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The VIR form is part of the Workplace Violence Resource binders Cole and Rickford developed and provided to each unit. The binders also include information on Kaiser's policy on workplace violence prevention, Cal/OSHA regulations, the KP Learn educa- tion module, a how-to guide for the employee event summary, and the employee assistance program. "This is a major change in the way we report workplace violence, so we also pushed for an education piece," said Cole, who worked with Rickford on the education module that explains the VIR pro- cess and informs employees about Kaiser's policy on workplace violence prevention and Cal/OSHA regulations. "When you launch something like this, you need education to go out with it." Cole wrote the proposal to get the workplace safety committee's approval for safety project funding for paid release time to work on the project, including PPC members' hours. All told, it took the pair a year to get all the approvals for the new VIR form and education module. During that time, Cole went from PPC member to being the safety liaison and Rickford shifted from safety liaison to quality liaison. "Our real hope is that for a new employee, it will be part of the competencies," said Rickford. "Violence should not be tolerated or accepted. Do the report and we can do what we can to fix the situ- ation." When Kaiser Roseville's TMRT education component is done, Ho said that the idea is to combine it with Kaiser South Sacra- mento's VIR education module. Together, these KP Learn modules will ensure that Kaiser nurses know how to mitigate workplace vio- lence and what to do when an incident occurs. Chuleenan Svetvilas is a communications specialist at National Nurses United. J U LY | A U G U S T | S E P T E M B E R 2 0 2 1 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 19 Workplace Violence Prevention Tips The first thing you have to do is stop assum- ing that workplace violence is part of the job, said Joanne Imwalle, RN at Kaiser South Sac- ramento and a longtime advocate for workplace violence prevention. Robin Cole, RN at the same facility, agrees, stating, "We really need a culture shift." "It's up to all of us, not just nurses, to say, 'No, workplace violence is not OK,'" said Renee Stalker, RN at Kaiser Roseville. "It's not part of my job to be hit, screamed at, or threatened." "Number two, is recognizing when patients or family members are escalating," said Imwalle. "Threat mitigation is good for both sides so the patient and the nurse are safe." Here's advice from the five Northern Cali- fornia Kaiser nurses who have been working on mitigating and preventing workplace vio- lence at their facilities. Communicate "It is vital to have communication between nurses to keep each other safe," said Thuy Ho, RN at Kaiser Roseville. "Within each unit, share your concerns with your supervisor. Keep each other informed about what is hap- pening. We all want to make sure we work in a safe environment." Start with the unit and if there's a profes- sional performance committee (PPC), bring up the issue and see if you can track the infor- mation and follow up. "If you work in silos, you only know what happening in your unit," noted Ho. "This is why the PPC is so impor- tant, so you know what is going on in the whole hospital." Report and track Reporting is important so you can hold employers accountable. If you are involved in an incident, use your facility's protocol to report it and then follow up with manage- ment and facility administrators, advised Cole. When incidents occur, it is essential to track them and find ways to mitigate or they will keep occurring. By collecting and track- ing data, you can identify what type of incidents are happening as well as when and where they are happening in your facility. With that information, you can take action to prevent them from recurring. "Chart it, doc- ument it, acknowledge that the incident happened and realize that we don't have to tolerate this," said Debra Rickford, RN at Kaiser South Sacramento. Know the law If you are in California, which has work- place violence prevention regulations enforced by Cal/OSHA, Renee Stalker, RN at Kaiser Roseville, recommends that nurses read the text of the Cal/OSHA Workplace Violence Prevention in Health- care Standard. "Become familiar with it and understand what your facility should be working towards to comply with the law," said Stalker. Minnesota nurses have a law that requires hospitals to conduct workplace violence training for all health care workers annually and for new employees. The train- ing must include safety guidelines for responding and deescalating violent inci- dents, ways of identifying potential violence or abuse, and hospital plans for responding to incidents and for violence prevention. If you are outside of California, support the federal bill to create a national standard, the Workplace Violence Prevention for Health Care and Social Service Workers Act, H.R. 1195. The bill passed the House in April 2021 and is moving forward in the Senate. This legislation is modeled on California's land- mark workplace violence prevention law. "Read the federal bill and start mobilizing," advised Stalker. "Strategize your fight for better regulations." Follow up and organize "Once you start, be persistent and work within the parameters of your facility," said Cole. "If you don't see any follow through or any changes to mitigate workplace violence, then organize!" Cole recommends doing an action, such as creating a petition and getting other nurses involved. "Use whatever means you have," said Cole. "Get committees involved, reach out to the local community to get support there." If you don't have a professional per- formance committee of nurses, organize to collectively prevent workplace violence. "Organizing is the only way we're going to do stop workplace violence," said Imwalle. "By staying together, we not only have made the conscious decision that it's not part of our job, but the employer has a legal and moral responsibility to keep us safe. Collectively, we have to come together and stop the violence."