New federal worker safety webpage includes case studies of workplace violence program and training implementation by MNA RNs at Providence Behavioral Hospital and Mercy Medical Center.
A new publication by the federal government focusing on preventing workplace violence in health care settings uses case studies from around the country to show best practices, including the successes of unionized registered nurses at Providence Behavioral Health Hospital in Holyoke and Mercy Medical Center in Springfield.
The Occupational Safety & Health Administration report was published Tuesday on a new webpage called “Worker Safety in Hospitals: Caring for Our Caregivers.” On the page, OSHA points out that health care accounts for nearly as many serious violent injuries as all other industries combined. The National Institute for Occupational Safety and Health defines workplace violence as “violent acts, including physical assaults and threats of assault, directed toward persons at work or on duty.”
“The nurses at Providence Hospital and Mercy Medical Center are excited to have their years of hard work presented to the public and made available for use by nurses and health care professionals around the country,” said Andrea Fox, RN, an MNA Associate Director and chief bargaining negotiator for both units. “This achievement underscores the valuable role unionized nurses can play in improving the safety of workers and patients.”
Among the tools presented by OSHA are the following guides featuring RNs at Providence and Mercy: “Preventing Workplace Violence: A Road Map for Healthcare Facilities” and “Workplace Violence Prevention and Related Goals.” Efforts by nurses represented by the Massachusetts Nurses Association at Providence Hospital to improve in such areas as de-escalation and alternative restraints are presented in detail by OSHA.
“In the late 1990s and early 2000s, registered nurses at Providence Hospital—a 104-bed behavioral health facility in Holyoke, Massachusetts—raised concerns about rising levels of violence and high rates of assaults by patients. With assistance from their union, the Massachusetts Nurses Association, the nurses brought their concerns to the bargaining table during contract negotiations. The union proposed research-based changes to hospital policies to address workplace violence,” OSHA wrote.
“The joint efforts of labor and management have led to more than a decade of collaboration on preventing workplace violence, a multidisciplinary task force, an open dialogue, a greater emphasis on prevention and de-escalation instead of restraint, and ultimately a decrease in the number and severity of assaults by patients.”
Cindy Chaplin is an RN at Providence Hospital and chair of that hospital’s bargaining committee, as well as co-chair of its Workplace Violence Taskforce. She is quoted in the OSHA report, speaking about how Providence has found success in treating patients.
“Where some hospitals would limit their approach to medication, we use a more holistic approach,” Chaplin said. “We work with patients as individuals, to find out what has a calming effect on them, and help them put that into practice. The result can be a positive change that lasts the rest of their lives.”
OSHA also details a full-scale active shooter exercise conducted at Mercy Medical Center earlier this year. It included three scenarios: gang violence in the ED, a behavioral health escalation incident, and an estranged ex-boyfriend in the maternity unit. Staff from many Mercy units and from Providence Hospital participated in the drill.
“Evaluators noted participants’ situational awareness, law enforcement response, communication, emergency operations, and treatment and triage,” OSHA wrote. “The exercise was followed by an open and blame-free evaluation that identified opportunities for improvement.”
The MNA has made efforts to address a growing epidemic of workplace violence in health care a major organizational initiative for more than a decade, both at the union negotiating table and in the state legislature. The organization has two occupational health and safety experts on staff who work with practicing nurses on its Workplace Violence Prevention Task Force to develop model contract language to deal with the issue, as well as educate nurses, managers, local law enforcement and policymakers throughout the state about the issue and best practices to reduce workplace violence.
The MNA also has a bill pending before the state legislature that would require health care facilities to implement workplace violence plans. An Act Requiring Health Care Employers to Develop and Implement Programs to Prevent Workplace Violence (H.1687/S.1313) 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. Hospitals would then need to develop a written violence prevention plan and put measures in place to minimize risks. The bill also requires the creation of an in-house crisis response team to support victims of workplace violence.