Good afternoon, and thank you for the opportunity to address your committee today.
I speak on behalf of the 680,000 members of the Canadian Union of Public Employees. Our members are on the front line of the health care system, and as such are personally dealing with the phenomenon of workplace violence. Of our members, 158,000 work in health care environments, including hospitals, public health, residential long-term care facilities, community health, home care and the Canadian Blood Services.
Our written submission contains many statistics that help illustrate the prevalence of violence in our health care system. I hope to spend my time here today highlighting the impact on our health care system and on the individual workers that Canadians count on in their times of greatest need.
Almost 1,700 years ago, the Roman poet Juvenal famously asked, “Who watches the watchmen?”, a question that helped articulate the fears of a society concerned with the abuse of power and centralization of that power. If there were a Canadian equivalent to that question in 2019, it would be “Who cares for the caregivers?”
As a society, we have decided that health care is a priority and we've dedicated many resources to its provision, yet we have failed to tend to the needs of those who are on the front lines providing those essential services.
Employers have failed to take appropriate actions to address workplace violence. Provincial governments have failed to appropriately regulate and fund our health care workplaces to address these challenges. Our judicial system has failed to introduce accountability for those who assault our careworkers.
Who cares for the caregivers? Their families do, and so do the unions, but most importantly, the countless Canadians who look to them every day for help and support care deeply for our caregivers in this society. We need to make sure that they feel those in power care as well.
Violence in our health care system is reaching epidemic levels, and that is not just hyperbole. The statistics from workers' compensation boards in all Canadian jurisdictions attest to the fact that workers in long-term care settings alone report more incidents of violence than any other workplaces. A care worker in a long-term care setting is more likely to experience violence on any given day than a police officer or a prison guard.
I wish I could say that now is the time to act, but sadly, that moment passed long ago. Now is the time we can try to limit the damage and do what we can to protect those workers who care for us.
My role at CUPE brings me into contact with care workers every day when their workplace health and safety system fails to protect them and the judicial system fails to hold their assailants accountable and they turn to their unions for support. I am not able to provide the resources they need to be safe at work and I am not able to impose sanctions on those who have assaulted them, but I am able to advocate for them, and that is why I'm here today.
I am here to give voice to our members working in the home care sector who have been beaten and sexually assaulted because when this female-dominated workforce is sent into the homes of their clients, they have no control over their working environment and have no colleagues to turn to when things go wrong. I have met these people. Just last month, I spent an afternoon listening to one of our members who was sexually assaulted at work and didn't want to report it because the last time it happened, nothing happened, except that she had one less client the next day and four hours' less pay.
I'm here to speak on behalf of our members in long-term care workplaces across this country, those workers who strive to provide safety and dignity to a generation of Canadians who built much of what we all enjoy today. Unfortunately, these workplaces have changed dramatically in recent years.
What we used to refer to as “retirement homes” now house everybody who needs care but does not fit anywhere else within our health system. That includes people like a former bodybuilder who suffered a traumatic brain injury and is now unable to regulate and control his violent impulses. This is a real resident in a real long-term care facility. I have personally witnessed the aftermath of his assaults every time adequate staffing resources are not available when he needs care. The lucky ones only have bruises. Three workers over the last two years who have worked with this resident have had bones broken.
It is not just the young and physically vigorous residents who are a source of violence. Rates of cognitive impairments in the elderly are on the rise, and many, such as Alzheimer's or dementia, can compromise the residents' ability to regulate their own behaviour. Through no fault of their own, these residents have also become a frequent source of workplace violence. A lack of resources puts staff at these facilities at risk, as well as the other residents in care.
I'm here to advocate for our members in the acute care sector: the workers in hospitals who provide care to us in our moments of greatest need and all of those who keep these services running, including everyone from the dietary workers in the kitchen to the administrative workers and the environmental service workers who keep our hospitals sanitary and safe from pathogens and bacteria. They are all suffering from violence in their workplaces.
Our hospitals are difficult workplaces at the best of times, but when violence occurs, it makes this difficult work almost untenable. Employees in almost every other sector can pause work in dangerous situations by using the right to refuse unsafe work. This system has broken down in the acute care sector. Licensed staff are threatened that to pause care in any situation could be construed as abuse and cost them their licences and their livelihood. Others are compelled by their empathy to put themselves at risk because someone else is in need.
While other workplaces can bar people with a history of violent behaviour from entering, hospitals must accept everybody and find some way to provide care to anyone who is in need. Our members would be the first persons to advocate for the right of everyone in Canada to receive quality care. CUPE advocates for the right to be safe while providing that care.
The factors causing violence in our health care system are complex and multi-faceted. Researchers have identified four distinct types of workplace violence, and each one is truly a unique workplace hazard that requires a different approach to solve.
What is known as type I workplace violence occurs through criminal acts. Legislative changes such as those proposed in Bill C-434 will help deter some of these events. I would implore the committee to not stop there and to also turn its attention to other forms of violence that plague our health care workplaces.
What the researchers refer to as type II workplace violence is caused when those whom the workplace provides services to become the source of violence. It is incredibly complex in a health care setting. This risk is increased by heavy workloads, staff shortages and a lack of adequately trained security professionals fully integrated in the care teams.
The federal government has the ability to help address these challenges through specific targeted funding as part of the Canada health transfer. Such targeted funding could be earmarked to increase staffing levels and ensure replacements for staff who are sick or injured to ensure that nobody works alone. We could expand health services so that specialized treatment facilities are available and patients are not kept in settings that don't meet their needs or that don't have the training and infrastructure to provide care safely.
Other recommendations on what targeted funding could achieve include the provision of comprehensive in-person training for all staff to better equip them to recognize the signs or conditions that might lead to violence, as well as training on how workers can de-escalate violence and protect themselves if attacked. We can provide front-line workers with personal alarms and ensure that other stationary alarms in the facilities are available and functional, which is not always the case.
Also, we can provide support for workers who have been injured and/or traumatized, such as counselling services, and allow adequate time away from work to recover from an incident. We can provide province-wide access to chart information to inform staff of previous behaviours in patients who have been transferred between facilities, because in many provinces this is not the case.
As well, we can increase the provision of one-to-one care. We can also provide therapeutic programs to reduce patient stress, fear, frustration, boredom and anger. We can increase security personnel with high levels of training and the capacity to intervene with violent individuals.
Our written submission highlights these and other specific recommendations on how the federal government can take practical steps to reduce the risk of violence in health care facilities.
I thank the committee for inviting us to speak today. We look forward to further opportunities to help care for the caregivers in our society.