2011 News

A nurse is not a punching bag: RNs advocate for safer workplaces

08.15.2011

From the Massachusetts Nurse Newsletter
August 2011 Edition

By Riley Ohlson
Associate Director

  
  Testimony from RN experts: Karen Coughlin, left, Joanne DaCosta and Karen Duffy.
   

On June 23, the Joint Committee on Public Safety held a public hearing on S.1237, An Act Requiring Health Care Employers to Develop and Implement Programs to Prevent Workplace Violence. This bill was filed by the MNA to address the crisis of violence in hospitals across the commonwealth. Sen. James Timilty (D-Walpole), Senate chair of the committee and Rep. Mike Brady (D-Brockton), House vice-chair of the Committee, sponsored the bill.

Karen Coughlin, MNA vice president and a bedside nurse at Taunton State Hospital, led the MNA panel of testifiers and began by thanking legislators for their support last year in passing legislation that enhances the penalties for those who assault health care workers while they are in the line of duty. Coughlin went on to identify the next step in reducing this type of violence. “Addressing the problem of violence in hospitals requires a multi-pronged approach. Last year, we dealt with the issue of punishment, which is a crucial piece of the puzzle. But I think that even more important than punishing offenders is preventing this violence in the first place, and that’s what SB 1237 addresses,” Coughlin explained.

S.1237 would require health care employers to work with their employees to perform annual risk assessments and identify factors that may put employees at risk of workplace violence. These factors vary from facility to facility.

Once these factors are identified, the bill requires health care employers to develop and implement a plan to minimize the risks. Because the risks are different from hospital to hospital, the plan will be different in each facility. Finally, the bill would require employers to work with their employees to evaluate the plan annually and make adjustments as necessary.

After Coughlin finished, Joanne DaCosta, an RN in a psychiatric unit, testified about the problems her unit faced with violence when her hospital started dangerously increasing the census without adding additional staff. “Despite difficult circumstances, for many years we were able to provide safe, quality care to our patients. We were even able to dramatically reduce the use of restraints in our unit, a major goal of the Department of Mental Health. However, in 2009 we began to see a number of negative changes. Where admissions to the unit were once controlled, patients are now admitted whether or not staff believes that there are sufficient resources available to care for them. Predictably, serious problems with violence emerged almost immediately.”

DaCosta described coworkers’ efforts to convince management to remedy the problem, offering such seemingly common-sense suggestions as moving a security guard from the hospital to their unit, which is physically isolated from the rest of the facility. Nevertheless, her facility’s management has yet to respond to calls for proactive steps to reduce violence, and workers and patients continue to suffer the consequences.

Karen Duffy, an RN at Signature Healthcare Brockton Hospital, used an example from recent history to explain what can happen when the concerns of health care professionals are heard and the suggestions are implemented. Five years ago, violence was epidemic at Brockton Hospital. Between May 2006 and May 2007, more than 1,000 calls were made from within Brockton Hospital to 911—more than three violent or potentially violent incidents within the hospital per day. Nurses had been imploring management to take the problem seriously for years. They even conducted an informational picket at the hospital, and eventually asked OSHA—the Occupational Safety and Health Administration—to come in and see the problems for themselves. OSHA issued a devastating report validating the RNs’ concerns, and finally hospital management responded.

Brockton identified weaknesses in its security system and implemented a plan to make the hospital safer. As Duffy explained in her testimony, positive results occurred immediately. “As you can see from this chart … calls to 911 from inside the hospital began to drop. In 2008, there were 464 such calls, more than 50 percent fewer than before. In 2009, there were 341 such calls, and last year only 160. That is almost a 90 percent reduction in these emergency calls in just a three year period,” said Duffy.

While the job is not finished at Brockton Hospital, Duffy made it clear to legislators that the common sense steps outlined in S.1237 can make rapid and impressive strides toward a safer workplace. Legislators on the committee were supportive of the nurses’ testimony, with one state representative even suggesting that the bill be made more stringent to prevent hospitals from taking advantage of any possible loopholes. One month later, the bill was reported favorably out of the Public Safety Committee.

The bill is now before the Joint Committee on Health Care Finance, and legislators need to hear from you about the problem of workplace violence and how important it is for them to act on this prevention legislation. To find your legislator, visit capwiz.com/massnurses. For more information or to get involved contact Andi Mullin at amullin@mnarn.org or 781.830.5716.

Visit our Workplace Violence page.

FPO