Thank you for giving us the opportunity to speak here today.
My name is Adriane Gear. I'm the executive councillor for health and safety for the B.C. Nurses' Union. I'm joined today by BCNU occupational health and safety director, Moninder Singh.
Both of us are honoured to have been given this time to address the growing epidemic of violence against nurses in the province of British Columbia and across the country. It's an issue of significance for us and the more than 47,000 nurses and allied health care workers we represent.
I sit here today not only as an elected representative but also as a registered nurse who has spent close to 25 years in the field and has the personal understanding of what nurses experience every day while we strive to provide safe patient care.
Over the last 20 years, BCNU has been sounding the alarm about violence against nurses and health care workers. Two years ago, we launched the very successful campaign, “Violence. Not Part of the Job”. This has consisted of public advertising, member outreach and lobbying efforts with the provincial government. Our work has resulted in a significant increase in awareness about violence in health care. Our main message is that violence is not part of any nurse's job.
Despite this, I feel it's important to share with you just a few of the many personal examples of violence members have shared with me. This past Christmas Day in Victoria, a patient in an adult psychiatric intensive care unit attacked a nurse from behind and placed him in a chokehold. The nurse blacked out and then the patient proceeded to slam the nurse's head repeatedly on the ground.
That same month in Kamloops, a nurse who was 26 weeks pregnant was punched in the stomach by a confused patient. Thankfully, the baby was medically cleared. In Prince George, a young nurse, a new grad, was assaulted by a male patient in a premeditated attack. He waited until she was alone in the nursing station, then crawled along the floor before attacking her from behind. Luckily, the nurse had self-defence training and was able to fight off her attacker.
This past April, another nurse was struck from behind with a wheelchair footrest after a patient followed her into the room. While the nurse pulled the call bell to alert someone, she was again struck and she could not protect herself. It took three workers to pin down the patient. Security refused to assist due to physical inability.
Stories like these along with grim statistics provide strong evidence that more needs to happen. A 2015 WorkSafeBC report found that on average, 26 nurses a month suffer a violent injury at work in the province, and the injuries due to violence have been steadily increasing year after year. This is despite a general downward trend of claims across other sectors.
Just this year, the Fraser Health Authority, B.C.'s largest health authority, released a violence data report that found that the number of violent incidents reported in health care workplaces increased by 52% between 2014 and 2018. While we understand that violence is most prevalent in emergency and psychiatric units, it is not limited to just these areas of health care. We hear concerning stories coming directly from our members who work in community and home health, geriatrics, palliative care and critical care. Violence impacts all nurses in all workplaces in all health care settings.
A 2017 BC Nurses' Union survey, conducted in partnership with the University of British Columbia, found that only 27% of our members said that they always feel safe at work, and a sobering 40% said they were thinking of leaving the profession entirely, because of workplace violence. This level of despair pushes us to keep asking why.
Why is it that according to a WorkSafeBC report, more than 40% of the injuries that nurses suffered were the result of violence in the workplace, even more than security and law enforcement?
The BCNU is determined to find solutions and get to the bottom of this crisis that is impacting so many nurses in this province and around the country.
Data collected from a recent BCNU violence survey found that nurses felt safer when they had access to fixed and personal alarms that worked. Our members told us that the presence of appropriately trained security personnel—people who are there specifically to respond to an incident—made them feel safer.
Nurses told us that they wanted to be included in prevention planning, and we agree this action will both improve confidence and empower nurses. The survey also asked nurses to provide some suggestions of their own. Not surprisingly, many offered valuable insight. Respondents said the addition of well-trained security 24-7, better staffing, the enforcement of existing zero tolerance violence policies and the reduction of overcrowding in our hospitals would be welcomed.
We fully agree that all these recommendations if implemented would contribute to establishing a culture of workplace safety. We are also cognizant of the psychological impact of violence on our members. BCNU is the first union to negotiate the mandatory implementation of the CSA standard for psychological health and safety in the workplace. While we have been frustrated with the lack of progress in the implementation of the standard, we remain hopeful that once it's implemented the rates of psychological injury will be reduced.
Over the last year, we have been very busy applying pressure on the provincial government to stand up and deliver on promises to keep nurses safe. Last October, we delivered 25,000 signed postcards from concerned citizens to the Ministry of Health, demanding that violence in health care be eliminated. In addition to applying provincial pressure, we recognize the importance of engaging on a federal level to ensure nurses' needs are met.
We welcomed federal NDP MP Don Davies’s introduction of a bill to amend Canada’s Criminal Code to make people convicted of assaulting health care workers eligible for more serious sentences. A 2017 Mustel poll commissioned on behalf of the BCNU found that 84% of British Columbians support tougher sentences for criminal assaults against health care workers.
However, we want to make it clear that this change to the Criminal Code would only be applicable to people found criminally responsible for assault. The intent is not to criminalize behaviour that is due to medical circumstances or focus on patients with mental health needs. Our goal is to hold culpable assailants accountable, not target vulnerable patients.
We support the Canadian Federation of Nurses Unions' recommendations that national minimum-security training standards for health care environments need to be legislated, and protocols for responding to and investigating workplace violence incidents need to be established. The BCNU also proposes adding a related recommendation for national guidelines for communicating risk of violence in health care settings. The BCNU supports the CFNU's recommendation that federal funding needs to be targeted towards CIHI's collecting and reporting on health care facility-level workplace violence-related data. We feel that the routine collection of data at the national level will help to inform and evaluate progress on this important issue. We also believe this will help address some of the difficulties around the under-reporting of violence in health care.
Finally, while the BCNU supports the spirit of the CFNU's recommendation for a study into health human resources planning, we call for stronger language and immediate action. We know that Canada is experiencing a nursing shortage, and that the shortage is likely to get worse as the baby boomers retire. The BCNU is calling for immediate targeted funding for additional nursing seats in each province, and funding to hire the resulting additional graduates into new positions.
We believe it's important to work collaboratively with all levels of government, health care institutions and unions to effectively address this problem in all areas of our health care system.
I'd like to end by saying that all too often we hear statements like “Violence is part of the job” and “Is it really a crime?” It is this lack of understanding that motivates all of us at BCNU to work towards changing this culture. From the nurse manager in an emergency room to the federal politician in Parliament, we believe the safety of nurses and health care workers is everyone's responsibility.
Thank you.