Violence and abuse are not part of the job
Being assaulted is not in any health care provider’s job description. Yet even with a vigorous, three-year prevention campaign, violence is still taking place in our hospitals and clinics.
In one unit, an agitated patient grabbed a CNA’s hair. Another tried to strike a nurse with a telemetry box. Just this month, a patient brought by police to an Asante Emergency Department attacked and injured staff members.
Stories like this abound at health care facilities across the United States, which is why the American Hospital Association launched Hospitals Against Violence, or #HAVHope. On June 4, Asante joins this national day of awareness to combat violence in the workplace and urges interested employees to share the message outside of Asante.
This observation is an extension of what the system has been doing since the Workplace Violence Prevention Council was established in 2020. Its goal is to reduce abusive and violent behaviors through cultural change, operational practices and environmental safeguards.
To date, this group has:
- Expanded training on de-escalation techniques, behavioral management and crisis intervention.
- Instituted a warning system to alert employees if a patient exhibits harmful behavior or has a history of violence against staff.
- Updating policies on code gray, disruptive patient, disposition of patient belongings and post-event forms.
- Drafted Words That Work to help employees communicate with violent or aggressive patients.
- Posted signs in patient care areas to remind the public that abusive or violent behavior will not be tolerated.
- Established an Incident Review Council that reviews incidents of workplace violence and develops a standardized process for improvements.
- Instituted purposeful security rounding.
- Adopted a cross-functional trauma-informed care response, or TICR, huddle to develop appropriate safety responses for a troubled patient.
- Created a one-stop Workplace Violence Prevention resource center on myAsanteNET with updated policies, instructional videos and toolkits.
- Strengthened security features on campuses, including adding exterior lighting and limiting unauthorized access to buildings.
Perhaps the biggest change, and one that’s hardest to measure, are the cultural shifts. For years, many employees accepted violent and abusive behavior as part of the job, particularly with patients who had behavioral health issues or suffering the effects of medication or illicit drugs.
As part of the Workplace Violence Prevention program launch, leaders have emphasized that “becoming the victim of violent or assaultive behaviors should never be written off as part of the job.”
The program has stepped up its effort to encourage staff members to file a responsible event report (RER) after an incident of abuse or violence — and to have confidence that Asante’s leaders will back them up.
This proved to be some comfort to Stacy Kostenbauer, manager of the Heimann Cancer Center. After receiving an alarming threat from a patient with a history of abusive behavior, she filed an RER, called Medford Police and was granted permission to handle the situation as necessary.
“That was key,” she said. “You have to have the support of your director and the risk management team — and we did.”
If you have a question, please contact the author or relevant department directly.