Following the sentencing of a patient at a Charlottetown mental-health hospital for assaulting a worker, the union representing the facility’s staff has met with the hospital administration regarding violence against employees.

The patient, a 21-year-old woman, was sentenced to two months of jail time for the attack on Aug. 18. This was the second time this year that she had been sentenced to prison time for assaulting staff while undergoing treatment at Hillsborough Hospital.

The second assault occurred while employees were taking the patient out in public, according to Debbie Bovyer, president of the P.E.I. Union of Public Sector Employees.

“They sent her out with five staff members. So they knew she was dangerous, but they still sent her out and endangered the staff members,” Bovyer explained. “Staff are being put at risk with patients that are showing no progress.”

Bovyer, along with three Hillsborough employees, discussed the issue of improving policies regarding violence on the job with the facility’s director of nursing and head of human resources, earlier in August.

“We asked them if we, as a working group, namely the union, and the employer could start developing policies that would protect the staff a little better, and we were outright told, ‘No,’” said Bovyer. “‘We have a plan for this particular patient if she should return to the hospital,’ but no changes in anything to protect the staff. I talked about their legal obligation to protect the staff, and they talked about progress of patients.”

Health P.E.I., the government organization that runs Hillsborough and other healthcare facilities around the province, did not respond to COHSN’s request for an interview.

Bovyer suggested that Hillsborough needed new policies to deal with worker safety without jeopardizing patient care. “They need to have stronger policies to protect staff, which they don’t seem to have now. They don’t seem to have any appetite to change policy, because their main concern is progress of patients.”

She added that this had been an ongoing problem at Hillsborough for about 20 years – and that many other P.E.I. healthcare facilities were also dealing with violence, to a lesser degree.

“The nursing-home people, they’re getting slapped, they’re getting scratched, they’re being spit on, pinched, hit, possibly run into with wheelchairs,” said Bovyer. “The management always comes back to staff and says, ‘What did you do wrong?’” In addition, staff members have been blamed and even fired from facilities as a result of violent incidents.

“So it’s an ongoing trend. It’s an increasing trend now.”

Currently, Hillsborough employs “commissionaires” to deal with violent patients, she said. “They said they’re going to get higher-trained commissionaires, but not – they never said anything about getting correctional officers,” added Bovyer. “Commissionaires are not really security.”

Other provinces have recently begun to take action on violence against healthcare workers. On Aug. 6, the B.C. Ministry of Health announced that it would be providing funds to increase security at four facilities (COHSN, Aug. 11), while the Government of Ontario has initiated a leadership table of experts to devise anti-violence strategies (COHSN, Aug. 18).

Bovyer was not optimistic that P.E.I. authorities would follow a similar route. “I can’t see them doing that here, because they are very much trying to get a decrease in their budget.”

Of the province’s healthcare workers, she lamented: “They’re not getting support on the floor, they’re not getting support from upper management.”

British Columbia’s Ministry of Health is collaborating with the B.C. Nurses’ Union (BCNU) to provide $2 million in funding to reduce occupational violence at four of the province’s healthcare facilities.

The move is part of the B.C. government’s Violence Prevention Action Plan, according to a Ministry press release dated Aug. 6. Staff at the four sites will use the money to carry out priority actions to improve worker safety over the next few months.

“Violence in the healthcare workplace is a real challenge faced by many dedicated healthcare workers on a daily basis in many cases,” B.C. Health Minister Terry Lake told reporters at a Vancouver press conference on Aug. 6, according to a transcript provided to COHSN. “But we can’t accept that this violence is inevitable or acceptable, nor should we accept that there is nothing that we can do about it.”

Lake added that this decision had stemmed from an April conference in Richmond, the Summit to Prevent Workplace Violence in Health Care, in which the Ministry, BCNU, healthcare workers and other unions and stakeholders discussed the issue of on-the-job violence in the sector (COHSN, April 14).

“We have heard the concerns about safety in the healthcare workplace, and we recognize the negative impact that violence and aggression can have on the quality of working life for our healthcare providers,” said Lake.

The safety improvements that this initiative will support include the following:

• Seven Oaks Tertiary Mental Health, Victoria: Security access for extra help in patient restraint, hiring of clinical nurse supervisor for mentorship and education, low-stimulation room for agitated residents;
• Hillside Centre, Kamloops: Increase in staffing levels, increase in mental-health staff with violence-response skills, improved training and education on resolving conflict;
• Abbotsford Regional Hospital, Abbotsford: Upgraded communication systems and panic buttons, extra security cameras, improved access to seclusion rooms for aggressive or risky patients; and
• Forensic Psychiatric Hospital, Coquitlam: Improved distress system, hiring of coordinator for mentorship regarding violence prevention, improved orientation and training.

The four sites were chosen because they were identified as high-risk sites for employees, according to BCNU president Gayle Duteil.

“They have a high level of violence, a high level of violence-related injuries, a high level of WorkSafeBC claims,” she explained. “Abbotsford Regional Hospital, in the emergency department, sees daily violence. There’s Hillside in Kamloops, where we’ve had many nurses assaulted in the recent months and years.” Duteil also called the Coquitlam hospital “a very difficult place to work.”

Lake noted that the four selected facilities also specialize in patients with severe mental-health issues and, sometimes, a history of violence.

“These sites particularly, I think, are the ones where staff need to be supported and we need to have the right systems in place,” he explained. “We’ve made some really great improvements, working with staff and having health authorities talk with staff about their needs.

“It’s probably not possible to get to zero incidents because of the unpredictable nature of people when under physical, mental-health stress, but we want to make sure that we get that risk to as close to zero as possible by providing healthcare workers with the tools and the training they need to de-escalate and avoid those violent incidents.”

Duteil pointed out that the collaboration plans to expand the initiative to eight more high-risk facilities later this year. “It’s a very good start, but it is only a start,” she said. “Violence against nurses and against healthcare workers is an epidemic across the province of B.C., so we want to continue on until every nurse in this province feels safe going to work.”

Although pleased with the progress to date, Duteil said that she hoped to spread these safety enhancements to more than 700 more sites.

“We need to do everything we can to reduce the level of violence, and it just cannot be considered part of the job.”

FEDERAL – Canadian employers who abuse the Temporary Foreign Worker Program (TFWP) and the International Mobility Program (IMP) will begin to face new penalties from Employment and Social Development Canada starting later this year, according to a media release from the United Food and Commercial Workers Canada (UFCW) union on July 13. Starting on Dec. 1, employers who violate the specifications and conditions of these programs could face fines ranging from $500 to $100,000 per charge, amounting to a maximum penalty of $1,000,000 within a year. Serious violations could potentially result in bans from a program lasting between one and 10 years or even expulsion, the release noted. “These new penalties might help, but there is still much more that needs to be done to provide migrant workers with the dignity, respect and legal protections they deserve while working in Canada,” UFCW national president Paul Meinema said in a media statement following the announcement.