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Heather Richardson was helping a nursing home resident get ready for breakfast one morning, a routine she does everyday for a few other residents at Kensington Village in London, Ont., when something happened that was clearly not routine: She was kicked in the stomach with enough force to send her flying across the room. “I got up, took a breath and went back to finish my job,” recalls Richardson of one of the worst experiences she’s had working as a health care aid since 1990. “I reported it to the nurse on duty, but I kind of just thought, you know, this was an unusual thing. It didn’t happen everyday at that time.”
But it did.
Everyday, Richardson and many of her co-workers experience a variety of aggression – verbal and physical – from nursing home residents in the course of doing their job. “We have many employees that get hit, kicked, punched, pinched, spit on, rolled over by wheelchairs, and verbal abuse, especially,” she says.
This story isn’t unique to Richardson’s workplace. Gloria MacDonald, an emergency room nurse for 21 years, says she and fellow ER nurses at Rouge Valley Health System in Toronto face verbal abuse from patients and their families on a daily basis. Occasionally, the violence would turn physical.
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MacDonald recalls an encounter with a psychiatric patient years ago: “That was when I first started in the emergency department so I may not have had as much experience with them. I was entering a room to give a psychiatric patient an injection, and he came across the room and punched me.”
Despite a level of expectation that aggression is a daily part of their workplace’s reality, Richardson says she doesn’t think workers ever really get used to the violence.
“As a group that work together, we try and just kind of communicate with each other in letting everybody know what’s going on with this resident that day, for example,” she says, adding that by communicating with co-workers they can try and avoid a potentially violent situation.
MacDonald says that while they face abusive behaviours daily, they should never be accepted as part of their job. “I don’t think it’s acceptable because I don’t walk into a bank or anywhere else and start yelling at the tellers because the lineup was 10 minutes. And I don’t think that we should have to take verbal abuse in the emergency department or anywhere.”
Higher risk
Workplace violence is a reality that some workers face more than others. A Statistics Canada report found incidents of violence in the workplace are more prevalent in health care and social assistance services, where 33 per cent of reported violent incidents occur. This report is based on 2004 figures, the latest known national data on workplace violence.
In Ontario, health care workplaces have the highest violence-related lost-time injury rate, accounting for 34 per cent, according to the Ontario Safety Association for Community and Health Care. This is even higher than municipal workplaces, where police forces face threats of violence on a daily basis, which only come in second at 22 per cent.
The Canadian Centre for Occupational Health and Safety defines workplace violence as any act in which a person is abused, threatened, intimidated or assaulted in his or her employment. These acts include threatening behaviour, verbal or written threats, harassment, verbal abuse and physical attacks.
In a 2008 survey conducted among 500 members of the Ontario Public Service Employees Union (OPSEU), 43 per cent admit they have been victimized by workplace violence over the past year. Of these, over 90 per cent have been threatened and close to three-quarters were physically assaulted.
In many cases, violent encounters at the workplace go unreported. A joint study conducted by professors at York University and Carleton University on violence against personal support workers in long-term care, estimated that of the 15,000 violent incidents experienced by workers over a six-month period, about 99 per cent go unreported. Workers have generally chosen not to report incidents for various reasons, including too much paperwork and fear of being blamed by their superiors, according to the study released in February 2008.
Although most incidents of workplace violence victimize health care workers, some areas of health care carry higher risk than others when it comes to violence, according to Tom Closson, president and CEO of the Ontario Hospital Association (OHA).
“Violence in the workplace, particularly if we’re talking about patient and family violence tends to be fairly concentrated in certain areas in health care,” Closson says. Workers in mental health units, emergency departments and long-term care environments are more likely to be subjected to abusive situations at work.
The OHA provides educational programs and other resources to help Ontario’s 157 hospitals deal with the issue of workplace violence and share best practices on developing prevention and protection programs. The solution to workplace violence, however, is not a one-size-fits-all, says Closson.
He explains hospitals have to develop and provide solutions based on their own needs and the type of environment they operate in.
“We’re dealing with such a wide range of hospitals by size and complexity so the solutions are actually quite different from hospital to hospital.”
The OHA chief adds other forms of violence affecting staff, including staff-on-staff, staff-on-patient and domestic violence, must also be considered when creating workplace violence prevention policies.
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