Hospital asked to take immediate steps to improve conditions, protect workforce
From the Massachusetts Nurse Newsletter
November/December 2007 Edition
In response to a complaint filed by the MNA on behalf of the registered nurses at Brockton Hospital, federal investigators issued a report in July of “significant findings” regarding workplace hazards that are contributing to a number of assaults against and injuries to nurses due to unchecked workplace violence.
The Occupational Safety and Health Administration (OSHA) found that “during the previous six months, employees are suffering physical assaults from patients which can lead to serious injuries. The types of physical assaults include, but are not limited to, punching, kicking, biting, scratching and pulling hair. Resulting injuries include, but are not limited to, bruising/contusions, cuts, hematomas, strains and sprains. The majority of the cases involved patient care givers who were assaulted while assisting and/or caring for patients in the emergency department and psychiatric unit.” Those details were highlighted in a July 13 letter sent to Kimberly Walsh, vice president at Brockton Hospital.
The letter said the problems were not violations of OSHA standards because, at this time, there are no specific OSHA standards related to workplace violence. However, the hazards are “considered serious enough to be brought to [the hospital’s] attention.” The letter calls upon the hospital to implement a number of initiatives to address the problem and to submit monthly reports to OSHA detailing the progress.
Specifically, the report calls for the creation of a workplace violence committee, including managers and frontline nurses, to review and analyze the problem and to develop a detailed plan and policies to address the crisis. It requires an analysis and implementation of changes to the physical plant, including metal detectors and barriers in certain areas to better protect staff. It also calls for hospital-wide training and education on the issue to help staff understand the risks and how to prevent violence, and it requires comprehensive and ongoing tracking of incidents so that steps can be taken to improve the program.
“On one level, this report serves as a vindication of a serious and growing problem faced by nurses and other workers at this hospital due to management’s failure to put in place policies and procedures to keep their workforce safe,” said Kathy Metzger, chair of the nurses bargaining unit and a leader in the effort to improve conditions contributing to an epidemic of violence at the hospital. “We only hope that our administration will take these recommendations seriously and finally act in the best interests of their employees.”
According to nationwide statistics, nurses are assaulted on the job as often as police offices and prison guards. OSHA has identified workplace violence for health care workers as a major problem and has encouraged hospitals to take steps to prevent workplace violence, as well as to provide proper treatment to employees who are victims of violence. Brockton Hospital has done neither, creating an unsafe work environment where violence is a regular occurrence and where nurses who are victims of violence are not provided with appropriate support. Brockton Hospital has the worst record—both in the number of assaults and in the administration’s efforts to respond to and address the problem—on workplace violence of any of the 51 hospitals where the MNA represents nurses.
In the last year alone, there have been 1,066 calls to 911 made from Brockton Hospital for police support. In comparison, nearby Good Samaritan Medical Center had only 388 calls to 911. In the last year, at least eight nurses have suffered vicious assaults from patients. One nurse was punched in the face by a patient; another was dragged by her hair by a patient; another was threatened by a patient with a knife, while one nurse had a urinal thrown at her. There have been fights in the emergency department among patients themselves, where in once instance a chair was thrown through a window. “There is no excuse for such chronic violence, especially when administrative policies are a contributing factor,” Metzger explained. “After the strike in 2001, management made the decision to eliminate a standard police detail to cover the night shift. In addition, hospital security services were cutback and security procedures were put in place that prevented security staff from making physical contact with patients. In essence, there is no security for nurses, patients and staff at Brockton Hospital.”
Legislation requiring workplace violence prevention
Last fall the nurses at Brockton Hospital attempted to negotiate union contract language that would have obligated the hospital to take many of the same steps that the OSHA letter has required of the administration.
The problem with the approach provided by OSHA is that the requirements and participation by the hospital in meeting the OSHA standards are voluntary. “We simply don’t trust this management team to do the right thing when it comes to protecting employees or patients,” Metzger said.
In addition to pursuing remedies to this problem at the union negotiating table and through OSHA, nurses at Brockton Hospital are also active—with nurses throughout the state—in fighting for passage of legislation (S.1345) that will require all health care providers to have a plan in place to prevent workplace violence. Metzger was one of several nurses who testified on the issue at a public hearing on the bill held at the State House in June. Many of the steps required under the proposed law mirror those outlined in the OSHA letter to Brockton Hospital.
“Brockton Hospital is the poster child for why there needs to be a state law to enforce protections against workplace violence,” Metzger stated. “It shouldn’t take months of union negotiations and a potential strike, or a federal investigation, to force a hospital to do what it should have done as a matter of common sense and common decency. Since hospitals like Brockton Hospital won’t do this on their own, we need a law to make them do it.”
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