GRH participates in program to stop violence in health care

The overall goals for each participating hospital were to:

Reduce incidence, risk and cost of staff injury related to patient handling and mobility and/or workplace violence.

Implement evidence-based best practices that will assist to sustain safe patient handling and/or workplace violence efforts at each facility.

Enhance the culture of safety and empower health care employees to create safe working environments.

Address patient handling and related ergonomics/safety issues and/or workplace violence proactively.

From June 2015 through May 2017, each facility worked with a Worker Safety Initiative consultant to assess and develop a new or enhance an existing workplace violence program or Safe Patient Handling and Mobility program.

Each hospital designated a project leader and formed or engaged an existing interdisciplinary committee to manage the project. These committees will also facilitate and provide future oversight of the workplace violence or Safe Patient Handling and Mobility programs.

Implementation of all program elements and evaluation of the workplace violence programs is in process and a “continuous improvement” approach will be used to sustain and enhance the programs at each facility.

— Oregon Association of Hospitals and Health Systems

The Observer is doing a series focusing on violence against nurses and the challenges hospital staff are seeing. This is the second story in the series.

Grande Ronde Hospital Emergency Room Nurse Manager April Brock walked through the ER. Every nurse she saw, she asked one question: Have you been physically assaulted by a patient in the last month?

All of them said yes. Some even laughed at the question — indicating that violence against nurses is so prevalent, the answer is obvious. Of course, some said. Others said it’s happened multiple times in the last couple of weeks.

The troublingly high number of nurses experiencing violence at work prompted the Oregon Association of Hospitals and Health Systems to begin a pilot program to create a toolkit that will keep nurses — and patients — safe.

Grande Ronde Hospital participated along with four other hospitals in Burns, The Dalles, Coos Bay and Portland.

Brock said GRH has made multiple improvements to keep staff safe. In the emergency room, the nurses station now has a partition between staff and those who walk through the ER. The height of the counter and the additional partition above that deter people from jumping over or lashing out at the staff.

After a certain time of the day, hallways are blocked off from patients. It limits wandering, which was a problem previously. Nurses were coming across patients in odd parts of the hospital at night. All hospital staff and emergency responders have badges that give them access to the parts of the hospital where patients can’t go.

“Most nurses here have seen or experienced an assault,” Brock said. “Our goal is that the patient and staff are safe. We’ve been fortunate to put steps forward (toward this goal). We also work very closely with law enforcement, and we’re grateful to them for responding.”

Although the “police are up here on a regular basis,” for general business, Brock said, the hospital has also added security staff. The pilot program concluded the presence of a uniformed security guard alleviates violent outbursts.

“The security officers’ uniform is a sign of authority. The security officers have been trained to de-escalate a situation — not to harm someone,” she said. “They’re good at talking people down.”

Generally, Brock said, people want to feel heard. They’re at the hospital because something bad has happened to them or a family member and they’re stressed and need an outlet.

“We understand no one wants to be here,” she said. “ER visits are unplanned. People feel like they don’t have control. They’re trying to grasp for that control and don’t react in the manner that they would usually.”

Brock said some of those who have displayed poor behavior to the hospital staff have come back later and apologized for their actions. She gets it, she said — nevertheless, physical violence is not acceptable, and the hospital is working to combat the number of incidents.

“This isn’t a GRH-specific issue,” she said. “We want to be a part of the solution, though.”

Among the security measures put in place by the hospital, Brock said, is teaching nurses how not to get blocked into a room.

She said nurses need to make sure they have a straight line to the door and not allow the patient to block their exit. It’s a strategy that works, she said, and it’s keeping nurses safer.

Brock said the idea that abuse from patients is just part of a nurse’s job needs to be changed.

“We need to come back to a culture of kindness,” she said. “We have a passion and desire to be healers. Don’t assume the worst about us. We are doing the best we can with the (medical) information we’ve been given. There’s no malicious nurse or doctor here.”

Brock said she’s had staff give patients clothes and money to help them in their time of need. Mistreating nurses is like biting the hand that feeds you. As Brock said: “We go out of our way to make someone’s bad day better.”