Justice Committee on Nov. 23rd, 2023

[Danette Thomsen]

Yes, that is so true. I'm going to say that around that table, they're desperate. They're desperate for help. Our nurses are out there and they are giving all they can. They're working sometimes in unthinkable circumstances, but they're there because they care. They're there because they want to make a difference.

It's about being recognized for what they're doing and what's happening. It's about how desperate they are for help. That the government would actually say, “Oh, my gosh, we see you, and this is not okay”—that's what sparks the emotion. It sparks the emotion in me. I mean, it's unthinkable. I have a beautiful granddaughter who I think will be a nurse one day. She's just going to be remarkable, but I don't even want her to be a nurse in these situations and in these circumstances.

That needs to change. That needs to change.

[Todd Doherty, Conservative, Cariboo—Prince George, BC]

Go ahead, Ms. Donnelly.

[Dr. Elizabeth Donnelly]

I want to echo what my colleague said. It's acknowledgement. If you spend so long feeling like this is the way it is, this is what I should expect and this is the level of violence that I should habituate to, it becomes background noise. It becomes just part of the business of doing your work.

For someone to say, “Hey, maybe tolerating abuse isn't an expectation. Maybe you can go to work and not have someone sexually assault you” is identifying. It's saying, “Hey, we see that this is a problem and we want to talk about it.” That then allows nurses and paramedics to say, “Yes, it is a problem and these are the ways in which this violence has impacted me.”

Asking that question is so incredibly powerful. Thank you for asking.

[Todd Doherty, Conservative, Cariboo—Prince George, BC]

I have 30 seconds.

I just want to again thank our guests who are here today. Your membership, and the firefighters, the paramedics and all of those who have shared their very emotional stories with me.... You can't help but be impacted by these stories.

I hope we'll do you right by passing Bill C-321—hopefully soon. I know the industry will share that message. It provides another vehicle to share the message that violence against our health care workers and first responders is not okay and it's not part of the job description.

[The Chair, Liberal, Lena Metlege Diab]

Thank you very much.

Go ahead, Madam Dhillon.

[Anju Dhillon, Liberal, Dorval—Lachine—LaSalle, QC]

Thank you, Madam Chair.

Thank you to all our witnesses for being here and sharing what everyone working in the health care system goes through. Thank you for representing pretty much all health care workers across Canada.

My question is for all three of you. I'll put all the questions out there, and then you can take your turn one by one.

We've heard your testimony. It's very painful to hear. Especially when you're serving people at their most vulnerable, you too are at your most vulnerable.

Could you tell us, please, if the increase in violence started prepandemic or after the pandemic? Please explain to us why you think there is this surge of violence and how COVID exposed this vulnerability of health care workers.

I'll let you start with that. If there's anything else, I'll follow up.

Thank you to all of you.

[Linda Silas]

I'll try to be very quick.

The first campaign against violence in health care was done in 1991 by the British Columbia Nurses' Union with posters reading “No to Violence”.

We've come a long way with regard to changing the Criminal Code. We've come a long way in trying to change the culture, and we still have a long way to go. That's key. It's a long process, because the culture of health care is an interesting one, to be polite.

[Anju Dhillon, Liberal, Dorval—Lachine—LaSalle, QC]

The question goes to our other witnesses on Zoom.

[Dr. Elizabeth Donnelly]

I'm going to be a little wonky. I hope you'll forgive me.

When you ask if the violence is increasing, in the paramedic community we don't know because we don't have the data. We have lots of anecdotal evidence and there are lots of news reports around it.

Is violence increasing? Maybe. Are our systems increasingly stretched and are we trying to do more and more with less and less? Absolutely. Are paramedics willing to talk about it more? One of my colleagues, Mandy Johnston, stood up and said “It's not okay. Violence is not okay”, and developed this entire program of research and this entire intervention strategy that has been able to bring these data to you.

Is violence increasing? We don't know right now. What we know is that it's unacceptably high.

[Danette Thomsen]

It's definitely increasing, but it was a problem long before COVID.

I think that since COVID, we've all seen changes in society that none of us really know.... We all have our theories of what's causing them, but honestly, the health care system is so stretched. The wait times, as Linda spoke to, and all of those things are adding to it.

There's just a change in society, period. People are walking down the street and assaulting one another. Those things we see outside are also being reflected inside.

[Anju Dhillon, Liberal, Dorval—Lachine—LaSalle, QC]

Can you please tell us, with the already existing Criminal Code provisions when it comes to violence against health care workers being an aggravating factor, how this legislation will build upon that, and if any of the three of you see any distinction with this legislation?

Thank you.

[Linda Silas]

Personally, I think it's enhancing Bill C-3. Bill C-3 is only two years old. We have to do education on it. We've been working with the justice department on how we can promote it. It has to be talked about.

[Anju Dhillon, Liberal, Dorval—Lachine—LaSalle, QC]

Could I hear from the other two witnesses on Zoom, please?

[Danette Thomsen]

I agree, Linda. Let's have a big campaign and promote the realization that violence to our nurses in this country will not be tolerated by the Government of Canada. Those are the types of things we need to see.

I think it is enhancing this. I'm so glad to see our paramedics, our first responders, being included. We are a team. You can walk into an emergency room in northern B.C. and see that the paramedics are assisting in the emergency room because there's such a shortage. This needs to include everyone.

[Anju Dhillon, Liberal, Dorval—Lachine—LaSalle, QC]

For the last 30 seconds, Dr. Donnelly, you can take as long as you want.

[Dr. Elizabeth Donnelly]

I would just say that paramedicine specifically sits at this really interesting nexus, because we're identified as public safety personnel and first responders, and we're also sort of identified as health care professionals. When we try to say whether this applies to paramedics, it isn't clear, because sometimes we hang out with fire and police and sometimes we hang out in the ED because we're helping our very worthy colleagues.

When we think about the enhancement of this—

[The Chair, Liberal, Lena Metlege Diab]

I'm sorry to interrupt. Thank you so much.

We're going to go for the final two minutes each.

Go ahead, Mr. Fortin.

Then we'll have Mr. Garrison.

[Rhéal Fortin, Bloc, Rivière-du-Nord, QC]

Thank you, Madam Chair.

Again, thank you to all three witnesses.

You talked about the increase in violence since the pandemic, despite the amendments to the Criminal Code in 2021. The level of violence has continued to increase over the past two years. I stand wholeheartedly behind you. My spouse is a teacher, and every week, she comes home with horror stories. She works in an elementary school. Social workers and teachers are being bitten and hit. There seems to be a real problem in our society. You all mentioned the need to educate people or perhaps do a better job of supporting them and making them aware of the problem. That's what I want to discuss with you.

What can we do? What are the root causes of the problem? Why are people becoming more violent towards health workers, whatever their job, and teachers? In hospitals, is the problem due to the wait times? Is the issue that people are waiting too long? Is it access to care? Is it a lack of doctors and nurses? Is mental health to blame? You work in the field, so I'm interested in hearing your views. You can go first, Ms. Silas.

What is the root cause of the increase in violence?

[Linda Silas]

Poor staffing is to blame. We are short-staffed everywhere. Even before the pandemic, we didn't have enough staff in high-demand units. The patient-to-nurse ratio has to be improved. We need a ratio that keeps people safe.

[Rhéal Fortin, Bloc, Rivière-du-Nord, QC]

The other witnesses may want to answer the question, so they can go ahead.

[Dr. Elizabeth Donnelly]

One of the things we found in our research is that a significant number of the violence reports and a significant number of the assaults do involve people who have primarily mental health or substance use concerns identified as their primary problem code. That points to inadequate services for folks in those situations. That's leading them into crisis, which leads them into interaction with our public safety personnel and our nurses. We need to spend more time and energy focusing on taking care of those human beings.

[Rhéal Fortin, Bloc, Rivière-du-Nord, QC]

Thank you.

[The Chair, Liberal, Lena Metlege Diab]

Thank you.

Our final round goes to Mr. Garrison.

[Randall Garrison, NDP, Esquimalt—Saanich—Sooke, BC]

Thank you very much.

I guess I need to make sure that Ms. Thomsen gets in on that last round here, because I think that's an important question, and we had some important suggestions.

[Danette Thomsen]

I think it's also the facilities themselves. We have mental health patients being placed sometimes for days on stretchers underneath busy ER counters with the lights on. We don't even have enough beds or enough staff. We have mental health patients who are being held longer than is actually even legal, in seclusion, because there are no beds to move them to. I think there's a whole system review that needs to be done.

We need safe staffing in B.C. We just landed patient ratios, but they cannot come fast enough. I think the government needs to look at how we're going to incentivize people to come into the health care system. How are we going to help build our own and fix our own, whether it's nursing, paramedics or doctors? How are we going to create those within Canada?