Take a stand against workplace violence

Nurses back legislation that enforces higher penalties on perpetrators
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By Carole Jakucs, MSN, RN, PHN
EDITOR'S NOTE: Carole Jakucs, MSN, RN, PHN, is a freelance writer.
Several states have enacted legislation to protect nurses and other healthcare workers against violence in the workplace. Illinois is one of them. Alice Johnson, esquire, executive director of the Illinois Nurses Association in Chicago, was one of several people involved with the creation of a bill that recently passed the Illinois state legislature.

Known as HB 4100 and called the Health Care Violence Protection Act, the bill is awaiting final approval by Illinois Gov. Bruce Rauner. Johnson said the governor is expected to sign the bill and there has been no opposition to it. Once signed by the governor, the new law takes effect in January 2019, she said. The INA lobbied for the passage of HB 4100 Johnson said. “This bill was drafted in the summer of 2017, in response to violence that occurred against two nurses in Illinois in May 2017,” she said. “They were held hostage at gunpoint by a prisoner who was receiving medical care at their hospital. One of the nurses was raped, beaten and shot over the course of several hours while being held prisoner in a dark room, until the SWAT team came and killed the perpetrator.” Alaska recently passed legislation known as HB 312, to protect nurses and other healthcare workers. The bill includes stiffer penalties for assaulting a medical worker, according to the Juneau Empire.
On the flip side, some states are struggling to get legislation passed that protects nurses and other healthcare workers against workplace violence. The Montana Nurses Association has been advocating for a law that would make it an automatic felony to assault a nurse, first responder or other healthcare worker while they are on duty said Vicky Byrd, BA, RN, OCN, executive director of the Montana Nurses Association.
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“We’ve had nurses who were sexually assaulted and others who have publicly shared their stories to raise awareness of the problem who were kicked and slammed against walls.”
— Vicky Byrd, RN
Two states fight for legal protection
Massachusetts is another state whose nurses are seeking workplace safety legislation but also experiencing the frustration of their bill going nowhere. HB 1007 would require healthcare employers conduct annual risk assessments regarding safety and implement programs to reduce workplace violence which includes staff training, monitoring of events and having reporting processes in place.
Suddenly you hear it — the yelling, the crashing of equipment hitting a wall, then the sounds of someone being struck — is it the TV? You know you’re at work, and not at a wrestling match. You realize these are the sounds of your coworker under attack.
“HB 1007 was introduced in the Massachusetts House in 2017 and is still on hold,” said Donna Kelly-Williams, RN, president of the Massachusetts Nursing Association.
One example of a law requiring hospitals take a proactive stance to reduce violence in healthcare is AB 508 — in existence in California for more than 20 years, said Yalanda Comeaux, MSN, MJ, RN, CMSRN, a legislative team coordinator with the Academy of Medical-Surgical Nurses. The law requires hospitals to conduct annual education and training to workers who provide direct care to patient in how to reduce the risk of violence and how to respond to violence when it occurs, she said. In addition to some employers needing to do more to protect their nurses and other workers, Comeaux recommends nurses be encouraged to familiarize themselves with safety training and become active in workplace committees involved with developing policies and procedures to protect themselves from workplace violence.
Tragically, this scene is very real and happening more to nurses in the U.S. nearly every day. From verbal abuse and being spit on to having their hair pulled and being brutally raped and beaten, violence against nurses is becoming an epidemic. According to the U.S. Bureau of Labor Statistics, there were 16,890 workers in 2016 who intentionally injured by another person in the workplace — of these, 70% worked in the healthcare and social services professions.
“We had seen an uptick in the amount and extent of violence in healthcare, and in ERs especially over the past two years, from 2016 through 2017,” said Dennis Murray, vice president of long-term care at the Alaska State Hospital and Nursing Home Association in Anchorage. “We suspect some of this may be attributable to the opioid epidemic. The violence prompted one hospital to bring in K9s (security dogs) to accompany their security personnel when they make their rounds. We have found that this has a significant deterrence effect.” Murray pointed out members of ASHNA had been raising concerns about the increase in violence for the past few years with some healthcare providers tracking data, along with various government agencies. Even though the use of K9s is effective, the cost to bring in trained K9s (security dogs), as well as other possible security measures can be cost prohibitive for many health care providers, prompting more action at the legislative level to be taken, Murray said. Alaska’s bill received bipartisan support — drafted by both a republican and a democrat, Murray said. “I think both lawmakers felt this was a serious problem that needed to be addressed,” Murray said. “One of the two is a former police chief in Kenai, Alaska, so he had an awareness from that prospective too.” The bill passed both the Alaska house and senate and was signed into law by Alaska’s governor on June 14, 2018. The new law will take effect 30 days later.
States enact protection legislation
The Montana bill, HB 268 was introduced to a legislative committee in January 2017 and was shelved in that same committee in April 2017, Byrd said.

“Some of our nurses have experienced horrific acts of violence in the workplace,” Byrd said. “We’ve had nurses who were sexually assaulted and others who have publicly shared their stories to raise awareness of the problem who were kicked and slammed against walls.”

Many times, nurses are reluctant to report to local police agencies for various reasons, Byrd said. Some fear retaliation from their employers, don’t feel supported by their employer after the assault or have more concern for their patient’s well-being over their own, while others feel they were discouraged to make a formal report by some of the police agencies with which they interacted. 
“The Montana Nurses Association will continue to work at getting this legislation passed to protect nurses,” Byrd said. “We had one nurse who was sexually assaulted, the police came and took the perpetrator [who was a patient]. But due to the jail being full and this crime is not a felony, they had to kick him loose. If these assaults were automatic felonies, these crimes would go through the legal channels for district attorneys to review and the courts to decide.”
Seeing an increase in violent acts against their nurses and other healthcare workers, the Massachusetts Nurses Association has been working on efforts to improve workplace safety for nurses and other healthcare workers for nearly 10 years, Kelly-Williams said. “Nurses in Massachusetts are attacked on the job more than police and correctional officers combined,” she said. “When a nurse named Elise Wilson suffered a violent knife attack by a patient while on duty, it confirmed what we already knew – that more needs to be done to stop the violence against nurses and other healthcare workers.” Dubbed “Elise’s Law,” the measure would require hospitals and other healthcare employers take the initiative to prevent workplace violence, not just respond to it when it happens, Kelly-Williams said.
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