Violence against front-line hospital staff on rise, more protection needed: union

TORONTO -- As a 42-year nursing veteran of Ontario's hospital system, Linda Clayborne is no stranger to what's become a growing phenomenon -- escalating incidents of violence perpetrated by patients and even family members against front-line health-care staff.

"I've been kicked, spat on, bit, pushed and had verbal abuse," said Clayborne, who retired in June 2016 from St. Joseph's Hospital in Hamilton and now works part-time doing private nursing.

"Violence is really a daily occurrence at the hospital," said Clayborne, who spent much of career working as a forensic psychiatric nurse.

But she said it's a scenario played out in hospitals across the province and throughout Canada, with nurses, personal support workers and other staff bearing the brunt of patients' emotional meltdowns.

A new survey of almost 2,000 health-care workers being released on Monday by the Ontario Council of Hospital Unions (OCHU) bears out that contention.

Almost 70 per cent of respondents reported experiencing at least one incident of physical violence in the past year, while 20 per cent said they had been subjected to such assaults nine or more times during that period.

Eighty-three per cent said they had endured at least one incident of non-physical abuse, such as name-calling, threatening gestures or intimidation, with 35 per cent reporting at least nine such occurrences in the last year.

Sexual harassment or assault also occurred, with 42 per cent of workers reporting at least one incident, and six per cent saying it happened nine times or more.

OCHU president Michael Hurley called the findings "staggering."

And it isn't only front-line staff like nurses and personal support workers who are being subjected to physical and verbal attacks, he said. "The rate of assault against clerical staff, against cleaners, against dietary aides would be in the neighbourhood of about 34 per cent."

Hurley said violence by patients and family members can occur in virtually any part of a hospital, from the emergency department to the intensive care unit to obstetrics.

"They may be people with mental illness, people high on opiates, people distressed about the quality of their care, or distressed about the length of time they've waited -- and they take that aggression out on the health-care staff that they meet."

He cited the recent case of a mentally ill man who had come to a Smiths Falls, Ont., hospital and grabbed a pair of blunt scissors off the admitting clerk's desk and "plunged them" into her neck.

"Had she had a Plexiglas barrier completely around her, that couldn't have happened," said Hurley, adding that budget restraints often mean hospitals aren't making even such minimal investments to protect staff.

Another factor is that the health-care sector is female-dominant -- 85 per cent of staff are women -- and societal attitudes are reflected within hospitals' walls, Hurley suggested.

"You've got in Canadian society, unfortunately, a very high degree of tolerance for violence against women," he said.

"So you've got this general societal attitude and it doesn't stop at the door of the hospital. It comes right in and it's compounded by the fact that if you assault someone in a hospital, you may not face charges."

Clayborne said violent incidents began rising about 15 years ago, in lockstep with ongoing staff cuts that left front-line workers to deal with unruly patients, where once trained crisis teams were there to respond.

"In my opinion as a nurse, I am there to nurse, to nurture, to help people get well," she said. "It's become an expectation that I become part of the goon squad, so to speak."

"For me and my colleagues, we don't want to do that. We've been hurt, we've been thrown to the floor. I had my head banged against the wall."

Clayborne said she was traumatized by one incident in particular: a Code White -- an SOS when a worker is in trouble -- was called during one shift and she and other staff went racing to help a nurse who was being attacked by a male patient.

"She was on the floor in the fetal position ... and all I could hear was the thump of his foot against her back," she said.

In another incident, a worker was struck by a food tray and thrown to the ground, hitting her head on a cement floor. She suffered permanent brain damage.

Scott Sharp is also trying to recover from what may be permanent injury from an attack.

The personal support worker was on the midnight shift in the emergency department at a Guelph, Ont., hospital in January 2015 when he ran to help co-workers restrain a physically aggressive young man who was high on crystal meth.

"He punched me in the face, like uppercut me," recalled Sharp, 48, who lives in nearby Elora.

Sharp lost his balance and slid under the gurney. His back then hit the floor and his head slammed through a steel rack and into a wall.

The father of four ended up with spinal damage that has left him reliant on a walker or crutches, suffering chronic pain and bladder-control problems.

Sharp said he has had difficulty getting compensation from the Workplace Safety and Insurance Board (WSIB), which refused to pay for some of his medications.

And when his wife had to take time off work to be his caregiver for many months, she didn't get paid, devastating the family financially.

"We ended up losing our house," said Sharp, his voice breaking.

"I shouldn't, but I think back that if I hadn't have let my guard down, I'd still be the dad I was before and I'd still be the husband I was before."

While he had lots of support from co-workers, that wasn't the case with hospital administrators, said Sharp, who wants to see more accountability from upper management in cases of workplace violence.

But under legislation, hospitals can't be sued for work-related injuries. Police and public prosecutors typically discourage workers from seeking charges against patients, especially those with dementia, mental illness or under the influence of drugs, because conviction is unlikely, Hurley of OCHU said.

"It's not that we want people to be prosecuted ... but from our perspective it should be the courts that make that determination whether a person at the time of the attack (understood) the nature of what they were doing or not."

OCHU also wants hospitals to beef up protection for staff and it is calling on the Ontario government to provide enhanced legal protection for people who report violent incidents to their superiors -- something both Hurley and Clayborne said most workers are reluctant to do because they fear reprisals.

"I think that the hospital has to have some responsibility to keep us safe," said Clayborne, including "going to the government and saying: 'Our employees are being beaten and we need the money to keep them safe.'

"But it's not happening."