From the Massachusetts Nurse Newsletter
April 2004 Edition
|RN Marie Dupont, a member of VNAB’s Hyde Park office staff, gets into a cab en route to her rounds.|
"The streets change when it gets dark or when the weekend comes around," is how Sandy Grant described the inherent conditions of work as a registered nurse with the Visiting Nurses Association of Boston (VNAB).
"There is an escalation of violence in the city particularly in the summer and fall months, but problems can occur outside higher crime areas and sometimes just have to do with one patient, not the environment," said Grant, with VNAB for the past ten years. "But management has heard us and there is a heightened awareness and concern for our safety."
That increased awareness and concern has translated into new contract language relative to security, a more active Safety & Security Committee, cab availability and two-way radios for staff working in "high crime" areas. Moreover, a stronger working relationship with Boston police is now in place. VNAB is also in the process of upgrading its phone plan to ensure that all staff members have cellular phones. Meanwhile, monthly reimbursement is provided to all who use their own cell phones.
The oldest Visiting Nurses Association in the country, VNAB employs 450, including 170 nurses who in the year 2003 served 15,000 patients throughout Boston and surrounding communities, including Somerville, Quincy and Braintree.
"There are a number of issues a visiting nurse might have to deal with, including going into homes where there is no phone," according to Grant, vice chair for the Hyde Park office union whose active involvement on VNAB’s Safety & Security Committee is in part borne of personal experiences while on the job.
"Personally, I have had to call 911 when I was with one diabetic client who was high on drugs and having hallucinations," she said. "I was with the same patient at a different address when the police conducted a drug raid on the floors above and below us. Both were frightening experiences. Nurses know there is always a risk, but if we keep things in the forefront, everybody stays aware."
While VNAB’s security committee has been long-standing, it recently combined with the facility’s safety committee and has become more active due to increased crime within the areas its personnel enters. As a result, cabs are available in high crime areas for those on the evening team, and said Grant, "there is now a stronger emphasis for cabs during the day."
"Our executive committee works closely with management," said Grant, noting positive implementations, including screening patients of violent crimes prior to their being accepted as clients and establishing security alerts for nurses entering at-risk areas where an act of violence was recently committed.
Annmarie Martin, district director at VNAB’s Charlestown office said VNAB management is committed to ensuring personnel’s safety.
"We ask the clinician to leave a situation if they feel compromised," said Martin, co-chair of the Safety & Security Committee. "While an issue could be environmental, sometimes it’s related to the client’s home. It could be a family member who may become agitated, or it could be a neighborhood issue, such as youths on the street during the summer."
The 10-member committee, which includes a former Boston police officer, asks personnel to report all incidents so they can be analyzed for trends.
"We also conduct incident de-briefing because sometimes a clinician is in an area where their safety is at risk and they don’t realize it; it doesn’t hit them immediately," said Martin. "VNAB also holds educational safety workshops at least once a year. Making sure our staff is safe is on-going. You can never stop working at it."
Cathy Regan, bargaining unit chapter chair and a member of the VNAB staff for the past 20 years applauded the "increased communication between staff and management."
"It has come over a course of time and now there is more standardized language in the contract," said Regan, in reference to a December 2004 contract insertion that states, "Management and staff are committed to open communication about security concerns. Staff will immediately notify a designated manager on each shift of safety concerns in the field. The VNAB designated manager will be responsible for disseminating information that may affect overall staff safety as appropriate."
"Management is committed to keeping the nurses safe," said Regan. "Things seem to be working out."
Grant echoed that sentiment.
"I’ve seen a true vested interest in staff’s safety," she said. "Management knows we need to be safe and it is acknowledging that 100 percent."