Nurse Workplace Safety in Pennsylvania: Caring for those who care for others

May 06, 2019

I’ve been a nurse, working alongside and leading nurses, throughout my 33 year career. As a profession, our primary instincts are to advocate and care for our patients, and to comfort them.

Sadly, and with greater frequency, nurses find themselves needing protection from those they are trying to help. In my current role as chief nursing officer, I receive reports of such incidents almost daily. Most are the result of physical or verbal abuse by patients and their families or visitors.

Main Line Health’s experience aligns with that of hospitals across the state and the nation. Analyzing surveillance data from 2012 to 2015, the National Institute for Occupational Safety and Health (NIOSH) found a 72 percent increase in the rate of workplace violence injuries within 105 hospitals participating in the Occupational Health Safety Network.

To address hospital workplace violence, first make it visible

NIOSH defines workplace violence as “violent acts, including physical assaults and threats of assault, directed toward persons at work or on duty.”

Main Line Health prioritizes the reporting of such incidents. They are included in our health system’s daily STAR reports, sent to all senior leadership and reviewed by leaders in departments where incidents took place.

At Main Line Health, we encourage transparency around this important issue. We want everyone in the organization to understand the realities of the care environment, so we can take steps to improve it.

5 ways to improve workplace safety and help staff recover from violence

Main Line Health works hard to create a safer workplace, and to help staff recover from unfortunate incidents when they do happen. In addition to more standard security measures, these five strategies have proven effective.

1. MOAB® (Management of Aggressive Behavior) training that teaches staff how to calm patients, diffuse anxious or aggressive behavior, and avoid violence and injuries. Training is open to all employees, but staff in some areas, such as emergency departments (ED), are required to complete it.

2. Code Green Levels 1 and 2, for use by nurses and other staff to request help from a team specially trained in de-escalating patients showing anxious or aggressive behavior, including physical threats. “Level 1” indicates that a patient is showing warning signs, such as a highly emotional state or loud, aggressive language, and is used to address potentially unsafe situations early on. By adding this level to our protocol, we have successfully reduced the number of more serious Level 2 incidents reported.

3. Critical Incident Response Team, on call 24/7, to provide psychiatric first aid to staff within an hour after an incident. The team monitors the affected staff, provides compassionate listening, and follows up to help support healing.

4. No last names on ED badges. Main Line Health’s security team has received special permission to remove last names from the badges of ED staff, to help protect identity and prevent unwanted social media contact.

5. Support for staff who want to press charges. Employees have been harassed, kicked, and had their hair pulled. If staff want to press charges with the police department, we help them do that.

Help protect Pennsylvania hospital employees

The necessity of these significant investments in workplace safety is an unfortunate fact of health care today. Fortunately, Pennsylvania lawmakers are considering steps to help improve workplace safety at Main Line Health and all Pennsylvania hospitals and health systems.

Please take a moment to read on and learn how you can help.

House Bill 39, introduced by state Representative Pam Snyder (D-Fayette), would remove health care workers’ last names from their facility ID badges. This legislation aims to protect staff identities and help prevent awkward, uncomfortable, or downright threatening interactions over social media or even, in rare cases, in person.

A simple online search of hospital employees’ names can yield a mountain of personal information, such as home addresses and family members’ names. That information can easily help an ill-intentioned person stalk, threaten, or assault health care workers.

I know this from experience. Main Line Health has even had to go so far as to obtain a restraining order to protect a staff member from a patient’s threats. Thank goodness the need for this legal action was, to date, a one-time occurrence.

Senate Bill 351, introduced by state Senator (and registered nurse) Judy Ward (R-Blair/Fulton), would update current law to make it a felony assault to cause bodily harm to many different kinds of health care workers.

Now more than ever, health care is a team sport. Doctors, nurses, support staff, physician’s assistants, nurse practitioners, health educators, social workers, therapists, and others all play important roles in caring for patients. Senate Bill 351 would extend the same legal protections to all these professionals.

Right now, these protections are a mixed bag. A physical assault on some kinds of professionals would be a felony, but a misdemeanor for others. Senate Bill 351 would protect the entire health care team.

We’ll soon have to tell lawmakers how important these bills are. Stay tuned for more information from The Hospital and Healthsystem Association of Pennsylvania and Healthy Me PA. Your voice will help move this important legislation forward.

Thank you for your interest—and for taking the time to take action. Safe, supportive, nurturing hospital workplaces are essential for those who give care, and those who receive it.