BOSTON, Mass. – Amid skyrocketing violence against health care workers, many Massachusetts hospitals are failing to protect their staff, prompting nurses from across the Commonwealth to call for legislation requiring employers to take action.
“A hospital should be a place where patients go to heal and nurses and other health care professionals are able to provide care in a safe environment. Unfortunately, hospitals are growing increasingly violent for both employees and patients,” said MNA Vice President Karen Coughlin, a registered nurse with the Department of Mental Health at Taunton State Hospital. “I have six colleagues who will never return to work because of the trauma they experienced in just my workplace alone.”
Frontline nurses and former Boston Police Chief Daniel Linskey testified today at the State House in favor of An Act Requiring Health Care Employers to Develop and Implement Programs to Prevent Workplace Violence (S.1313/H.1687), a bill whose components are supported by a new Massachusetts Nurses Association survey of more than 220 union and non-union nurses.
Fear of violence and physical and verbal abuse are rampant in Massachusetts health care facilities, according to the survey. More than 85 percent have been punched, spit on, groped, kicked or otherwise physically or verbally assaulted. Yet only 19 percent of nurses say their employer was supportive and tried to find solutions after they experienced violence, while 76 percent said existing workplace violence policies are not enforced.
“These numbers are disturbing, but not surprising to those of us who work in our state’s health care facilities,” said Kathy Metzger, RN retired at Brockton Hospital and an MNA board member. Metzger noted that the vast majority of nurses surveyed support a range of solutions, such as violence prevention training, better admissions policies, upgraded security equipment and improved policies and procedures.
“Experiencing the trauma of an assault can cause physical and psychological damage, and those problems can linger for weeks or months, affecting a nurse’s ability to perform her job or even return to work,” Metzger said. “Without legislative action, hospitals and other health care facilities are under no obligation to put the measures in place that will help to mitigate workplace violence.”
A 2015 report from the Centers for Disease Control (CDC) found that between 2012 and 2014 incidents of violence “nearly doubled for nurses and nurse assistants.” Violence against health care workers accounts for nearly as many injuries as in all other industries combined, according to the Occupational Health and Safety Administration. That is at a rate five times greater than the average worker in our country, with nurses experiencing more non-fatal incidents of workplace violence than against the police or corrections officers.
The hospital industry’s failure to implement effective workplace violence prevention programs on its own has frustrated the 3,000 nurses at Brigham and Women’s Hospital, according to Patricia Powers, OR RN and MNA Local Unit Chair. The fatal shooting of Dr. Michael Davidson at the Brigham in January 2015 illuminated security concerns for nurses at the hospital, Powers testified. Yet despite receiving two OSHA warning letters within six weeks, hospital management and Partners HealthCare have refused during ongoing contract bargaining sessions to make concrete changes to improve underlying security problems.
“Without a law requiring hospitals to work with staff to adopt violence prevention programs, we face an uphill battle.” Powers said. “This law will apply to every workplace and protect every health care worker in the Commonwealth, whether or not they are unionized. Unions should not be a substitute for good government regulation to keep people safe.”
Former Boston Police Chief Daniel Linskey, now a managing director with the international security firm Kroll, has examined the security at Brigham and Women’s on behalf of the nurses. He concluded that there are numerous ways Brigham management and Partners HealthCare can make the hospital safer for staff, patients and visitors.
“In an unofficial site visit, I walked into the hospital as a member of the public and was able to access restricted areas and equipment. Unfortunately, security is often lowest on the list of priorities,” Linskey said. “We have made great strides over the past century in ensuring workplaces are safer than they used to be, but this did not happen without some government intervention such as fire and building codes. If we had waited for industries to adopt these measures on their own, I do not think we would have seen such improvements.”
Components of S.1313 include:
• Requires health care employers to perform annual risk assessments in cooperation with employees to identify factors which may put employees at risk for workplace violence
• Requires hospitals to look at factors like working hours, public access to the area, working in high-crime areas, staffing levels and other factors that affect safety
• Requires hospitals to then develop a written violence prevention plan and put measures in place to minimize risks
• Requires the creation of an in-house crisis response team to support victims of workplace violence
When a patient attacked Ellen Farley several years ago, he had already violently assaulted other staff numerous times. Farley, a registered nurse at Taunton State Hospital, knew she had to do something. Farley filed criminal charges and a judge sent her attacker to Bridgewater State Hospital for evaluation, stemming the patient’s revolving door of criminal courthouse to Taunton State Hospital and back again. The experience showed Farley that the law and its repercussions can be a powerful tool against health care violence.
“I believe the absence of a state law requiring health care employers to have a comprehensive workplace violence program in place has come at a great cost to me, my colleagues and all the individuals we serve,” Farley said. “The time and resources spent on those who become violent takes away from our other patients. We have patients who are traumatized by witnessing acts of violence in an environment which should be conducive to recovery, health and wellness, not an environment where there are repeated assaults or threats.”