National Nurses United

O C T O B E R | N O V E M B E R | D E C E M B E R 2 0 1 9 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 N A T I O N A L N U R S E 11 with Sutter officials and didn't relent until they finally secured a meeting with the chief nurse executive in January 2017. Meanwhile, the Cal/OSHA Workplace Violence Prevention in Healthcare Standard went into effect in California, thanks to CNA. By April 2017, employers were required to implement a violent incident log. "The workplace violence prevention law and having Califor- nia Nurses Association behind us gave us extra firepower," said Seils, who has worked in the L&D unit for 20 years. Incidents were being logged, but the nurses saw few changes so the PPC decided to do a group walkthrough of the facility and parking areas in August 2017 and document all the unresolved problems. They noted each unlocked door in closed units. They saw that anyone could open a door into the ICU. "We looked at every door and took photos of the doors that didn't latch because they weren't maintained," said Altaffer, who has worked in the trauma neuro ICU for 18 years. "One door said it was alarmed and you were supposed to swipe to open it, but it opened without swiping and the alarm didn't go off." "We walked the entire campus and print- ed out every single picture of all the areas people could access," said Altaffer. "I took a photo of a broken call box that was on the ground in the parking lot." The PPC presented their security and workplace violence concerns to the regional manager of security and human resources. There were some improvements, such as fixing a few doors, but the PPC's security concerns were still being ignored and the CNE and security director refused to attend the PPC meeting in September. Clearly, they did not think it was important to hear what PPC members had to say as nurses who face potential risks every day. The nurses refused to be ignored and circu- lated postcards demanding that Sutter Roseville improve safety and security and work with the PPC. Hundreds of nurses signed the cards and a group of nurses delivered the thick stack of cards to the CNE and HR. Finally, nurses began seeing changes in 2018, the year California health care employers were required to implement workplace violence prevention plans and procedures. It was a slow process, but the nurses didn't give up. The nurses knew that their employer was responsible for creating a safe environment for staff and patients and to have plans and procedures in place to prevent physical violence and threats from happening. It was also important for nurses to be involved in creating plans for workplace violence prevention. The PPC repeatedly asked management for data on the call boxes in the visitor and staff parking lots. They were small, waist-high, and not visible if a car was parked in front. In January 2019, they learned that all but one call box was broken. Since then, a new four-story parking structure has been built with clearly marked call boxes on every floor. Today the PPC gets a workplace violence report from management and reviews the data to hold management accountable. Someone from security attends PPC meet- ings. Nearly 20 security guards now work at the facility and they do rounding in the parking areas as well as in the hospital, checking that all doors are closed or locked. L&D and the main lobby now have a dedi- cated security guard at the entrance 24/7. Broken doors have been repaired. The L&D doors now display signage that reads, "STOP: RESTRICTED ACCESS." Broken call boxes in the existing parking lots have been fixed and are more clearly marked. A badging system for visitor screening has been expanded hospital-wide in January 2019 (it was initially limited to the family birthing unit and the ED after hours). Sutter Roseville is far safer and more secure due to the nurses' hard work but there are still improvements to be made, such as having PPC members participate in the workplace violence committee that reviews policy. So the work continues. "Remember that you have power in numbers," said Seils. "And that even a small change is a victory." —Chuleenan Svetvilas Nurses successfully pushed management to post new signage to tighten hospital security and fix call boxes in the parking garages.

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