National Nurses United

J U LY | A U G U S T | S E P T E M B E R 2 0 1 6 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 5 CALIFORNIA B randy welch, rn, a pediatric nurse in Long Beach, never thought she would experience workplace violence. She cared for children, after all. All that changed when a distraught, autistic boy threw a 20-pound chair straight at her. She managed to catch the chair with her right hand, saving both her and the boy's mother from being hit. But her arm was damaged in the process, and she now struggles with even basic tasks, from walking her dog to hanging IV bags. As registered nurses, we are all Brandy Welch. We have all known violence at work. RNs and healthcare workers experience higher levels of workplace violence than all other occupations, and to protect our patients, registered nurses have long known that we must ensure a safe working environ- ment in which to provide high-quality care. That's why it was such a groundbreaking victory when the California Occupational Safety and Health Standards Board in Octo- ber voted unanimously to adopt nation- leading regulations to prevent workplace violence in the state's hospitals and health- care settings. The new standards specifically require hospitals to develop comprehensive plans to prevent workplace violence, to implement these plans and provide all the training needed, and to involve nurses and healthcare workers in creating these plans. The regulations—the most comprehen- sive in America—are the culmination of two years' worth of public testimony, lobbying, and direct action by nurses to implement SB 1299, state workplace violence prevention legislation that California Nurses Associa- tion/National Nurses United (CNA/NNU) sponsored. The law passed in 2014—after nurses stood up to a healthcare industry that challenged the rules every step of the way. "I no longer feel safe at work, and I know this injury will chase me through my life and career. Workplace violence should not be part of the job," said Welch, who shared her story during a hearing attended by nearly 100 RNs to consider the final regulations. She noted that if common workplace violence prevention practices—such as bolt- ing heavy furniture to the ground—had been in place, she would not have been hurt. CNA co-president Deborah Burger, RN, advised the board, "All the nurses in this room either know someone or have them- selves experienced physical violence, threats, and assault while on the job. They all experi- ence the fear and frustration of knowing that the procedures their employers have in place are not enough to prevent violent acts from occurring, or to respond adequately and supportively when they do." The procedures under which healthcare employers have been operating have proven inadequate. Violence in healthcare settings has been pervasive despite known ways of reducing risk, such as appropriately staffing units, and engineering the physical environ- ment to protect staff and patients. But it was not until passage of the CNA/NNU-spon- sored legislation and resulting approval of the regulations that risk reduction measures will move toward being mandated. Nurses lauded two key aspects of the workplace violence regulations: Planning. The new standards specifically require hospitals to include nurses and healthcare workers in developing compre- hensive plans to prevent workplace violence. The standards also require hospi- tals to implement these plans, provide all the training needed, and conduct an annual review to correct any problems. Prevention. Because increasing punish- ment for perpetrators after the fact does nothing to protect workers, nurses laud these regulations for their emphasis on prevention over criminalization. The regula- tions—protecting against both threats and acts of physical violence—require employers to identify and evaluate environmental risk factors for each individual facility, unit, serv- ice, or operation. Employers will also be required to use engineering and work prac- tice controls to mitigate or eliminate hazards by removing sight barriers, installing alarm and surveillance systems, and securing objects that can be used as weapons. No other state, nor the federal govern- ment, has established these kinds of sensible and effective workplace violence prevention regulations for healthcare workers. Regis- tered nurses hope that this victory will become a model for other healthcare facili- ties throughout the country, as well as other industries. Caring for others should not be a life- threatening endeavor, and nurses will keep advocating until workers, patients, and members of the public nationwide are protect- ed from workplace violence. —Kari Jones state safety board adopts new workplace violence prevention regulations New rules are unprecedented and most comprehensive in the nation

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