle Latulippe-Larmand, Terry Mendoza and Oswin Chang. CAMH
was later fined $80,000 in the beating incident.
(Gregory Bennett/COURTESY OF THE ONTARIO NURSES ASSOCIATION)
Paulin,
60, has been unable to work since she was attacked in 2011. Although
she received workers’ compensation for her injuries, she says her
benefits were cut in half in 2015 after the board told her — against the
advice of her psychiatrist, she says — that she was able to return to
work. She is now appealing the decision.
The
WSIB cannot comment on individual cases, but a board spokesperson,
Christine Arnott, said the board’s aim is to “help injured workers
recover safely and return to work and their lives.”
“Ultimately,
we want people to recover successfully and receive the assistance they
need from the WSIB. If someone is concerned about a decision or other
aspects of their claim, we encourage them to speak with us. We are here
to help,” she said.
“Right now I’m going
to the banks because I owe too much money, because I’ve been struggling
and struggling since they knocked me in half,” said Paulin. “I’m at the
point where I have to sell the house.”
She says she has already lost something even more valuable.
“I’m not me.” she said. “I’ve never been me since this happened.
Published on: March 10, 2017 | Last Updated: March 10, 2017 2:59 PM EST
The exterior of Hotel-Dieu Grace Healthcare is pictured in this July 2015 file photo.Dax Melmer / Windsor Star
In what it is calling a “course correction,” Hotel-Dieu Grace
Healthcare is reducing the ratio of registered nurses to patients on
some of its units from one-to-three to one-to-five or one-to-six.
Hospital and union leadership say the quality of care to its patients in its complex continuing care units should not suffer.
And while the change will cause upheaval, the nursing job losses will be small and done through attrition, they say.
“It will look different, but it will not be poor quality care,” CEO
Janice Kaffer said Friday. Staff got news of the changes on Thursday.
Acknowledging that some of her members are upset, Jo-dee Brown,
president of the hospital’s Ontario Nurses’ Association unit, said the
complex continuing care units in Hotel-Dieu Grace’s Emara Centre For
Healthy Aging and Mobility are “generously staffed” — a situation
inherited from when Windsor Regional Hospital ran the campus.
“Maybe if you’ve been coming to work for 20 years and been that extra
pair of hands, and now all of a sudden you’re not going to be that
extra pair of hands, maybe that isn’t palatable. I get that,” said
Brown, who has about 171 active members.
“I guess it’s time for reflection for the individual. Do they want to
pull up their socks and earn their money in a different way, or do they
want to leave?”
Kaffer, who is a nurse, said that current one-to-three ratio is better coverage than at many acute care hospitals.
A realignment in 2013 saw the city’s two hospitals trade locations
and change their roles. Windsor Regional became the acute care hospital
at two campuses. Hotel-Dieu Grace became the non-acute hospital at the
Tayfour campus on Prince Road, typically taking care of patients for
weeks and months as they recover from major illnesses or go through
end-of-life stages in palliative care.
When there are few patients on a unit, the nurse-to-patient ratio can be as low as one-to-one or one-to-two, Kaffer said.
There are also registered nurses who aren’t assigned patients.
Instead, these more highly skilled RNs spend their shifts assisting
registered practical nurses with tasks RPNs could be doing. As part of
this staffing change, RPNs are getting extra training so they can work
“their full scope of practice,” Kaffer said.
She said there will be reductions in the numbers of both RPNs and
RNs. The numbers haven’t been revealed yet to staff but she said it will
be much less than a 10 per cent cut, and should be handled by early
retirement packages.
“It does change the workload, appropriately so,” said Kaffer, adding
that the change will be made gradually over the next six to 12 months,
to ensure there’s no decline in quality of care. “It’s what I’m calling a
course correction.”
Brown said the union will learn more details about the staff changes
at a meeting with management on Wednesday. But she’s been assured no one
will be going out the door involuntarily.
“I’m not happy with it either, but fiscal responsibility and reality
is something we have to live with and I believe that the employer has
handled this in the most fiscally responsible way they can right now,”
she said.
