Transcript: Facing Violence and Assault in Health Care | Jan 16, 2018

Steve sits in the studio. He's slim, clean-shaven, in his fifties, with short curly brown hair. He's wearing a gray suit, white shirt, and checked blue tie.

A caption on screen reads "Violence and assault in health care. @spaikin, @theagenda."

Steve says HEALTH CARE WORKERS
ACROSS THE PROVINCE REGULARLY
FACE SITUATIONS THAT PUT THEIR
PERSONAL HEALTH AND SAFETY AT
RISK.
THAT'S ACCORDING TO A RECENT
STUDY, "ASSAULTED AND UNHEARD:
VIOLENCE AGAINST HEALTHCARE STAFF."
IT WAS CO-AUTHORED BY
OCCUPATIONAL AND ENVIRONMENTAL
HEALTH RESEARCHERS WHO WERE
STUNNED BY WHAT THEY HEARD.
THOSE RESEARCHERS ARE JIM BROPHY
AND MARGARET KEITH, AND THEY'RE
WITH US TONIGHT TO TELL US WHAT THEY FOUND.

Jim is in his late fifties, with receding white hair and a goatee. He's wearing glasses, a brown leather jacket and a black sweater.
Margaret is in her fifties, with wavy blond hair and bangs. She's wearing a magenta blazer over a white shirt.

Steve continues NICE TO HAVE YOU TWO HERE, ALL
THE WAY UP FROM WINDSOR,
ONTARIO.
I GUESS YOU GOT TOP BILLING ON
THE REPORT, I'M NOT SURE WHY.

Jim says MY LAST NAME
BEGINS WITH "B."

Steve says IT'S ALPHABETICAL
ORDER.
FIRST QUESTION TO YOU: WHY DID
YOU DO THE STUDY?

The caption changes to "Jim Brophy. Co-Author, 'Assaulted and unheard.'"
Then, it changes again to "Unsafe workplaces."

Jim says THE GENESIS OF THE STUDY
BEGAN BECAUSE THE HEALTH CARE
UNIONS, THE ONTARIO COUNCIL OF
HOSPITAL UNIONS, CUPE, WAS VERY
DISTURBED BY REPORTS THEY WERE
RECEIVING FROM THEIR FRONT LINE
CARE-GIVERS ABOUT THE INCIDENCE
OF VIOLENCE AND HOW WIDESPREAD
IT WAS.
AND SO ABOUT TWO YEARS AGO, THEY
HELD A CONFERENCE OF NURSES AND
PERSONAL SUPPORT WORKERS, ABOUT
150 DELEGATES, AND EVERY SINGLE
DELEGATE HAD BEEN PERSONALLY
ASSAULTED WITHIN THE LAST YEAR.

Steve says EVERYONE HAD A STORY?

Jim says EVERYONE.
SOME OF THOSE STORIES WERE MADE
PUBLIC, AND A NURSE WHO SPOKE
OUT ABOUT IT WAS FIRED.
AND SO THIS STARTED A WHOLE
INVESTIGATION BY THE UNION TO
TRY TO FIND OUT WHAT WAS
HAPPENING IN THE HEALTH CARE
SYSTEM.

Steve says ALL RIGHT.
LET'S GET TO SOME OF THE NUTS
AND BOLTS OF IT THEN.
CUPE COMMISSIONED THE STUDY.
HOW MANY PEOPLE DID YOU SURVEY?

The caption changes to "Margaret Keith. Co-Author, 'Assaulted and unheard.'"

Margaret says WE HELD
INDEPTH INTERVIEWS WITH HEALTH
CARE WORKERS FROM ACROSS THE
PROVINCE.
WE KNOW THE NUMBERS ARE OUT
THERE.
THOSE ARE STATISTICS AND THEY'RE
REALLY NOT DEBATABLE.
WHAT WE REALLY WANTED TO KNOW IS
WHAT THEY BELIEVED WAS BEHIND
THE NUMBERS.
WHAT WERE THEIR EXPERIENCES?
WHAT WAS IT LIKE TO BE A HEALTH
CARE WORKER, WORKING WITH A
THREAT OF VIOLENCE?

Steve says THE OBVIOUS
FOLLOW-UP HERE IS THAT THERE ARE
THOUSANDS OF PEOPLE WHO WORK IN
HEALTH CARE IN THE PROVINCE OF
ONTARIO, AND YOU'VE INTERVIEWED
54.
IS THAT AN ADEQUATE SAMPLE SIZE
TO GET A SENSE OF WHAT'S GOING ON?

Margaret says IT IS WHEN YOU'RE DOING
QUALITATIVE RESEARCH.
WHAT YOU DO IS YOU TALK TO
PEOPLE UP TO THE POINT OF
SATURATION, WHEN YOU START TO
HEAR THE SAME KINDS OF STORIES
OVER AND OVER AGAIN, YOU KNOW
YOU PRETTY WELL HAVE...

Steve says GOTCHA.
JIM, OF THE THOUSANDS OF PEOPLE
WHO WORK IN HEALTH CARE, THEY DO
MYRIAD DIFFERENT JOBS.
WHO ARE WE TALKING ABOUT?

Jim says WE WERE LOOKING
ESSENTIALLY AT FRONT LINE HEALTH
CARE WORKERS, NURSES, PERSONAL
CARE WORKERS, ORDERLIES.
ONE OF THE UNIQUE FEATURES ABOUT
THIS STUDY, A WIDER RANGE OF
OCCUPATIONS WITHIN THE HEALTH
CARE SYSTEM, SO THAT WOULD BE
THE CLEANERS, THAT WOULD BE THE
KITCHEN STAFF, THAT WOULD BE
ADMINISTRATIVE STAFF,
SECRETARIES WHO, YOU KNOW, MIGHT
DO PATIENT INTAKE.

Steve says AND YOU COVER THEM ALL?

Jim says WE COVER THEM ALL.

Steve says AGAIN, WE ALL KNOW
TODAY THAT ASSAULT CAN BE THAT
OR IT CAN BE A PUNCH IN THE JAW
THAT BREAKS YOUR JAW.
THAT'S A PRETTY BIG CONTINUUM.

Jim says IT IS.

Steve says WHAT DID YOU FIND ON
THE CONTINUUM?

Jim says WELL, I MEAN, I THINK BOTH
MARGARET AND I WERE HORRIFIED BY
THE STORIES THAT WE HEARD AND
HOW WIDESPREAD AND NORMALIZED
VIOLENCE HAS BECOME WITHIN THE
HEALTH CARE SYSTEM.

Steve says NORMALIZED?

Jim says NORMALIZED.
AND IT'S NOT JUST THAT WE'RE
SAYING THAT.
THAT'S WELL-DOCUMENTED IN THE
SCIENTIFIC LITERATURE, WHICH IS
VERY ROBUST ON THIS ISSUE.
SO, WE WERE HEARING... I MEAN,
ALMOST ALL, AND I MEAN ALL, OF
THE PEOPLE WE INTERVIEWED
EXPERIENCED SOME FORM OF ABUSE
ON A DAILY BASIS.
AND WHEN WE WOULD ASK THEM, YOU
DON'T REALLY MEAN DAILY.
YOU'RE TRYING TO GIVE US A SENSE
OF WHAT IT IS?
THEY SAID, NO, WE MEAN DAILY.
AND THAT COVERS A WHOLE
CONTINUUM, AS YOU SAID, FROM
PHYSICAL ASSAULT, WHICH IN SOME
CASES HAS BEEN HORRENDOUS, TO
BEING PUNCHED, BEING KICKED,
HAVING YOUR ARM GRABBED, YOUR
BODY GRABBED, PRIVATE PARTS OF
YOUR BODY GRABBED, BEING
VERBALLY ABUSED, BEING CALLED
NAMES, YOU KNOW, RACIALIZED
WORKERS ARE TARGETED, WOMEN ARE
TARGETED AND SO ON.
DOWN TO HARASSMENT AND ASSAULT,
SEXUAL ASSAULT.

Steve says IS THIS SO
WIDESPREAD THAT IT LITERALLY
HAPPENS IN EVERY HOSPITAL IN THE PROVINCE?

Margaret says I THINK IT
DOES HAPPEN IN EVERY HOSPITAL.
I THINK THERE ARE SOME TYPES OF
HOSPITALS, SOME AREAS IN THE
HOSPITALS, WHERE IT'S MORE
LIKELY TO HAPPEN.
AND, AGAIN, THIS HAS BEEN
DOCUMENTED BY OTHER RESEARCHERS.
PEOPLE WORKING IN MENTAL HEALTH.
PEOPLE WORKING IN EMERGENCY
DEPARTMENTS.
PEOPLE WORKING IN DEMENTIA CARE.
ARE MORE LIKELY TO BE SUBJECT TO
VIOLENCE.
BUT THERE ARE PEOPLE WORKING IN
ACUTE CARE HOSPITALS WHO WOULD
GO IN TO TALK TO A PATIENT AND
BE GRABBED.
THERE ARE FRUSTRATIONS.
THERE ARE ALL KINDS OF ISSUES
THAT ARE CREATING AN ATMOSPHERE
THAT IS... IT SEEMS TO BE MORE
STRESSFUL THAN IT'S EVER BEEN.
THEY TALK ABOUT HOW THIS IS A
GROWING PROBLEM, AND ACTUALLY
THAT'S SOMETHING THAT WE WERE
TRYING TO UNDERSTAND.
WHY IS THERE MORE VIOLENCE NOW
THAN THERE WAS 20 YEARS AGO?

Steve says LET ME FOLLOW UP ON
THAT WITH JIM.

Margaret says OKAY.

Steve says BECAUSE I WONDER
WHETHER THE VIOLENCE IS AS A
RESULT OF GENERAL... PATIENTS
FEELING GENERALLY MISTREATED IN
THE HEALTH CARE SYSTEM, OR
WHETHER IT IS SOMETHING SPECIFIC
TO THE NURSE, THE ORDERLY, THE
WHOMEVER THEY ARE DEALING WITH
ON ANY PARTICULAR ISSUE.
DO YOU HAVE A BETTER SENSE OF THAT?

Jim says I DON'T THINK
WE CAN LAY THIS PROBLEM AT THE
DOORSTEP OF THE HEALTH CARE STAFF.
I DON'T THINK THEY'RE
RESPONSIBLE, THE VICTIMS IN A
SENSE ARE THE RESPONSIBLE
PARTIES HERE.
I THINK THAT THERE'S BEEN
ENORMOUS RESTRUCTURING OF OUR
HEALTH CARE SYSTEM.
THE WORLD HEALTH ORGANIZATION
SAID TWO DECADES AGO THAT YOU
COULD NEVER ADDRESS THE ISSUE OF
VIOLENCE IN AN UNDER RESOURCED SYSTEM.
EVERYWHERE WE WENT...
EVERYWHERE... THE CONSTANT
REFRAIN WAS THE TREMENDOUS
BURDEN OF UNDERSTAFFING, THE
LACK OF RESOURCES TO TRY TO DEAL
WITH PREVENTION.
SIMPLE THINGS LIKE BUZZERS,
FLAGGING, SECURITY, SIGNS.
IN SOME HOSPITALS, FOR INSTANCE,
THERE WAS A SIGN IN THE FOOD
COURT SAYING "ZERO TOLERANCE OF
VIOLENCE" AND THE NURSES MADE
THE POINT THAT'S NOT WHERE
THEY'RE WORKING.

Steve says TO BE CLEAR, IT'S
NOT THAT NURSES OR ORDERLIES ARE
DOING ANYTHING WRONG, THEY JUST
HAPPEN TO BE THE FRONT LINE
CONTACT OF THE SYSTEM, AND
THEREFORE...

Jim says THAT'S RIGHT.

Steve says... THEY'RE GETTING IT.

Jim says THAT'S RIGHT.
THEY'RE THE ONES AT THE
RECEIVING END OF THIS CRISIS.
AND IT REALLY MADE US REALIZE,
ESPECIALLY AS OCCUPATIONAL
HEALTH RESEARCHERS, REALLY, WHAT
IS GOING ON IN THIS WORK
ENVIRONMENT FOR A SECOND HERE?
I MEAN, THIS VERY HIGH DEMAND,
LIMITED CONTROL, A HIGH-PRESSURE
ENVIRONMENT... IT'S A PERFECT
CAULDRON, REALLY, FOR A TOXIC
WORK ENVIRONMENT.

Steve says MARGARET, I'LL GET
YOU TO COMMENT ON THESE.
I WANT TO READ A COUPLE OF
TESTIMONIALS THAT COME STRAIGHT
FROM YOUR REPORT.
THESE ARE TESTIMONIES YOU
RECORDED DURING YOUR FOCUS
GROUPS, AND HERE IS THE FIRST ONE.

A quote appears on screen, under the title "Quotes from health care workers." The quote reads "One of the staff was working nights and a patient bashed her head into a piece of equipment. She was by herself. She couldn't call for help. She didn't even have a phone. She suffered a concussion and never came back to work."
Quoted from James Brophy, Margaret Keith and Michael Hurley, "Assaulted and unheard." September 12, 2017.

Steve says HERE'S THE SECOND...

Another quote reads "We don't report sexual violence because it happens so frequently. Sexual harassment is definitely a problem for women workers. If I go in with a male worker, the patient is not going to pinch his butt. They'll pinch mine or make a sexual comment. You feel disgusted with yourself after someone makes an inappropriate pass. It makes you feel violated."

Steve says HOW MUCH OF ALL OF
THAT DID YOU RUN INTO IN YOUR STUDIES?

The caption changes to "A common struggle."

Margaret says WE RAN INTO
THAT OVER AND OVER AGAIN.
WE HELD FOCUS GROUPS WHERE THE
PERSON WHO WAS TALKING TO US
TELLING US A STORY WOULD BE IN
TEARS.
OTHER PEOPLE IN THE GROUP WOULD
COME UP TO TRY TO COMFORT HER.
IT WAS INCREDIBLY UPSETTING.
AND ALL THE RESEARCH WE'VE DONE
OVER THE YEARS, THIS WAS THE
MOST EMOTIONALLY DIFFICULT
DATA-GATHERING WE'VE EVER DONE.
WE TALKED TO PEOPLE WHO HAVE
NEVER RECOVERED EMOTIONALLY FROM
A TRAUMATIC EVENT.
WE HAD SOMEONE WHO TALKED TO US
ABOUT A SEXUAL ASSAULT THAT WAS
JUST DISMISSED BY HER MANAGER AS
UNIMPORTANT BECAUSE SHE WASN'T
ACTUALLY RAPED.
SHE WAS FIGHTING FOR HER LIFE
PHYSICALLY, FIGHTING FOR HER
LIFE, A PATIENT WHO HAD ATTACKED HER.

Steve says A MALE PATIENT, PRESUMABLY.

Margaret says A MALE PATIENT.
A STRONG MALE PATIENT.
AND SHE ENDED UP HAVING TO TAKE
SOME TIME OFF WORK.
BUT THE ISSUE WAS NEVER TREATED
SERIOUSLY.
AND THIS IS SOMETHING THAT WE
HEARD OVER AND OVER AGAIN.
THAT VIOLENCE AND SEXUAL
VIOLENCE, SEXUAL HARASSMENT ARE
JUST SOMETHING YOU HAVE TO PUT
UP WITH.
IT'S PART OF THE JOB.
SOME OF THEM WERE ACTUALLY TOLD
THAT.
YOU KNOW, WHEN YOU WENT INTO
THIS PROFESSION, YOU KNEW THAT
YOU WERE GOING TO HAVE TO PUT UP
WITH THIS SORT OF THING.
IT'S UNFORTUNATE, BUT THAT'S THE
WAY IT IS.
THEY DON'T GET THE KIND OF
SUPPORT THAT THEY NEED TO BE
ABLE TO BECOME HEALTHY AGAIN
AFTER AN EPISODE LIKE THIS.
WOMEN WHO HAVE BEEN... YOU KNOW,
WE'RE HEARING SO MUCH ABOUT IT
NOW WITH WHAT'S BEEN GOING ON IN
HOLLYWOOD.

Steve says THIS IS THE STORY WE
EXPECT TO HEAR OUT OF THE
STEREOTYPICAL HOLLYWOOD
PRODUCER, ETC., ETC., BUT WE
DON'T THINK OF PATIENTS,
VULNERABLE IN HOSPITALS, AS
BEING THE TYPICAL PERPETRATORS
OF THIS KIND OF BEHAVIOUR.

Margaret says I WAS SURPRISED BY HOW MUCH
OF THIS I WAS HEARING AND HOW
EASILY IT WAS DISMISSED AND HOW
HURT SO MANY OF THESE WOMEN
STILL ARE BY IT.
YOU KNOW, PEOPLE WHO HAVE
SUFFERED THAT KIND OF TRAUMA
NEED HELP IN GETTING OVER IT.
OTHERWISE, THEY'RE GOING TO
CONTINUE TO CARRY IT WITH THEM.
IT AFFECTS OTHER PARTS OF THEIR
LIVES.
THEY'RE TRIGGERED, WHICH IS WHAT
WAS HAPPENING IN THAT GROUP THAT
I WAS TELLING YOU ABOUT.
THE WOMAN WHO WAS TELLING US
ABOUT THIS SEXUAL ASSAULT WAS
TRIGGERING THE OTHER WOMEN IN
THE ROOM.
AND YOU COULD SEE THAT, YOU
KNOW, THE WAY THEY WERE ACTING,
THEY HAD THEIR STORIES TO TELL
AS WELL.
SOME OF THEM HAD DIFFICULTY
LOOKING AT US IN THE EYE, YOU
KNOW?
THEY WERE SHAKING AND UPSET.
OTHER PEOPLE CRYING.
I THINK THIS IS A VERY COMMON
EXPERIENCE, AND I DON'T THINK
IT'S BEING TREATED SERIOUSLY
ENOUGH.
YOU CAN'T JUST DISMISS THIS SORT
OF ISSUE AS UNIMPORTANT.
AND GOING BACK TO HOLLYWOOD.
I MEAN, THIS IS WHAT WAS
HAPPENING 20 YEARS AGO.
YOU WERE EXPECTED TO PUT UP WITH
THIS.
IT WAS PART OF THE JOB.
IF YOU WANTED TO GET AHEAD AND
BECOME A STAR, YOU HAD TO PUT UP
WITH A CERTAIN AMOUNT OF SEXUAL
HARASSMENT AND EVEN ASSAULT.
YOU WERE QUIET ABOUT IT.
AND SOMEHOW THE HEALTH CARE
WORKERS ARE EXPECTED TO...
STILL, IN THIS DAY AND AGE, TO
BE QUIET ABOUT IT.
THEY'RE NOT ALLOWED TO GO OUT
AND TALK ABOUT THESE THINGS.

Steve says IF THE GOLDEN GLOBE
AWARDS ARE ANY INDICATION, WE
SAW THOSE BUTTONS, TIME'S UP.
TIME'S UP IN HOLLYWOOD.
IS TIME'S UP HERE NOW?

Jim says I THINK SO.
IT'S BECOMING INCREASINGLY CLEAR
THE HEALTH CARE WORKERS ARE NOT
PREPARED TO ACCEPT THESE WORK
CONDITIONS ANYMORE.

Steve says THEY'RE PREPARED TO
GO PUBLIC, TO REPORT ON THESE
THINGS, BRING IT TO MANAGEMENT'S
ATTENTION?

Jim says PART OF THE FRUSTRATION IS
THEY ARE BRINGING IT TO
MANAGEMENT'S ATTENTION, ALTHOUGH
THEY FEEL THAT IT'S NOT VERY
PRODUCTIVE.
THEY DON'T THINK ANYTHING WILL
REALLY HAPPEN ABOUT IT.

Steve says WHY IS THAT?

Jim says WELL, BECAUSE OF THEIR
EXPERIENCE.
WE SAT IN A GROUP, FOR INSTANCE,
THE NORMAL PROCESS HERE, IT
WOULD BE THE JOINT HEALTH AND
SAFETY COMMITTEE WOULD HAVE A
REPORT ON THESE THINGS.
SO WE SAW EVIDENCE OF TWO YEARS
OF HEALTH AND SAFETY MEETINGS
EACH MONTH WHERE EVERY MONTH
EIGHT, NINE, TEN CASES WERE
REPORTED.
SAME THING THE FOLLOWING MONTH.
NO FOLLOW-UP...

The caption changes to "Escalating incidents."

Steve says MANAGEMENT'S
RESPONSE WOULD BE WHAT?

Jim says AS I SAY MARGARET SAID, THIS
IS SEEN AS NORMALIZED.
THIS IS PART OF THE JOB.
YOU KNOW, AS SOON AS THE... AND
THE FEAR OF REPRISAL IS
ENORMOUS.
PEOPLE FEEL IF THEY SPEAK OUT
ABOUT THIS, THAT THEY WILL BE
TARGETED, THEY'LL BE
STIGMATIZED.
THEY'RE FORCED, IF THEY GO SO
FAR AS TO SPEAK PUBLICLY, WELL
THEN, YOU KNOW, THEY COULD LOSE
THEIR EMPLOYMENT.
THAT WAS VERY MUCH A PART OF
EVERY BEGINNING OF EVERY SESSION
WE HAD: PEOPLE'S FEARS THAT IF
ANY OF THAT EVER BECAME PUBLIC
ABOUT WHAT THEY WERE DOING AND
WHAT THEY HAD SAID, THAT THEIR
JOBS WERE ON THE LINE.

Steve says I MEAN, AT THE RISK
OF TORTURING THE METAPHOR HERE,
LET'S DO THE HARVEY WEINSTEIN
COMPARISON HERE.
HARVEY WAS A BIG, POWERFUL
PRODUCER IN HOLLYWOOD WHO COULD
MAKE OR BREAK YOUR CAREER IF YOU
DIDN'T PLAY ALONG WITH HIS
OBJECT SENT AT THIS.
THESE TEND TO BE VULNERABLE
PATIENTS WHO ARE DOING THIS KIND
OF INAPPROPRIATE BEHAVIOUR.
DOES THAT MAKE IT DIFFERENT?

Margaret says I THINK WE
HAVE TO TAKE IT BEYOND THE PATIENTS.
I MEAN, WE HAVE A SYSTEM THAT IS
ALLOWING THIS TO HAPPEN, THAT IS
KEEPING WOMEN QUIET ABOUT THESE
ISSUES.
YOU KNOW, I CAN'T UNDERSTAND WHY
IT IS THAT THE PATIENTS ARE
DOING THIS.
SOME OF THEM HAVE DEMENTIA
PERHAPS.
YOU KNOW, THAT WAS CERTAINLY THE
CASE WITH THE PEOPLE WORKING IN
LONG-TERM CARE.
OTHERS JUST FEEL THAT THEY
SOMEHOW HAVE THE RIGHT TO BE
ABUSIVE TO NURSES.
YOU KNOW, THERE'S THIS IMAGE OF
THE SEXY NURSE OR A SEXY NURSE
COSTUME YOU CAN GET FOR
HALLOWEEN.
I THINK THERE'S STILL THIS IMAGE
SOMEHOW THAT A NURSE IS SOMEHOW
OPEN TO THIS KIND OF HARASSMENT.

Steve says I SHOULD CLARIFY ON
THIS... SORRY.
IT IS PATIENTS THAT YOU ARE
FINDING ARE DOING THE ABUSE
HERE?
NOT DOCTORS OR MANAGERS OR...

Margaret says NO.
IN FACT OUR STUDY WAS TYPE 2
VIOLENCE.
THIS IS PATIENTS AND THEIR
FAMILY MEMBERS AGAINST THE
STAFF.
NO, THESE ARE PATIENTS.
THESE ARE PATIENTS WHO WILL BE
LYING IN THE BED, A NURSE WILL
WALK IN AND THEY'LL REACH UP AND
TOUCH HER BREAST.
WE TALKED TO PEOPLE GROPED ON A
REGULAR BASIS.
THEY'LL PULL AWAY, TRY TO SAY
SOMETHING TO THE PATIENT, MAYBE
STEP OUT OF THE ROOM FOR A
MINUTE AND COME BACK IN.
I THINK THEY SHOULD BE ABLE TO
GO TO THEIR MANAGERS AND HAVE
THE MANAGERS COME INTO THE ROOM
AND SAY "THIS IS NOT
ACCEPTABLE."
YOU KNOW, WE SHOULD HAVE ZERO
TOLERANCE AND THAT ZERO
TOLERANCE POLICY NEEDS TO BE ENFORCED.

Steve says I WAS IN SUDBURY
OVER THE HOLIDAYS.
I HAD A RELATIVE WHO IS IN
HOSPITAL UP THERE.
HEALTH SCIENCES NORTH.
THERE ARE SIGNS ON THE WALLS
EVERYWHERE SAYING: WE WILL NOT
TOLERATE THE ABUSE OF OUR STAFF
BY ANY PATIENTS, PATIENTS AND
VISITORS.
THEY SEE ALL THAT THERE.
ARE THOSE SIGNS NOT WORKING?

Jim says WELL, FIRST OF
ALL, I MEAN, I'M VERY PLEASED TO
HEAR THAT SUDBURY IS DOING THAT.
BUT YOU COULD GO TO ANY NUMBER
OF HOSPITALS THROUGHOUT THE
PROVINCE, AND YOU WILL NOT FIND
THAT.
I MEAN, THE DIFFERENCES, THE
LACK OF SUPPORTS FROM ONE PLACE
TO THE NEXT, THE LACK OF
CONSISTENCY OF THESE POLICIES IS
UNIVERSAL.
I MEAN, IN SOME CASES, YOU KNOW,
WE MENTION IT IN THE REPORT, ONE
OF THE NURSES SAID, THE FIRST
TIME SHE FOUND OUT THERE WAS
SUCH A THING AS A BUZZER WAS AT
A CONFERENCE, A HEALTH CARE
WORKER, SOMEONE OUT OF LAUNDRY
SAID EVERY TIME YOU GO TO A
CERTAIN HALLWAY, YOU HAVE TO PUT
IT IN.
SHE SAID WE DIDN'T KNOW THERE
WAS A BUZZER.
WE JUST SCREAM.
THAT KIND OF LACK OF
CONSISTENCY, LACK OF
ACROSS-THE-BOARD POLICIES, THAT
YOU COULD WORK IN ONE LOCATION
AND HAVE THAT SUPPORT AND NOT
ELSEWHERE...

The caption changes to "Creating a safe workspace."

Steve says WE SHOULD SAY HERE
WE DID OUR DUE DILIGENCE
JOURNALISTICALLY HERE AND INVITED
A REPRESENTATIVE FROM ALL THE
HOSPITALS IN ONTARIO.
DIDN'T GET BACK TO US.
WE INVITED SOMEONE TO COME ON
THE PROGRAM AND DISCUSS THIS.
THEY DIDN'T GET BACK TO US.
WE REACHED OUT TO THE OFFICE OF
THE MINISTER OF HEALTH AND
LONG-TERM CARE, ERIC HOSKINS.
HE WAS APPARENTLY UNAVAILABLE.
HERE'S WHAT HIS OFFICE DID SEND
US IN A STATEMENT.
WE'LL PUT THIS UP HERE RIGHT NOW.

A slate appears on screen, with the title "The province's response."

Steve reads data from the slate and says
THEY HAVE LAUNCHED A WORKPLACE
VIOLENCE PREVENTION AND HEALTH
CARE LEADERSHIP TABLE, WHICH HAS
MADE A NUMBER OF RECOMMENDATIONS
TO IMPROVE THE SAFETY OF HEALTH
CARE WORKERS.
SINCE 2014, THROUGH THE MINISTRY
OF LABOUR, THEY ARE INSPECTING
ALL ACUTE CARE HOSPITALS.
THEY ARE ALSO INSPECTING SOME
LONG-TERM CARE HOMES AND
COMMUNITY-BASED HEALTH CARE
SERVICES.
THAT'S THE OFFICIAL REACTION
FROM THE GOVERNMENT OF ONTARIO.
THOUGHTS?

Margaret says OKAY.
WE HAVE READ THE REPORT AND WE
HAVE ACTUALLY SPOKEN TO PEOPLE
IN THE GOVERNMENT ABOUT THIS AND
THEY RECOGNIZE THAT THE PROBLEM
EXISTS AND THEY HAVE GONE
THROUGH AND COME UP WITH
RECOMMENDATIONS, AND I GUESS OUR
REACTION IS THAT WE'VE KNOWN
ABOUT THIS PROBLEM NOW FOR AT
LEAST 20 YEARS.
THERE HAVE BEEN HUNDREDS OF
ARTICLES PUBLISHED ABOUT THIS
PROBLEM.
THANK GOODNESS THEY'RE FINALLY
LOOKING AT THE ISSUE.
BUT I THINK IT'S AWFULLY LATE.
AND A LOT OF THESE THINGS ARE
STILL JUST RECOMMENDATIONS.
THEY HAVEN'T CHANGED THE LAWS...

Steve says DO YOU THINK THEY'RE
ADEQUATELY, IN GOVERNMENT,
SEIZED OF THE SIGNIFICANCE OF
THIS AND PREPARED TO MAKE SOME CHANGES?

Margaret says I THINK THEY DO UNDERSTAND.
I THINK THEIR HANDS ARE TIED BY
LACK OF RESOURCES, AS JIM WAS
SAYING.
YOU KNOW, YOU REALLY CAN'T FIX
THIS PROBLEM WITHOUT HAVING
FUNDING.
ONE OF THE BIGGEST PROBLEMS IS
UNDERSTAFFING.
YOU DON'T HAVE ENOUGH STAFF TO
GO IN AND DO TEAM...

Steve says DUMB QUESTION HERE:
WHY DO YOU NEED MORE MONEY TO
ENFORCE A CODE OF CONDUCT AMONG PATIENTS?

Margaret says WELL, I MEAN, I THINK ONE OF
THE PROBLEMS IS THAT YOU HAVE A
LOT OF PATIENT FRUSTRATION.
THEY'RE WAITING.
YOU CAN GO INTO THE ER AND WAIT
FOR HOURS TO SEE SOMEONE.
THE PATIENTS AND FAMILY MEMBERS
START TO BECOME AGITATED.
WHEN YOU'RE IN THE HOSPITAL,
YOU'RE ALREADY A BIT EMOTIONALLY
COMPROMISED.

Steve says SURE.

Margaret says IF YOU FEEL YOU'RE NOT
GETTING THE CARE THAT YOU
DESERVE, YOU'RE GOING TO LASH OUT.

Steve says A BETTER-RESOURCED
HEALTH CARE SYSTEM WOULD REDUCE
THESE KINDS OF SYSTEMIC ISSUES.

Margaret says IT WOULD ALSO PERMIT PEOPLE
WITH MENTAL HEALTH ISSUES TO GO
INTO APPROPRIATE FACILITIES.
WE'VE CUT WAY BACK ON MENTAL
HEALTH BEDS AND ON COMMUNITY
PROGRAMS THAT WOULD HAVE MAYBE
PREVENTED PEOPLE FROM HAVING TO
SHOW UP IN THE ER IN A CRISIS.
AND THESE ARE... I MEAN, THIS IS
SUCH A COMPLICATED PROBLEM, AND
THERE'S NO ONE EASY FIX.
BUT WHAT WE SAW OVER AND OVER
AGAIN, IN TALKING TO EVERY ONE
OF THE HEALTH CARE WORKERS THAT
WE'VE SPOKEN TO, THERE WERE
THESE TOP THREE THINGS, AND TOP
I THINK WAS STAFFING, THE
UNDERSTAFFING PROBLEM.
THE OTHER WAS SORT OF THIS LACK
OF RESPECT, THIS DISMISSAL OF
THE PROBLEM.
YOU KNOW, YOU'RE EXPECTED TO PUT
UP WITH IT.
AS JIM WAS SAYING, A
NORMALIZATION OF VIOLENCE.
AND ALSO THERE'S THIS CULTURE
THAT EXISTS WITHIN A LOT OF THE
HEALTH CARE FACILITIES.
YOU KNOW, IN A LOT OF WAYS, THIS
IS A SYSTEMIC CULTURAL PROBLEM.

Steve says JIM, YOU WANTED TO ADD?

Jim says I THINK ABOUT,
YOU KNOW, THE GOVERNMENT'S
POSITION HERE.
I MEAN, I CAN TELL YOU ON THE
GROUND THAT THE REGULATORY
SYSTEM IS ABSENT.
NO ONE... THERE WAS NO
CONFIDENCE THAT THE MINISTRY OF
LABOUR OR THE MINISTRY OF HEALTH
OR ANY REGULATORY GROUP OF
WORKERS' COMPENSATION SYSTEM WAS
ANYWHERE IN THIS PICTURE, OTHER
THAN AS A POSSIBLE ANTAGONIST.
YOU NEVER EXPECTED THE MINISTRY
OF LABOUR, FOR INSTANCE, TO
INTERVENE AND ADDRESS THESE
ISSUES.
IT WAS JUST... THE HEALTH CARE
WORKERS' EXPERIENCE WAS THAT THE
REGULATORY SYSTEM WAS ABSENT,
AND THEY EXPERIENCED A
TREMENDOUS, YOU KNOW, LACK OF
RESOURCES, A CONTINUING LACK OF
RESOURCES.
I MEAN, IT'S VERY COMMON FOR
PEOPLE ALL BY THEMSELVES TO BE
WORKING ALONE AT NIGHT ON LARGE
WARDS, FACING... OR, YOU KNOW, A
NURSE ON ONE FLOOR AND A PSW ON
ANOTHER BY THEMSELVES, WITHOUT
ANY SECURITY, WITHOUT ANY
BUZZERS, WITHOUT ANY KIND OF
BACKUP.
SO THIS KIND OF ATMOSPHERE, I
MEAN, I THINK IS A REAL
BAROMETER OF THE HEALTH OF THESE
HEALTH CARE WORKERS AS A
BAROMETER FOR THE HEALTH OF THE
HEALTH CARE SYSTEM.
I THINK WE HAVE A VERY SERIOUS
CRISIS, IF YOU WILL, IN OUR
HEALTH CARE SYSTEM, THAT IS
ALLOWING THIS TYPE OF BEHAVIOUR
TO DEVELOP.

Steve says OKAY.
A COUPLE OF MINUTES LEFT AND I
WANT TO TOUCH ON A COUPLE OF
MORE THINGS HERE.
MARGARET, THIS IS NOT A CYNICAL
PROGRAM AND I AM NOT A CYNICAL
PERSON.
HOWEVER, YOU'RE GOING TO FORGIVE
THIS QUESTION.
CUPE, FOR WHOM YOU DID THE
STUDY, AND THE ONTARIO HOSPITAL
ASSOCIATION, ARE CONSTANTLY IN
NEGOTIATIONS FOR, YOU KNOW, AS
CONTRACTS END AND THEN THEY HAVE
TO RENEGOTIATE NEW CONTRACTS.
I'M SURE THEY'RE IN CONTRACT
TALKS ALL OVER THE PROVINCE
RIGHT NOW.
A CYNICAL PERSON MIGHT WONDER
WHETHER OR NOT THIS STUDY WAS
DONE AT THIS PARTICULAR TIME IN
ORDER TO HAVE A PARTICULAR
INFLUENCE ON WHATEVER CONTRACT
NEGOTIATIONS ARE HAPPENING RIGHT
NOW.
SPEAK TO THAT, IF YOU WILL?

Margaret says OKAY.
I'M NOT A MEMBER OF CUPE, SO I
DON'T KNOW... YOU KNOW, I CAN'T
SAY WHAT THEIR TIMING IS.
I BELIEVE THEY ARE IN CONTRACT
NEGOTIATIONS NOW.
WE STARTED THIS STUDY A YEAR AND
A HALF AGO.
WE WENT IN INDEPENDENTLY.
YOU KNOW, WE HAD TO FOLLOW OUR
OWN CODE OF ETHICS THROUGH THE
UNIVERSITY OF STERLING.
WE WENT IN AND ASKED THE
QUESTIONS AND PRODUCED THE RESULTS.

Steve says AND AT NO TIME DID
CUPE SAY, BOY, IT WOULD SURE
HELP US AT CONTRACT TIME IF YOU
COULD FIND SOMETHING OUTRAGEOUS.

The caption changes to "tvo.org/theagenda."

Margaret says ABSOLUTELY NOT.
WE WERE SO SURPRISED BY WHAT WE
WERE HEARING.
WE DIDN'T HAVE A SENSE FROM THEM
THAT THEY EXPECTED TO HEAR
ANYTHING LIKE WHAT WE HAD HEARD.

Steve says JIM, DO YOU WANT TO
SPEAK TO THAT?

Jim says I THINK FIRST
OF ALL WE'RE NOT A PART OF THE
UNION, ALTHOUGH WE'VE WORKED
WITH THEM VERY COLLABORATIVELY
ON THIS STUDY.
BUT NEGOTIATIONS ACTUALLY HAVE
BROKEN DOWN.
IT WAS ON THE QUESTION OF
VIOLENCE.
THE UNION HAS MADE THIS A VERY
IMPORTANT ISSUE.
LIKE, THE HUMAN RIGHTS OF THEIR
MEMBERS IS BECOMING INCREASINGLY
IMPORTANT.
AND I THOUGHT IT WAS VERY
INFORMATIVE THAT THEY COULD NOT
REACH ANY KIND OF COMMON GROUND.
LIKE, I THINK THE DISTANCE
BETWEEN THE EXPERIENCE OF THE
HEALTH CARE WORKERS, THE FRONT
LINE HEALTH CARE WORKERS AND THE
PEOPLE THAT ARE RUNNING THE
HOSPITALS AND THE HEALTH CARE SYSTEM...

Steve says YOU THINK THE
HOSPITAL MANAGEMENT JUST DOESN'T
CARE ENOUGH ABOUT THE HEALTH OF
THEIR WORKERS?

Jim says IT'S NOT THAT THEY DON'T
CARE.
IT'S JUST THAT IT'S NOT ON THEIR
RADAR.
I THINK THAT THE BUDGETS AND
PROGRAMS AND PROBABLY THE HIGHER
LEVEL PROFESSIONALS WITHIN THE
HEALTH CARE SYSTEM DOMINATE THE
AGENDA, AND WHAT'S HAPPENING TO
NURSES AND PERSONAL SUPPORT
WORKERS AND TO THE CLEANERS...
THAT'S JUST NOT ON.
AND THAT'S THE STORY THAT WE
HEARD, AND IT'S ACTUALLY... I
MEAN, AGAIN, IT'S VERY MUCH
VALIDATED WITHIN THE SCIENTIFIC
LITERATURE.

Steve says IN WHICH CASE,
MARGARET, LET'S FINISH UP ON
THIS: HOW CONFIDENT ARE YOU,
HAVING DONE THE STUDY, HAVING
HEARD MANAGEMENT'S REACTION,
HAVING HEARD THE RESPONSE FROM
THE MINISTRY OF HEALTH AND
LONG-TERM CARE, HAVING SEEN THE
REPLIES, HOW CONFIDENT ARE YOU
THAT ANYTHING IS GOING TO BE
DONE ABOUT THIS?

Margaret says I'M HOPEFUL
THAT IT WILL BE.
ONE OF THE BIG THINGS IS THE
GENERAL PUBLIC NEEDS TO KNOW
THAT THIS IS HAPPENING.
I THINK THEY HAVE A SUSPICION OF
IT, BUT I THINK IT'S IMPORTANT
THAT HEALTH CARE WORKERS BE ABLE
TO SPEAK OUT ABOUT IT.
I'M GLAD THAT WE HAD THE
OPPORTUNITY TO BE ABLE TO DO
THIS STUDY AND TO BE ABLE TO GET
THIS INFORMATION OUT.
BECAUSE I DON'T THINK THE
GENERAL PUBLIC WANTS THIS TO
HAPPEN.
AND I THINK ONCE THEY HEAR ABOUT
THIS, THEY WILL BE PUTTING
PRESSURE ON OUR GOVERNMENTS TO
DO SOMETHING ABOUT IT.

The caption changes to "Producer: Katie O'Connor, @KA_OConnor."

Steve says THE NAME OF THE
STUDY IS "ASSAULTED AND UNHEARD:
VIOLENCE AGAINST HEALTH CARE
STAFF."
A REAL EYE-OPENER.
JIM BROPHY, MARGARET KEITH,
WE'RE GRATEFUL YOU CAME ALL THE
WAY FROM WINDSOR TO TVO TONIGHT
TO SHARE YOUR VIEWS ON THIS.

Jim says THANK YOU VERY MUCH.

Watch: Facing Violence and Assault in Health Care