Less than a week after Ontario’s Ministry of Labour (MOL) filed charges against the Centre for Addiction and Mental Health (CAMH) in Toronto, regarding a violent incident last January, the facility experienced yet another patient assault against one of its employees.

On Dec. 23, the MOL filed four counts against CAMH under the province’s Occupational Health and Safety Act (OHSA), relating to an assault that occurred on Jan. 12 of last year. CAMH is facing charges, as an employer, of failing to:

• provide proper information, instruction and supervision to ensure the safety of a worker;
• take every reasonable precaution to protect an employee from violence;
• establish and implement sufficient measures and procedures to protect workers from the risk of violence; and
• establish safety measures and procedures in writing.

“A nurse was attacked by a patient while carrying out observation rounds,” said MOL media representative William Lin, describing the incident that led to the charges. “The first court appearance is to be heard on February 5th.”

Another nurse was critically injured at the facility on Dec. 29, when a patient pushed her down to the floor and punched her in the head repeatedly. “The worker was transported to St. Michael’s Hospital, and a police report was filed by the employer,” explained Lin. “We assigned an inspector who immediately contacted the workplace.”

According to Lin, the MOL didn’t receive notification of the Dec. 29 incident until the afternoon of the following day. Section 51(1) of OHSA requires employers to report critical injuries to the ministry “immediately.”

Rani Srivastava, CAMH’s chief of nursing and professional practice, confirmed that the MOL had visited the worksite on Dec. 31. “We had a really good meeting with them, and at this point, we’re just continuing to work with them very closely,” she said.

Srivastava could not provide further information on the Dec. 29 incident, due to the ongoing investigation. But she expressed disappointment that the MOL had charged them for the previous attack.

“Everyone at CAMH was very shaken by that particular incident,” she said. “I feel for the nurse that was attacked, who was hurt, as well as her colleagues who were also harmed, whether they were directly involved in the incident or they were witnesses. We know that physical violence can happen.”

Linda Haslam-Stroud, president of the Ontario Nurses’ Association (ONA), noted that there had been 453 incidents of physical assault or abuse at CAMH over the 2013-14 fiscal year alone. “Violence is not part of our jobs, and it shouldn’t be accepted as part of our jobs,” she said. “If we’re going to reduce the incidences of violence, it can’t be kind of an after-the-fact type of resolution. We need to be putting measures and procedures, obviously, in place on a proactive basis.”

Ontario has seen an escalation of violence in healthcare facilities, she added, citing similar attacks and assaults at the Southlake Regional Health Centre in Newmarket (COHSN, Dec. 15) and a nurse stabbing at the Brockville Mental Health Centre.

“Part of ONA’s strategy for the upcoming year is a renewed violence strategy that will be encompassing everything,” explained Haslam-Stroud, “right from the communication of the issues to the public, to working with the government, to trying to ensure that our joint health and safety committees are fulfilling their obligations.”

CAMH has also been taking steps to counter workplace violence, according to Srivastava. Last year, the facility formed a committee consisting of its own team members and reps of unions, clinical operations and human resources, aiming to create a safer work environment at CAMH. “They’re coming together to discuss ideas, explore solutions and see what strategies or what ideas can come from that,” she said. “They’re looking at their own ideas; they’re looking at what other organizations are doing.”

The facility also plans to revise its debriefing processes, improve training and education for staff on preventing and handling aggressive patient behaviour and provide emotional support for traumatized employees, Srivastava added. “Patient safety and staff safety are really important things to us, and they go hand in hand.

“That includes caring for our staff, and the only way,” she said, “is if we’re able to work together and have that dialogue about, ‘How do we make sure we’re providing the best possible care, in an environment that supports our staff in the best possible way?’”