Canadian Occupational Safety

18 Canadian Occupational Safety | www.cos-mag.com actually more likely to be assaulted at work than police offi cers. That's shocking." While all health-care staff is at risk for violence, nurses experience the lion's share as they interact with the public the most. The type of violence that is most often experienced is from patients or residents. Health-care facilities are also seeing more aggression from family members and visitors. Sometimes the violence is intentional, such as when an individual brings a fi rearm or knife into an emergency department or when patients are spitting, punching, choking, kicking or biting staff with the intent to cause harm. A survey of members by the Manitoba Nurses Union found 46 per cent had been punched and 39 per cent had been bitten. Other times, the violence is unintentional. "It could be a patient who is acting out because of an underly- ing medical condition. It could be dementia delirium; it could be medication reactions; it could be physical things like an electrolyte imbalance or low blood sugar. So they are reacting because of that and they maybe don't understand the consequences," says Henrietta Van hulle, executive director, health and community services, at the Public Services Health and Safety Association (PSHSA) in Toronto. The type of violence can range from physical assaults to verbal abuse, threats and harassment, which can cause psychological injuries. "Sometimes family members say terrible things to health-care workers. So maybe comments about being incompetent, not knowing what you're doing," says Van hulle. "In long-term care, where the residents are there for a longer period of time, we hear about some family members who are there frequently, constantly harassing certain staff members. There's also discrimination that happens based on any number of the human rights factors." Incidents seem to be more severe now than ever before. Over the past fi ve years, client cases have become much more complex, says Shelley James, manager of organizational health and safety at Northwood, a long-term care and home-care provider in Halifax. "Where it used to be that most of our clients had dementia, now it will be mental health and dementia mixed together. This is kind of new for our staff in terms of knowing how to respond to help prevent some of the violence," she says. "It kind of keeps you up at night." Many provincial governments — including Nova Scotia, n October, a man brought a fi rearm into the emergency depart- ment of Soldiers' Memorial Hospital in Middleton, N.S., and was behaving erratically. He was charged with possession of a fi rearm while prohibited, unauthorized possession of a rifl e and careless use of a fi rearm. In March 2015, a man viciously attacked a nurse in the emergency department at the Abbotsford Regional Hospital in British Columbia. The nurse suffered trauma to the head and face and needed stitches around the eye. In October 2014, a men- tally ill patient stabbed a nurse multiple times in the head and neck at the Brockville Mental Health Centre in Ontario, leaving her seriously injured. Incidents like these are becoming more and more common across the health-care spectrum in Canada, including acute care, long-term care and community care. In B.C., claims related to acts of workplace violence have been steadily increasing over the last six years and nurses (including aides and health-care assistants) accounted for more than 40 per cent of all violence-related injuries, according to WorkSafeBC. In Saskatchewan's health-care industry, 8.84 per cent of the time-loss injuries in 2016 were caused by assaults, violent acts, attacks and harassment. Violence is the fourth highest cause of injury within health-care. Across all industries, nurse aids, orderlies and patient service associates suffer the most injuries from violence, according to the Saskatchewan Workers' Compensation Board. In Ontario, violence claims make up 11 per cent of the lost- time injuries in hospitals, according to the Ministry of Labour. In 2015, 31.8 per cent of lost-time injuries due to workplace violence occurred in the health-care sector. Two-thirds (66 per cent) of nurses in New Brunswick reported physical or verbal abuse — or both — in the past year, according to a survey by the New Brunswick Nurses Union. "It's everywhere," says Gayle Duteil, president of the British Columbia Nurses' Union (BCNU) in Burnaby, B.C. "Nurses are Heath-care workers are victims of physical violence – including punching, biting and stabbing – more now than ever before By Amanda Silliker

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