National Nurses United

N urses in the trauma unit at the University of Califor- nia, San Diego (UCSD) were constantly calling security. This had been the situation for as long as Deanna Scott, RN, could recall. "People who had been sedated would wake up and get violent," recalled Scott, who began work- ing in UCSD's trauma step-down unit in December 2013. "We didn't have proper training or anything to deal with these situ- ations. Nurses were getting injured and burned out." Valerie Ewald, RN, who has worked in the adult ICU of the Santa Monica campus of the University of California, Los Angeles (UCLA) for 19 years, was kicked in the head in April 2019 as she drew blood from a patient. At the time, she didn't even think of calling security. Unfortu- nately, workplace violence is far too common in hospitals and far too many nurses have been injured or threatened with violence. According to the Bureau of Labor Statistics, in 2018, the injury rate of RNs was more than three times higher than violence-related injuries for workers overall. But the University of California (UC) nurses knew that, together, they could hold their employer accountable for preventing work- place violence. And the UC nurses knew that they could use the requirements of the Cal/OSHA Workplace Violence Prevention in Healthcare Standard, which had recently become law thanks to their union, the California Nurses Association (CNA). Starting in April 2017, health care employers, including hospi- tals, home health care/hospice, and others, had to start logging all violent incidents and then by July 2017, hospitals had to report cer- tain violent incidents to Cal/OSHA. By April 2018, employers had to have involved nurses and their union in creating and implementing unit-specific workplace violence (WPV) prevention plans as well as implementing a robust training program, among other provisions. UCSD and UCLA are part of the 10-campus University of California system, which touts itself as a "world-class public research university," and includes five medical centers and about 14,000 nurses. However, this stellar reputation does not mean that UC is exempt from workplace violence in its hospitals. WPV prevention was not a UC priority, so nurses and CNA fought for strong contract language during negotia- tions for their current five-year contract, which was ratified in Sep- tember 2018. The current agreement states that UC facilities must have comprehensive WPV prevention plans in place. In addition, the con- tract specifies that when the WPV prevention language differs from safety laws and regulations, the higher standard will be in effect. The professional practice committees (PPCs) at all five UC medi- cal centers have been working hard to get their employers to make their workplaces safer, and they've seen some progress. The PPC, comprising elected nurse leaders, surveyed their nurse colleagues to identify problems and focus the WPV prevention campaigns for each campus. Each medical center operates independently, with its own management team and chief nursing executive (CNE). UCSD nurses were the first to be surveyed about whether their employer was complying with the law. In January 2019, at a PPC meeting, UCSD nurses told management that they were not in compli- ance and gave them a list of recommendations based on the survey results. Over the next year, UCSD began making changes, creating a 14 N A T I O N A L N U R S E W W W . N A T I O N A L N U R S E S U N I T E D . O R G J A N U A R Y | F E B R U A R Y | M A R C H 2 0 2 0 Making Systemic Change University of California nurses organize to win workplace violence prevention measures. B Y C H U L E E N A N S V E T V I L A S

• Cover