How training empowers safety: MGH Chief Executive Nurse shares firsthand workplace violence experience

For Irene Andress, the desire to equip health professionals with information they need to do their job free from violence is a deep held belief.

It was when Irene first started working as a personal support worker while training for nursing school that she experienced her first alarming feeling of being fearful for her own safety while caring for a patient.

She walked into a room without knowing a patient's history and triggers.

‘For some reason he perceived me as a threat and swung at me'

“I entered a patient's room that I didn't know, intending to help him with some bathing needs. At face value, he did not look agitated or at-risk,” recalls Irene, Vice President of Patient Experience, Health Professions & Chief Nursing Executive (CNE) at Michael Garron Hospital (MGH). 
 

“For some reason, he perceived me as a threat, swung at me, grabbed the metal wash basin that I was carrying and threw it across the room.”

As CNE, Irene works with the security team, clinical professionals, members of labour groups, and organization development staff on the ongoing development of workplace violence prevention at MGH. The program has many facets with a large focus on training staff to recognize warning signs, de-escalation techniques and safely removing themselves from potentially dangerous situations.

“Our training programs also address interpersonal communication and effective teamwork as we know there can sometimes be tensions between providers that can make work more difficult.”

Promoting safety, training and inclusion on the job

The team also uses data from incident reports to help education staff about the misconceptions that violent patients are only in the emergency department or mental health unit. Often older patients with different stages of cognitive impairment or dementia can react when restrictions are placed on them. Other patients can react to medication such as anesthesia drugs for surgeries that can increase violent behaviours in an otherwise calm patient.

While documentation is important, not everyone on the care team has access to the patient chart to read about past violent behaviour so other visual cues are important. Food service workers and cleaning staff are just a few examples of staff that need other mechanisms to be informed of patients at risk of violent behaviour. That is why the program also incorporates signage and purple armbands as a quick reference for those entering a patient room.

Importance of partnerships

MGH works collaboratively with a number of partners to constantly grow and improve on our approach to workplace violence prevention. Members of the MGH team have presented alongside the Ontario Nurses Association at various healthcare conferences.

MGH also works with six other community hospitals in the GTA to help apply and share best practices in workplace violence prevention as a part of a spread project through the Joint Centres. The latest collaboration involves a research study with the Institute for Work and Health around the types of violence experienced by healthcare workers and reporting.

While Irene was not injured by the agitated patient who threw the wash basin, it was an unforgettable moment in her career. Now, she works to ensure that no healthcare worker should feel ill-prepared in training when walking into a patient's room.