Thank you, Mr. Chair and committee members, for providing me the opportunity to speak to you today about workplace violence in health care.
My name is Thomas Hayes. I'm the Director of Safety, Security, Parking and Staff Health at The Ottawa Hospital. I've been at the hospital for over 16 years. We're one of Ontario's largest hospitals, with close to 16,000 staff, including 4,400 nurses, 1,400 physicians and midwives and 1,100 volunteers. We're a teaching hospital with thousands of students each year. We have 19 sites across the city of Ottawa. We see over 174,000 emergency visits a year and nearly 1.2 million ambulatory care visits, and last year, we delivered 6,211 babies. We have over 2,000 researchers and are ranked third in Canada for peer-reviewed funding from the Canadian Institutes of Health Research.
At the same time, last year we had 58 staff members who suffered injuries at work as a result of violence that was serious enough that they lost time from work or needed to see a physician. The security team at the hospital responded to an average of seven code white urgent physical interventions a day and three pre-emptive calls a day.
I want to acknowledge that violence in health care is a difficult topic to talk about. I want to tell you about two stories, and I've changed some of the aspects of these stories to protect the confidentiality of those involved
First, imagine you're a nurse. You're working in an emergency service. It's night. You have several patients being assessed and treated while they're being considered for admission, one of whom is with a visitor. It's been a long shift, and the security guard in your area asks if he can go get a coffee. You say, of course. Everything's quiet and everyone needs a break once in awhile.
Now you're alone. A few minutes pass and one of the patients under your care starts pacing the hall and trying to get into the rooms of the other patients. You go into the hall to speak to him, and he starts returning to his room.
The next thing you know, he's lunged at you, grabbing you, pulling your shirt over your head and punching you as you fall to the floor to protect yourself. The visitor, hearing the commotion, peers into the hallway, sees what's happening, goes back into the room and hits a panic button on the wall. Luckily, the security office is right across the hall from your area, and seconds later, four guards arrive and start to restrain the patient who's punching you, who by now seems to have lost interest in continuing to assault you. A nurse and a physician arrive to help as well, and you crawl to the locked nursing station to start to recover. What if that visitor hadn't been there? What if the visitor had left a few minutes earlier? You had no way of summoning assistance. There was no system or schedule in place to replace that guard who needed a break.
Fast forward a couple of years. You're a dialysis nurse working in the evening as several patients finish their day-long treatment. You know from your safety huddle earlier in the shift that one of the patients has exhibited violent and disruptive behaviour in past visits. Your manager had invited a safety officer and a member of the joint health and safety committee to provide a refresher on violence prevention training at your last team meeting and had encouraged people to report and to summon assistance when they needed it. They told you that this could happen anywhere in the hospital, not just in the emergency department or in mental health areas, and that, in fact, at one of the other campuses recently, a dialysis patient had come to his treatment with a large knife in his bag.
You notice that the patient is starting to get very upset with another nurse, who's trying to calm him down and lower his voice. You ask the clerk to call a code white, and you hear it paged overhead, calmly, almost right away. Less than a minute later, several security guards arrive, along with the overnight nursing supervisor. They check in with you, and together they approach the patient to discuss his concerns and are able to de-escalate the situation.
You provide a report in the safety learning system, where you're encouraged to report issues that relate to both staff and patient safety. The next day, your manager checks in with you after reading the report to make sure that you're okay. She thanks you for your action and lets you know she will be reviewing the incident with the violence prevention working group to see if there is anything else that can be learned from this event and shared with other departments.
At the Ottawa Hospital, we realized several years ago that we didn't really know how widespread violence against our staff members was and that it was much more serious than we thought. We decided that in order to achieve our vision to provide each patient with the world-class care, exceptional service and compassion we would want for our loved ones, we needed to provide that care and compassion to our staff as well. We expanded our corporate strategy to include a quadruple aim. Beyond better quality at lower cost, healthier populations and a better patient experience, it now includes a better staff experience. We have learned that through collaboration with labour groups like the Ontario Nurses' Association and our front-line staff, including physicians, we create a safer environment.
We know we still have a long way to go, like every other healthcare workplace, to address violence, but at least we feel more comfortable that our staff are not afraid to report issues so that they can be addressed in a way that respects the needs of patients, visitors and staff.
Thank you.