New Brunswick health-care workers under 'constant threat of violence'

The president of the New Brunswick Medical Society says violence in the workplace is an all-too-common reality for health-care professionals.

This comes after nurses called on the Higgs government to address what they call a "security crisis" at hospitals across the province.

"I think the last thing that [a] health care provider needs when they go to work is the concern and the worry that they're going to be a victim of violence, whether it be someone screaming at them, whether it be someone taking a swing at them," Dr. Serge Melanson told CBC's Information Morning Moncton. 

"And the reality is unfortunately, that tends to be the culture in our health care system."

Melanson, who is also an emergency room physician at the Moncton Hospital, said he's seen violence against his colleagues occur many times. 

He said the emergency department can be a volatile environment, since long wait lines often cause frustration. 

Threats and physical violence occur regularly, he said. 

"We've got people there with complex memory problems, elderly people with dementia who are not in control of their own faculties who may act violently towards caregivers," said Melanson.

"We have patients with mental health problems that can sometimes become in crisis and sometimes aren't in control of their behavior either."

He also said there's a "significant population" of patients who come in while under the influence of drugs.

At work last Wednesday, Melanson said he was treating a patient who was high on methamphetamines. Melanson described the person as "very agitated" and "threatening to harm other people."

Security had to be called to help restrain the patient. 

"We then had to chemically restrain them to keep them safe, to make sure they weren't going to hurt themselves or anyone else," he said. 

"And during that ... it's a very volatile 10 or 15 minutes. And it's not uncommon for people to become injured when that happens sometimes."

Not enough security guards, resources

One issue is that there aren't enough security guards. According to the New Brunswick Nurses Union, nearly half of the security guard positions at the province's hospitals are vacant.

Melanson said being a security personnel at a hospital requires a lot of responsibility, but staff only get paid minimum wage. 

On top of that, two-thirds of security personnel feel like they don't have the resources to succeed in their jobs, and there's an 82 per cent turnover rate annually. 

Melanson described these numbers as "alarming."

"We need to do much better when it comes to supporting our security staff, so that they, in turn, can support us, the health care workers," he said.

Paula Doucet, president of the nurses union, has called the situation "a dangerous and unacceptable state-of-affairs" for staff and patients.

The union said Horizon Health Network experienced 1,005 violent incidents in 2017-2018, while Vitalité saw 586. 

"One more nurse, one more health care provider being assaulted at work is one too many," Doucet said. 

'Try not to take it out on your health-care provider'

Although violence in the workplace is not a new problem, Melanson said it's becoming worse. 

"I have residents training with me all the time, and I make a point of basically educating them on how to keep them safe and how best to deal and de-escalate these very volatile situations," he said.

He said health care providers need to be extra careful. Even with training, experienced staff are still at risk. 

When walking into a patient's room, Melanson has a keen sense of his surroundings. Melanson said he and other staff have even had to remove weapons, like knives and pepper spray, from patients. 

Violent events sometimes trigger the emergency department to shut down. The violent behaviour also puts other patients and their families at risk.

"These people that are there are very disruptive," he said. "It's very upsetting to patients and their families and, to be frank, they share the same risk as we do, to some extent, in terms of when these people get out of hand."

In addition to hiring extra security guards, Melanson said the province needs to re-focus on training hospital staff. He also suggested implementing technologies that can alert the rest of the staff if there's a problem.

And just talking about the issue in the first place helps too, he said.

"It brings very much an awareness to our citizens of the additional pressures that our health care providers are undergoing," he said.

"Not only doing exceptional work under tough circumstances [and] limited resources, but under the constant threat of violence."

While there may be problems with the province's health-care system, Melanson stressed that they are not the fault of the people working at hospitals.

"The majority of patients that we treat are respectful and are very appreciative of the work that we do," he said. 

"But for those who are feeling more and more frustrated with the system, just try not to take it out on your health-care provider."