Ontario Nurses Release Workplace Violence Prevention Guideline

The Registered Nurses' Association of Ontario have issued comprehensive recommendations to promote violence-free workplaces and educational settings, calling for mandatory reporting of workplace violence and stricter policies governing employee conduct.

Aimed at governments, employers, educators, professional bodies, regulators and unions, as well as individual nurses and those from other disciplines, the new guideline, "Preventing and Managing Violence in the Workplace," was announced at St. Michael's Hospital in Toronto on Dec. 4. A team of nurses and other health experts spent the past two years identifying the strongest research evidence and developing recommendations to address verbal, emotional and physical acts of aggression and violence that could be perpetrated by health-care professionals, patients or patients' family members.

"We're in a profession where there's a greater risk of violence. Having said that, when people say 'it's part of the job,' that assumes it okay and that it's going to happen," said RN Margaret Keatings, co-chair of the panel that developed the guideline and the Chief of Interprofessional Practice, Chief Nurse Executive at The Hospital for Sick Children in Toronto.

She stresses that violence must not be tolerated and should be prevented from occurring. Governments, organizations, nurses and all health professionals need to understand preventive measures, know how to recognize risks early to prevent escalation, and know how to respond swiftly to prevent re-occurrences. "You can minimize occurrences and risk by intervening right up front," Keatings said.

While the public only hears about a small number of incidents, statistics show that they are not that unusual, the association said. Twenty-eight percent of Ontario nurses who responded to a Statistics Canada survey released in 2006 said that they had been physically assaulted by a patient in the previous 12 months. The report also found that 19 percent of Ontario nurses had experienced emotional abuse at the hands of physicians and nurse co-workers.

Doris Grinspun, the Executive Director of RNAO, says some organizations don't acknowledge they have a problem with violence until they find themselves involved in a very serious incident. As more and more employers begin to implement policies to address violence, Grinspun urges them to follow RNAO's guideline, keeping one fundamental principle in mind: "It's got to be clear to everyone associated with the organization -- from the chair of the board of directors and the CEO, to the chief of medical staff and the chief of nursing right down to patients and their families -- that the policy applies to everyone and there are no exceptions."

The recommendations include:

Governments should enact and enforce legislation that promotes a violence-free workplace. This legislation should include mandatory reporting and whistle-blower protection for those who report violence in the workplace. Adequate funding should be provided for staffing, mandatory education and leadership development to prevent, identify and respond to violence in the workplace. 
• Organizations should ensure that the safety of patients, staff, physicians, volunteers and students is a strategic priority. They must develop and implement a violence prevention policy and program that addresses all forms of violence in the workplace. 
Individual members of the health care team should collaborate with team members in a manner that fosters respect and trust and prevents violence. This includes refraining from actions such as gossiping, bullying, harassment, socially isolating others, pushing, throwing things, or any other aggressive behaviors.

For more information, visit www.rnao.org/bestpractices.

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