Facility constructing extra ER space for mental-health patients
(Canadian OH&S News) — Violence against nurses has continued at Abbotsford Regional Hospital in Abbotsford, B.C., and incidents over the last few months have led to a recent WorkSafeBC inspection report noting an emergency room (ER) running over capacity.
A registered psychiatric nurse (RPN) suffered a severe concussion after getting kicked in the head by a patient in the ER on Oct. 17, and two RPNs and a security guard were assaulted by a young patient on Sept. 8. Both assailants had been patients with mental-health issues whom the police had brought in, said Val Avery, president of the Health Sciences Association of British Columbia (HSA), one of the unions representing the hospital’s employees.
“Mental health is the public healthcare crisis of our times,” said Avery. “Our ability to respond to it in a healthcare setting has not grown with the same type of need that is required here. So we’re getting these overflowing departments and not the appropriate settings to care for the patients.”
Three more RPNs at the facility have been assaulted in the past few weeks, according to a Nov. 16 news bulletin from HSA. The hospital had 62 reported violent incidents between 2008 and early 2015, the union added.
Avery agreed that the large number of patients in the Abbotsford ER was a strong factor in the frequent violence. “Regardless of how many bodies are there, the police are still bringing in more people than the space can adequately handle. And so that places a lot of stress on the situation,” she explained.
But she also charged that the facility was not putting the right safety measures and practices in place to protect staff. For example, at the time of the Sept. 8 attack, the security guard who was assaulted was the only guard assigned to the area — “instead of the three that were supposed to be there,” she said. “There are a number of those types of violations.”
Last year, Fraser Health Authority (FHA), the organization that runs the Abbotsford hospital and others in the region, hired an outside consultant to conduct a review on violence in the facility. Released in July 2015, the report offered 29 recommendations to the hospital. But the hospital has yet to implement most of them, Avery claimed.
“I think they have looked at some things,” she said, “but staffing is an issue.” On top of understaffing, the hospital often does not assign a sufficient number of security guards to the ER, she added. “They haven’t adequately educated and trained all of their staff; I think there’s still at least ten per cent of the staff that haven’t received violence training.”
Valerie Spurrell, the executive director of Abbotsford Regional Hospital, disagreed that the facility had failed to implement the FHA report’s recommendations. She countered that the hospital had “often gone above and beyond just what was recommended” in areas such as training, staffing, protocols and personal protective devices for nurses over the previous year.
“We take every incident that happens very seriously,” Spurrell told COHSN, “so that we learn from them.”
Most significantly, the hospital has spent millions of dollars constructing a new emergency area designed specifically for patients with mental-health and substance-abuse issues. This space will open next summer, according to a news release that FHA sent out on Nov. 18. Adjacent to the current ER, the area is expected to have its own nursing station, consult rooms, stretcher bays and seclusion stations, with emergency doctors, nurses and psychiatrists on hand for immediate assessment and treatment.
“That will create a more calm and compassionate environment and increase safety for both patients and staff,” explained Spurrell, “and also reduce the congestion, a regular part of our emergency department right now, which is where those patients would normally be.”
“There are just a number of things that need to be looked at to ensure we have safer workplaces,” said Avery. “People just should not have to fear going to work in a healthcare setting.”