Written by Stephanie Bale, Senior Consultant, Communications and Public Affairs

I’m a dietitian. I speak with patients about their diet. Once, I prescribed diabetic meals for a patient. He didn’t like it so he told a nurse he was going to get a gun and shoot me.

Marg’s story, as captured by Stephanie Bale

I’m a dietitian. I speak with patients about their diet. Once, I prescribed diabetic meals for a patient. He didn’t like it so he told a nurse he was going to get a gun and shoot me.

I’ve learned you cannot downplay our patients' verbal threats, including yelling and swearing. These behaviours can take an emotional and physical toll on you over time. It helps to debrief with peers after incidents – sometimes we ask the Critical Incident Stress Management Team for supportI take steps to protect myself from violence. I keep my violence prevention training up-to-date. And I get involved in mock-training drills to practice de-escalating aggressive or violent patients. The training techniques have helped to ensure I get home safe after work each day.

On the job I take note of where the phone and panic buttons are. I check if the clinic room enables a quick exit without a patient blocking me in. In classroom settings with two exits, I place myself close to one of the doors. And when working alone with a patient I inform my co-workers so help is there if I need it.

Code White teams have our backs - I'm thankful for that. They are a team of trained personnel who respond to codes for aggressive or violent behaviour. They regain control of the room and help to prevent what might otherwise have dire outcomes.

We have strong safety systems in place. But we could do a better job of taking responsibility for communicating risk to our peers. When a patient has the potential for violent outbursts, we need to report it to our peers so they can take steps. At times, security services need to be involved.

Our ALERT System* helps communicate potential risks for aggressive behaviours. A purple dot is placed on the patient’s medical record, client chart, Kardex, and room nameplate if they are known to be aggressive. It signals us to read the patient’s care plan for triggers and strategies to prevent violence. Daily I check my patient care plans for ALERTs before approaching my patients.

Family physicians can help too. If their patient can be hostile they need to report it on their referral to us. The first time I take a patient into a clinic room I need to know of potential risks so I can prepare.

When violent incidents do occur we need to report them. If we don’t report a problem it cannot get fixed. After experiencing an incident sometimes we struggle and feel "it’s just me," or "it’s part of the job". But it’s not part of the job. And it’s not just you.

Violence in health care is a serious matter. I take the safety of my colleagues to heart. I’m a member of our local Joint Occupational Safety and Health (JOSH) Committee and the Regional Violence Prevention Committee.

JOSH members meet monthly and focus on site health and safety situations like slips, trips, falls and violent incidents. Union representatives take part as do outside contracted services and leaders. I represent my Allied Health members’ perspectives as well as other's viewpoints. Recently we helped to plan a clinic relocation where violence prevention was an issue. Employees and leaders worked together to ensure safety measures were in place for the clinic.

Committee work is rewarding. We all should know who our committee representatives are so we can raise safety concerns directly with them. They review incidents and determine corrective actions to keep everyone safe. The Regional Violence Prevention Committee does solid work. Together representatives of the unions, Workplace Health, WorkSafeBC and leaders oversee the Regional Occupational Safety and Health Strategy. They examine incidents of violence reported by the sites, and through the Patient Safety Learning System and the Workplace Health Call Centre. When unfortunate incidents occur at one site other sites can gain from any preventive actions taken.

We each play a part in keeping our environments safe. It's not okay to say that’s for someone else to do because an injury could occur and affect someone for life - that would be devastating for everyone.

Marg is a Dietitian working at Jim Pattison Outpatient Care and Surgery Centre. She has served on the Board of Directors for the Provincial Health Sciences Association for 10 years.

Marg’s story is one in a series where employees reveal their experience of violence to help build compassion for health care providers, educate the public and make our sites safer.

See our Stop Violence Campaign information on FH Pulse.

*Designation, Identification and Review of Clients at Risk for Aggressive Behaviour

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