Members take action at St. Paul's

The Report: December 2003 vol.24 num.6

SA members at St. Pauls Hospital in downtown Vancouver are becoming increasingly concerned about violence in their workplace. For example, employees working in the hospitals emergency department ... especially in the psychiatric emergency unit ... deal with violent incidents on a daily basis.

What is violence?
The Occupational Health and Safety (OHS) Regulation, section 4.27, defines violence as -the attempted or actual exercise by a person, other than a worker, of any physical force so as to cause injury to a worker."
Violence also includes -any threatening statement or behaviour which gives a worker reasonable cause to believe that he or she is at risk of injury."
Incidents of violence may not necessarily occur on the job site. Incidents are considered workplace violence if they arise out of the workers employment.

Threats generally involve any communication of intent to injure that gives a worker reasonable cause to believe there is a risk of injury. A threat against a workers family arising from the workers employment is considered a threat against the worker.
Examples of threats include:
• Threats (direct or indirect) delivered in person or through letters, phone calls, or electronic mail
• Intimidating or frightening gestures such as shaking fists at another person, pounding a desk or counter, punching a wall, angrily jumping up and down, or screaming
• Throwing or striking objects
• Stalking
• Wielding a weapon, or carrying a concealed weapon for the purpose of threatening or injuring a person
• Not controlling a dog menacing (for example, growling at) a worker

Assault involves any act, gesture, or attempt to apply force that gives a worker reasonable cause to believe there is a risk of injury, whether or not an injury (physical or psychological) occurs. Examples of assault include:
• Kicking, hitting, biting, grabbing, pinching, scratching, or spitting
• Injuring a person by using an object such as a chair, cane, or sharps container, or a weapon such as a knife, gun, or blunt instrument
• Verbal hostility and abuse
Source: Occupational Health and Safety (OHS) Regulation / Workers Compensation Board

Violence in the health care workplace: how is it different?
Violence in the health care workplace
differs from violence experienced by workers in other industries. Health care workers must interact closely with their patients/clients and their families, often under difficult circumstances. Patients/clients may act aggressively due to their medical condition or the medication they are taking. They may also have a history of violent behaviour, or feel frustrated and angry as a result of their circumstances.
Approximately 40 per cent of all violence-related claims come from health care workers, although these workers make up less than five per cent of the workforce in BC. These workers also have more accepted claims and lose more days of work due to acts of violence than any other group.

Whats the difference between violence and aggression?
Although the Occupational Health and Safety Regulation does not define aggression, this term describes hostile, unpleasant, or unacceptable behaviour that may include everything from offensive gestures or expressions to physical violence. Workers unfamiliar with the broad scope of the term -violence" may deny having experienced a violent incident, but may report having experienced incidents of aggression.
Thus it may be helpful to use both -violence" and -aggression" in enlisting the support of co-workers and conducting discussions about workplace safety concerns.
Source: Workers Compensation Board of BC publication Preventing violence in health care: five steps to an effective program

As the psychiatric emergency unit of an inner-city hospital providing care for residents of Vancouvers downtown eastside, St. Pauls -Comox Unit" treats a large number of patients with substance abuse problems, as well as with acute mental illness.

HSA members working in the Comox Unit recently notified HSAs chief steward at St. Pauls, as well as other HSA colleagues about this escalating problem. They fear that an already bad situation will become much worse when their employer contracts out security services. Knowledgeable HEU security guards with many years of experience at St. Pauls were replaced in November by private security guards ... many of whom may have little or no experience with hospitals, and little incentive to stick around long enough to gain this experience, because of the poor wages paid by private companies.

HSA members, stewards and staff have been working with BCNU and HEU to address violence issues throughout St. Pauls on a number of fronts. They have a brought the issue to the attention of the hospitals joint occupational health and safety committee, which apparently had not been receiving any information about violent incidents, even when reports were filed. The committee has met with WCB and management representatives to ensure that a proper violence prevention program is developed and implemented at St. Pauls.

The unions have also worked together to publicize the issue of workplace violence in Vancouver hospitals, and the increased risks posed by privatizing hospital security. Together, they also made presentations to the Vancouver Police Department and Vancouver City Council about the potential impacts of privatizing hospital security.

On October 17, the unions held a well-attended -Tri-Union Safety Day" at St. Pauls to raise awareness about workplace violence. Organizers also obtained information about members concerns and worked to build support for implementing an effective violence prevention program at the hospital.

WCB Prevention Information Line
604 / 276.3100 in the Lower Mainland or 1.888 / 621.SAFE (7233) toll-free in BC

WCB Publications
The following WCB publications may be helpful:
• Health Care Industry: Focus Report on Occupational Injury and Disease
• Coping with Critical Incident Stress at Work (pamphlet)
• Gently into the Night: Aggression in Long-Term Care (by Neil Boyd)

These and other publications can be ordered from the WCB:

Phone: 604 / 276.3068 or 1 800 / 661.2112, local 3068