By Vittorio Hernandez, AHN Media Corp.

Ottawa, Canada (AHN) - With Nursing Week to start Sunday, more concern has been raised by the federal government and Canadians over what appears to be declining nursing care in the country. But nurses too are complaining of bullying and intimidation on the job.

A finding by the Ontario Health Coalition that care in nursing homes did not move at 2.85 hours per resident for the past three years has prompted Health Minister George Smitherman to order tougher controls be placed.

Canadians are demanding for better nursing services following the boost in funding for the sector by 52 percent since 2003 to the tune of $3 billion annually. Another $600 million are on the budget for nursing homes for the next three years, but recent nursing home horror stories have prompted a deeper look how the extra funds had been spent.

Wally Baker, a resident at Leisureworld Caregiving Center, died on April 30 due to a fall from an automated lift used for moving elderly patients from beds to chairs. Three days before, another resident, Florence Coxon was strangled by a strap on her wheelchairs.

The flipside to apparent inadequate patient care is the growing number of caregivers who have suffered abuse from the hands of patients and colleagues. Denise Koster, a workplace consultant, cited a survey she has conducted among 2,500 healthcare workers in Ontario hospitals and long-term care centers which showed 47 percent of them had experienced bullying, while another 65 percent said they have been intimidated on the job.

It include incidents of verbal or sometimes physical abuse from patients or family members who vent their ire on nurses especially those in pain or sorrow. However, a larger portion of the abuse comes from hospital managers and fellow nurses, Evelyn Kerr, the director of nursing clinical practice at the Ottawa Hospital told the Ottawa Sun.

Koster said medical institutions must offer a safe workplace for it to keep and attract nurses. She added, quoted by the Ottawa Sun, “Nurses have it engraved in their souls that they must treat the patients with dignity and respect but the nurses also deserve the same respect.”

By Donna Casey, Ottawa Sun

Evelyn Kerr knows there are only a handful of nurses who report getting kicked, punched or bullied on the job at the Ottawa Hospital every year.

By sheer numbers, back injuries should be the top safety issue for nurses.

But Kerr, the director of nursing clinical practice at the Ottawa Hospital, knows there’s a story beyond what nurses often shrug off — that nurses fend off aggressive and intimidating behaviour every day.

Isolated Incidents

Some are what Kerr calls “one-offs”, isolated incidents with patients in poor health and family members lashing out in crisis.

But when nurses are bullied by managers or colleagues, hospital brass see it as a major threat to staff morale and patient safety.

“It’s the patient at the end of the day that ends up suffering,” says Kerr of bullying among nursing colleagues.

With Nursing Week kicking off Sunday, hospital administrators realize that a toxic workplace spawns poor morale, absenteeism and burnout among nurses.

“The tide is only just turning now in terms of people who work in health care realizing that it’s unacceptable to be threatened, to be yelled at and to be cursed at,” said Thomas Hayes, director of occupational health and safety at the Ottawa Hospital.

Hayes says violent outbursts by patients, family members or colleagues are “traumatic,” leaving nurses wondering if and when they’ll be assaulted again.

Five years ago, Kerr oversaw a survey of the Ottawa Hospital’s 4,000 nurses to gauge their sense of safety on the job.

Put at Risk

The study found a “significant number” of nurses felt they often put themselves at risk on the job.

Hospital executives installed signs explaining zero tolerance for aggressive behaviour and improved security for nurses working in emergency departments.

But one expert in workplace violence says nurses and personal support workers want more help handling workplace bullies.

It’s a type of “psychological abuse” where a client, family member or colleague makes “veiled threats” to report them to a supervisor to make them look incompetent, said Denise Koster, a workplace consultant who conducts seminars for health care workers on violence and bullying.

Among nurses, a workplace bully uses the silent treatment and gossip to isolate and discredit a colleague, says the Toronto-based consultant.

Koster surveyed 2,500 staffers in Ontario hospitals and long-term care centres and found that 47% of health care workers have been bullied, with 65% saying they’ve been intimidated by a colleague.

Koster says it’s important to go beyond reactive techniques, such as how to get out of a hold when a patient grabs you.

Patient’s Outburst

Nurses need to use their “emotional intelligence” to figure out what’s triggering a patient’s outburst, said Koster, while institutions know they need to offer a safe workplace if they want to retain and recruit nurses.

“Nurses have it engraved in their souls that they must treat the patients with dignity and respect but the nurses also deserve the same respect,” said Koster.

By Ross Arrowsmith, WorkplaceViolenceNews.com

WorkplaceViolenceNews.com has a fresh new look! In a continuing effort to enable users to more easily search for articles on workplace violence, workplace bullying, healthcare violence, school & campus violence and stalking, we have completely changed the look and feel of the site. As always, your feedback is important to us so let us know what you think. If you have any other suggestions for improving WorkplaceViolenceNews.com, or if you would like to contribute material or articles to the site, please contact us

from Cincinnati.com

The Tri-State Regional Community Policing Institute and Great Oaks Institute of Technology and Career Development recently conducted the “Forum on the Prevention, Response and Mitigation of Gun Violence in Schools.”

Approximately 50 representatives from Ohio and Kentucky recently met in Sharonville to discuss the development of a multidiscipline training curriculum to prevent, respond to, or mitigate school shootings.

School shootings, one of the most tragic phenomena of today’s society, affect everyone across America.

The forum was designed to bring together multiple disciplines to create course curriculum and training to address this very important issue.

“We must develop a national strategy on responding to school shootings that encompass everyone who must deal this increasingly frequent occurrence,” said Roger McHugh, Director of the Tri-State Regional Community Policing Institute.

Keynote speakers included retired Secret Service Special Agent Matt Doherty, who helped develop the U.S. Department of Education Preventative Strategy on School Shootings, FBI Special Agent Mark Rogers who will present the history of school shootings and Gerry Cavis, former Secret Service Special Agent in Charge of the Orlando, Florida field office.

Although the forum itself was a learning environment, it was primarily designed to create a multidiscipline curriculum that will address gun violence in elementary, middle, high schools and college campuses.

The forum included Socratic round table discussion groups intended to give critical review of shooting incidents in school environments.

The attendees included representatives from education, law enforcement, fire fighters and EMS, juvenile court, government representatives and students. Among them include Richard Caster, Executive Director of the National School Resource Officers Association, Karhlton Moore, Director of the Ohio Office of Criminal Justice Services, Tomi Doris, Executive Director of the Ohio Peace Officers Training Academy, Captain Richard Schmaltz, Cincinnati Police Department and President of the Hamilton County Police Association and Cindy Shain, Executive Director of the Eastern Kentucky University’s Regional Community Policing Institute.

This project is funded through a grant by the Tri-State Regional Community Policing Institute in partnership with the Great Oaks Institute of Technology and Career Development.

Contributors to the project are the Hamilton County Police Association, the Hamilton County Chiefs of Police Association, the University of Cincinnati’s Criminal Justice Division and the Cincinnati Police Department.

By Paul Mayne, Western News

Thursday, May 8, 2008 All members of the campus community have a role to play in the prevention of violence and promotion of safety on campus, according to the Safety Campus Community Initiative passed last week by the Board of Governors.
Featuring 50 security programs such as hazardous materials, foot patrol and emergency blue phones, the new plan is open to additional initiatives designed to help the community identify, report and prevent violence, and respond in a crisis. Campus Community Police Service Director Elgin Austin says the goal is to address safety concerns at an early stage and develop awareness of the many reporting and response systems in place at the university.

“We want to create not only a safe campus, but a respectful workplace,” says Austen. “We can be prepared for an emergency, but the idea is to prevent them from happening in the first place.”

By Ray King, Pine Bluff Commercial

Jefferson County Judge Mike Holcomb on Wednesday condemned violence portrayed in movies, television, and especially video games, saying they are “endangering our kids.”

Speaking at the monthly “Coffee with the Chief” sponsored by Weed and Seed, Holcomb described video games such as the highly popular Grand Theft Auto as “killing simulators.

“It used to be get the bad guys, but now the focus is on getting the good guys,” he said. “In fact, and I know this will make you law enforcement officers in the room real happy, there’s a new video where kids get rewarded for killing cops.”

Citing statistics which indicated that there were 48 school-related violent deaths in 2004, Holcomb said parents “used to feel secure sending their kids to school, but the schools now are not the sanctuaries they once were.

“What we put in our kids today comes out in the workplace tomorrow and any school, any workplace can be the scene of a disaster,” he added, noting that studies have shown an average child spends 45 hours each week watching television and playing video games.

In his remarks, Pine Bluff Police Chief John Howell said he learned recently that a number of Neighborhood Watch groups have complained that “the police have not been showing up when they’re called.

“I was not aware of these complaints and I monitor the radio traffic and know we’re getting calls, and we’re responding,” Howell said. “If we’re not doing what we’re supposed to be doing, I want you to let me know.”

On another subject, Howell said he has received calls about a number of juveniles roaming the streets, although there is a juvenile curfew that was adopted by an ordinance of the City Council.

“There have been instances where officers have checked the IDs of juveniles but the law says we can’t cite the juvenile, we can only cite the parent and that creates big problems if there is no parent and the kids are living on the street,” Howell said.

The chief said a possible solution could involve changing the ordinance, and allowing officers to cite juveniles who are found to be in violation of the curfew.

The Rev. Jesse Turner, coordinator of the Weed and Seed program, noted that incidents of criminal activity in the Central Park area are down.

Turner said homicides in the area declined 100 percent in the first three months of 2008, compared to 2007, business and residential burglaries are down, and drug arrests are up.

“There are some positive things happening in the Central Park Weed and Seed area,” Turner said.

The monthly Weed and Seed Commendation Award was presented to Rhonda Glover, a civilian employee of the police department, who created a program that allows police to rapidly track crime statistics in the Central Park area so those can be reported to federal authorities, who provide funding for the program.

By Charlene Laino, CBS News, WebMD

Abrupt restrictions on excessive computer use may have contributed to the 1999 Columbine High School shooting rampage, according to a researcher who combed through more than 30,000 pages of records relating to the tragedy.

Before the attack, shooters Eric Harris and Dylan Klebold spent “more and more time with their computers, to the point that they may have been unable to distinguish the boundaries between their virtual lives and their real lives,” says Oregon Health & Science University psychiatrist Jerald Block, M.D.

“Then, as they got into trouble with school authorities, limits were put on their use of the computer. This made them react with homicidal rage and suicidal depression,” he tells WebMD.

If that sounds like an extreme reaction to the cord being cut, it is. Every kid who can’t tear himself away from the latest video game is not about to commit a heinous act, stresses David Baron, DO, professor and head of the department of psychiatry at Temple University in Philadelphia.

But if a child is also showing signs of withdrawing from family, friends, and school, it could be a sign that something is wrong, he says.

Baron was chairman of the committee that chose which studies to highlight at the annual meeting of the American Psychiatric Association, where Block spoke on school violence.

Advice for Parents

Block came to his conclusions after examining “everything he could find on the Columbine shootings,” including police records, online postings, and diaries. He also looked at the role of computers in four other school shootings: Red Lake in 2005, Virginia Tech in 2007, Jokela High School in 2007, and North Illinois in 2008.

There have been at least a dozen school shootings in American schools and universities within the past three years, resulting in the deaths of more than 50 students.

Block tells WebMD that the findings contain several take-home messages for all parents. First, excessive computer use can be a sign that a youngster is struggling with some issues in real life, he says. “The child may be using technology to vent in a virtual world.”

Also, don’t just cut off access, Block advises. Parents who have concerns about how much time their children are spending on the computer should set up mutually agreed upon goals for cutting back on its use, Block says. “If they’re unable to hold to those goals, you might want to seek professional help.”

Signs of a Problem

So how do you know if your child’s computer use could be a sign of a bigger problem? Block says to watch for these signs:

- Sleep changes, such as staying up at night or waking up late or tired.

- Irritability, especially when separated from the computer.

- Guilt, which manifests as downplaying or hiding the extent of computer use.

- Nightmares , or dreams, about computers.

- Social withdrawal.

Terri Royster, a special agent for the FBI specializing in school violence who also spoke at the symposium, says one common denominator among children involved in school shootings “is that they don’t feel they have an adult they can talk to.”

The importance of spending time with and really listening to your youngster cannot be overstated, she says.

Related Press Release: OHSU Psychiatrist to Highlight Warning Signs for School Shootings at National Psychiatric Meeting

by Karen E. Klein, BusinessWeek.com

Last month, the Indiana Supreme Court ruled in favor of a hospital employee who sued a surgeon for emotional distress and assault based on his treatment of the person at work. The ruling drew national attention as an acknowledgment by the courts of workplace bullying both as a phenomenon and as legal terminology, says Garry Mathiason, chair of the corporate compliance practice group at labor and employment law firm Littler Mendelson. He spoke recently to Smart Answers columnist Karen E. Klein about the implications of the Indiana case for small business owners. Edited excerpts of their conversation follow.

In a survey of U.S. workers released last fall, nearly half said they had either been bullied at work or seen other employees bullied, according to the Workplace Bullying Institute. What should entrepreneurs think of those numbers?

The prevalence of bullying at work—54 million people have been bullied at some point, the institute estimates, based on the survey—combined with the recent court decision should serve as a warning for small businesses nationally to develop proactive measures preventing bullying at their companies.

What was the Indiana case about?

There was behavior claimed to be intentional inflicting of emotional distress by a surgeon who apparently had a terrible temper. What was particularly interesting about the case was that the jury instructions used the phrase “workplace bullying” and it was questioned whether that term was too general. But the Supreme Court said the term had viability as a commonsense phrase for a jury.

It may be a commonly understood phrase, but doesn’t the definition of bullying behavior range all across the spectrum and even from person to person?

That’s what makes it so hard to draw the line. Basically, it’s a form of employee harassment that isn’t necessarily tied to the immutable characteristics such as age, race, and sex that are protected categories in employment discrimination law currently. About 25% of the workplace bullying that’s complained about falls under existing statutes. For the remainder, there’s no specific channel or regulations that reach out to touch it.

But what is bullying to me might not be bullying to you. A manager may have to tell you something that hurts your feelings to help you do your job. If your boss screams at you for being late, for instance, you might think that’s horrible. A month later you might get a bad performance review, and a month after that you’re dismissed. Now, can you go to a lawyer and claim a bully for a boss? If so, every discharged employee theoretically could make that claim, and a lot of unnecessary litigation could result. If you get a jury evaluating uncivil workplace behavior and the jurors dislike the manager—as they are likely to—there’s tremendous potential for inconsistent verdicts and other problems.

What implications does the Indiana ruling have for small-business owners nationwide?

It suggests that there could be a trend of these kinds of decisions and small business should adopt a policy on proper conduct in the workplace. Model policies are available online and even very small employers would benefit from adopting one.

Even if it doesn’t become a legal challenge, isn’t bullying at the workplace a negative thing?

Of course it is. It increases employee turnover, it causes a loss of productivity, and it can give a company a bad reputation. Nobody wants to work for an abusive boss.

How does an entrepreneur determine what’s truly bullying behavior and what is not?

Most commonly, bullying consists of repeated verbal harassment. If it becomes physical there are existing legal tools to deal with it, such as assault and battery. Bullying behavior typically comes from somebody in a position of authority at a company. A bully can be a co-worker, but it’s more commonly associated with a boss and particularly with an immediate boss, as opposed to someone running the company.

How should entrepreneurs deal with bullies in their firms?

They should establish firmly that this kind of conduct is not condoned. Then administer that policy on a complaint basis. What you absolutely cannot do is leave the situation alone and hope it gets better. You have a responsibility as an employer to intervene. Apart from the legal exposure involved, you have a threat to your productivity and your turnover rates.

We recommend that the business owner counsel or get counseling for the individual who has been complained about. Let the person know that this kind of behavior is not supported and won’t be tolerated in the workplace. He should be able to determine whether this behavior is so much a part of his personality that the counseling is not going to work. If positive coaching doesn’t work, the business owner will have to build a basis for ending the working relationship.

Don’t some bullied employees just quit rather than risk whining about their bosses?

Yes, but they might feel differently if there were a business policy already established at the company. It’s common for companies to do periodic harassment training. That session could easily include a little section on rude behavior. Emphasize that treating all employees with respect is the way to make the company productive. Your business reputation will only be enhanced by having an anti-bullying policy that shows you really care about your people and want them treated with respect.

The most effective way to deal with this, it seems, would be to avoid hiring a bully in the first place. Is that possible?

It’s definitely smart to try to screen out people who are abusive, but it’s not easy to get that information. And a lot of times people behave differently when they are talking to the CEO from the way they do when they are talking to their employees.

By Mark Hunter, CommunityCare.co.uk

Violence against social workers: will new law make social work safer?

Can the long arm of the law succeed where hard-hitting media campaigns, government taskforces, expert reviews and £2m of public money have failed, and finally persuade social care employers to introduce effective protective measures to shield their staff from violence during working hours?

The question has been brought into sharp focus by the recent death of 47-year-old Lancashire community support worker and father of three, Philip Ellison who was stabbed while on a visit to a supported living scheme last month. Robert Searle, 51, has been charged with his murder.

Ellison’s name is now added to a tragic roll of social workers who have died while carrying out their duties. It was the death of Wandsworth social worker Jenny Morrison in 1998 that sparked Community Care’s No Fear campaign calling for social workers to be able to work without fear of violence or attacks. This culminated in the setting up of the National Task Force on Violence Against Social Care Staff which, in 2001, produced the A Safer Place report demanding action. The government accepted the report’s raft of recommendations and launched a £2m campaign with the target of reducing violence and abuse against social workers by 25% by March 2005. At which point the issue seems to have been promptly forgotten, although care minister Ivan Lewis recently defended the government’s record.

Today the position of social care workers who are expected to make visits alone, particularly domiciliary care workers, is as precarious as ever. A poll of Unison members in June 2004 revealed that 36% of lone workers experienced verbal or physical abuse on a daily basis.

Lone worker policies
When questioned about the existence of lone worker policies, almost a quarter said their organisation did not have a lone worker policy, with the same number saying that lone worker safety was not being addressed by their organisation. A further 35% said they didn’t have access to their organisation’s lone worker policy while 27% confirmed that staff did not have any risk management training at all.

Where an employer did have a lone worker safety mechanism in place, 54% said they did not have confidence in it.

In the same year, figures from the British Crime Survey by the Health and Safety Executive showed 849,000 reported incidents of threats and actual assaults each year. Within the NHS the problem has become so acute that £29m has been earmarked to equip lone workers with personal safety devices. Unfortunately no equivalent sum has been made available to social services staff.

“Thankfully, cases [such as the death of Philip Ellison] are extremely rare, but other forms of attack are not,” says Unison’s head of local government Heather Wakefield. “Time and again we have called on employers to provide proper risk assessments for their staff. Our members have a right to be made as safe as possible at work.”

There may, however, be one glimmer of hope on the horizon. In the interim between the deaths of Morrison and Ellison, an important change took place in the legal framework governing occupational deaths. On 6 April, the day before Ellison died, the Corporate Manslaughter and Corporate Homicide Act 2007 came into force.

There is no suggestion that Ellison’s employer, Lancashire Council, which is currently carrying out its own serious untoward incidents investigation with Lancashire Care Foundation Trust, has in any way infringed the new act.

New law adds muscle
Nevertheless, the legislation does add some considerable muscle to existing health and safety guidance. While before the act it was possible to prosecute a corporation for the common law offence of gross negligence manslaughter, this hardly ever happened as it was necessary to identify a single member of the senior management (or “controlling mind”) on whom to pin the blame. The new law means that prosecutions will be of the corporate body and not individuals. If a gross breach of health and safety standards results in the death of someone who is owed a duty of care, then the organisation will be liable to an unlimited fine and a publicity order requiring it to publicise details of its conviction. A remedial order may also be made to require the organisation to take steps to address the failures behind the death.

Public sector unions have welcomed the new act, although most would like to see it go further.

“The act needs to step up a gear and go further to protect workers,” says Unison health and safety officer Robert Baughn. “Individuals must be held responsible, so they can face a prison sentence if they are convicted of corporate manslaughter. We would also like to see wider sanctions such as corporate probation and the disqualification of directors to make this legislation more effective.”

But even without such individual responsibility, the senior management teams of any social services department, charity or private care organisation that employs social workers to work with potentially violent clients, will need to consider the act’s implications very carefully.

“All social care organisations will have to make sure they have the proper health and safety procedures in place and are carrying out full risk assessments to ensure they are protecting their employees and any other third parties to whom they owe a duty of care,” says Nadia Persaud, a personal injury specialist and senior associate at law firm Bevan Brittan.

“It’s also very important that they can show a full audit trail. If you are involved in a corporate manslaughter case then the jury is going to be poring over every aspect of your corporate culture. So it’s not good enough just to introduce risk assessment and risk management procedures. You also have to be able to show that you have done so.”

Sharp upturn
Persaud predicts that the new act will see a sharp upturn in the number of employers called to account over the deaths of their employees.

“Under the old civil law it was very difficult for large organisations to be prosecuted because you had to be able to identify one controlling mind. But under this new law the police and the CPS will be looking much more closely at work-related deaths because there is a much better chance of gaining a conviction. But it’s important to point out that the act only applies to gross failures. We are not talking just about negligence.”

And the act does not introduce any new health and safety standards. Rather, it will hold organisations to account against existing health and safety guidance. This is good news for social workers, especially those who find themselves expected to enter potentially dangerous situations on their own. In addition to guidance laid out by the National Task Force on Violence Against Social Care Staff (see panel), there is also explicit guidance for lone workers published by the Health and Safety Executive. This recommends that employers carry out risk assessment of the workplace and any threat of violence, offer specific health and safety training and use monitoring procedures such as telephone or radio contact, automatic warning devices and systematic checks to ensure that the lone worker has returned to base on completion of a task.

With the new act now in force, social care employers will ignore such recommendations at their peril.

Related Link: HSE guidance for lone workers: Working Alone in Safety - Controlling the risks of solitary work

National Task Force on Violence checklist for social workers

Your employer must provide:

- A code of practice that fits your job and where you work.

- Clear assessments of the risk to you from the individuals, families and groups you work with.

- Clear procedures about what to do when you think there is a risk, what to do after an incident, and what follow-up there will be.

- Training that fits your job, including what responsibilities you have towards colleagues and to service users.

- A working environment that maximises your safety.

- Support in dealing with your concerns about threats, abuse and violence.

- Procedures for making sure precautions are working and can be reviewed.

- Easily available support after an incident that fits what you and others who were involved need to recover from the experience.