How To Construct Safe Healthcare Workplaces

This is my third and, hopefully, final pass at writing this blog. Originally, I started with an upbeat sort of tone that felt empowering – change could really happen, and we might just find ourselves feeling like our workplaces embraced safety for those giving and receiving care. That was the rather fantastical vibe that I was trying to capture.

My next attempt got no further than the title. The goings-on in the world simply overwhelmed my ability to move into writing mode.

For instance, my home state has the dubious distinction of being #1 in the per capita COVID infection rate. There is a wide and angry divide among the general population, and it seems to be growing daily.

Last week, we also heard about the tragic shooting in Michigan with four lives brutally cut short in what should have been a safe place – their school. I’m a school nurse, and my heart breaks for all of the souls impacted by this brutal event.

Now, I am back and focused. I’m also going to bring things up that may make you feel all the feels: sad, angry, defeated … You may also see yourself in some of what I describe.

These thoughts and emotions may not sit comfortably with you. It’s okay; life is like that. Healthcare is not a bed of roses at the moment, and without a doubt, we are all being dragged through some sort of crappy muck.

I promise not to leave you without a lifeline. We ALL need some sense of hope to continue this adventure of working in the current healthcare arena.

As I see it, the first step in building a safe healthcare workplace begins with each and every one of us. Each. And. Every. One. Time to think about and step into the following:

–           Listen to your gut when something feels unsafe in your workplace. Respect that feeling.

–           Stop thinking and accepting that violence is simply “what you signed up for.” You have my complete support in pushing back when those who don’t walk in your shoes try to tell you that this is just part of your job.

–           Do not accept that it is your “fault” when clients/patients or their associates strike out at you verbally and/or physically.

–           Demand that your workplace listens to the safety concerns of those working on the frontlines.

–           Document acts of verbal and/or physical aggression.

–           Set clear boundaries that allow you to practice effectively and to be safe. Have a plan in place for what you need to do if those boundaries are breached.

 

Supporting our peers can be challenging. Take time to listen to each other without judgment or shame. Validate the concerns of colleagues.

 

Healthcare is a violent and dangerous field to work in; lose the toxic positivity and denial when your colleagues share their fears and experiences. We all have different perspectives, and I encourage you to approach each other from a position of curiosity and support.

 

Not long ago, I offered that it makes me really anxious when I see groups of students running by the Health Office. I acknowledged that when I see people running in buildings, my fight or flight response goes immediately into overdrive.

 

It never seems like a positive thing when groups of people are galloping through hallways while inside a building. Plus, a patient once came at me in a dead run, down a hallway, and assaulted me. Not a great memory, for sure.

 

One of the other nurses advised that I should just change my frame of reference and try to view the students as running to get somewhere nice — like getting extra ice cream or a fun treat.

 

While seemingly well-meaning, this is a prime example of what not to do and say to a peer who has just offered a valid concern. Here are some thoughts to consider:

 

–           Just listen. Don’t feel as though you need to justify, rationalize or explain violent behavior to someone who has experienced it.

–           Validate concerns and talk about ideas for partnering to stay safe.

–           Support the person in the moment. Help to access services and care.

–           Get used to feeling uncomfortable when acknowledging violence; it’s a tragic reality, and nothing about it makes caregivers feel good.

 

Often, I have heard that victims of healthcare workplace violence were asked by their managers, “What could you have done differently so that this wouldn’t have happened?”

 

I will challenge those in leadership and management roles to take a step back and re-frame this question. Ask what the management could change to make the workplace safer in the future. Do not put the burden of responsibility for healthcare workplace violence on those working in the foxholes and experiencing it.

 

–           Check in with those in the trenches; include those facing violence in all “safety rounds” and debriefings.

–           Validate the concerns and act on the suggestions of those working on the frontline. They have good ideas about how to make their workplaces safer.

–           Make it a priority to build a culture that supports workplace safety and does not allow violence. Also, commit funds to programs to implement safety strategies.

–           Verbalize that violence, verbal or physical, will not be allowed by consumers.

–           Ensure that there is enough well-trained staff to respond to violence when it does occur.

–           Have a plan in place to care for staff after a violent workplace episode.

–           Show up in the moment when there is bad stuff happening or after it has just happened. Be present and attend to those who have been traumatized.

I speak for many of those working in patient care when I say that we are drowning right now. Many healthcare workers are going down for the third and final time. The addition of violence and aggression into the toxic mix of high acuity and patient numbers is adding to the demise of many healthcare careers.

Not unlike the severely injured trauma patients, health care workers are bleeding out. Morale injury, healthcare violence, and the unending flow of tragic patients are draining our very lifeblood. Where do we start to stem the flow of this hemorrhage?

For those on the frontlines, allow yourselves the space and grace to care for yourselves. Reconnect with what you need to feel safe in your workplace. Say what you need out loud to those responsible for providing safety.

Those working on the frontlines of healthcare need to support each other. How? Be present, advocate for one another, and just listen without judgment or shaming. There will be no winners at the end of the day, only survivors. I’ll say it again, SUPPORT EACH OTHER.

And for those we serve, my heart is full of gratitude and humility for having been given the opportunity to care for you in your most challenging moments. Now, I welcome your support in helping us have safe workplaces where we can provide you with compassionate care and comfort.

Write letters, send emails and call those who have the potential to make changes happen. Ask those working in healthcare what they need to have a safe workplace. This is the time to speak up loudly and clearly so that we may continue to be there when you need us.

There’s a classic truism that I have often heard spoken in the operating room, “all bleeding stops eventually.” Indeed, sometimes the medical team can skillfully intervene to staunch the blood flow, and the patient survives.

Other times, the patient succumbs to their injuries and death results – once again, bleeding ceases. How will your actions end the metaphorical hemorrhage on the frontlines of healthcare?

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