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In BC, Being a Nurse Can Be Hell

Assaults, abuse blamed on workplace climate, cuts and staff shortages.

By Andrew MacLeod, 16 Apr 2009, TheTyee.ca

Nurse with head in hands

'Right there on the frontlines.'

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Nurses in British Columbia were more likely to report on-the-job abuse than their colleagues in other provinces, according to figures released by Statistics Canada this morning.

In B.C., 39 per cent of nurses providing direct care in hospitals or long-term care facilities reported having been physically assaulted on the job during the previous 12 months, based on a survey conducted in 2005. That was well above the Canadian average of 34 per cent and lower than only one province, Newfoundland and Labrador.

The number of B.C. nurses reporting emotional abuse from patients on the job was 53 per cent, compared to a national average of 47 per cent. The only province where a higher rate of nurses reported emotional abuse was Manitoba.

"We are very concerned by that," said Health Minister George Abbott. "We have been working with the nurses' union on the whole issue of violence in the workplace."

The Health Ministry has done some advertising in health care facilities to sensitize people to the issue, he said, and it is on the agenda for the common roundtable the government and the B.C. Nurses' Union recently agreed to form.

Some 218,000 nurses were providing direct patient care in 2005 across Canada, according to a summary of the StatsCan study, and 94 per cent of them were women. The reporting of abuse was higher for male nurses, those with fewer years experience, licensed practical nurses and registered psychiatric nurses. Nurses working 12-hour shifts reported higher levels of abuse than did those working days.

Workplace climate

Other "workplace climate" factors that contributed to higher levels of assault and emotional abuse included the "adequacy of staffing and resources," the working relations between nurses and doctors, support from supervisors and support from co-workers.

"The odds that nurses would report physical assault or emotional abuse tended to be high among those who perceived staffing or resources to be the least sufficient, who perceived that relations with physicians were unfavourable, who had low supervisor support, or who had low support from colleagues," said the StatsCan report.

"I believe all of those things apply in B.C.," said BCNU president Debra McPherson. Asked if anything had improved since 2005 when StatsCan researchers did the survey, she said, "not appreciably." "We really need to work on creating a culture of safety, starting from the top."

Short staffing leads to crowded hospitals and angry and frustrated patients, she said. Nurses get the brunt of that. "They're right there on the frontlines and they get it all the time," she said. It happens to some degree with all health workers, but often nurses are called when other professionals need help.

In many of those situations, she said, "It's the nurses who get the punch."

Service cuts

Nor do nurses, relatively low in the healthcare hierarchy, get much support, she said. There are managers who when a nurse says she or he has been hit, will ask, "What did you do to cause that?" It's similar to blaming the victim in a domestic assault and should not be accepted, she said. "That attitude's not uncommon in the health authorities."

"To some degree, it's the impact of cuts in services," said New Democratic Party health critic Adrian Dix.

"If you go around B.C., and talk to nurses, they'll tell you for them this is the workplace issue," he said. Other research has suggested B.C. nurses are subject to increasing levels of violence, he said. "This is definitely consistent with that and consistent with the consequences of the hallway medicine and crowded emergency rooms we've seen in recent years."

Abbott said it is "inaccurate" for Dix to say the government has cut health care. Spending has gone up from $9 billion in 2001 to $15 billion this year, he said.

BCNU president McPherson said Abbott and Dix are each correct in their own way. "They're both telling the truth because facts can always be spun," she said. Health spending has gone up, she said, but there have also been service cuts as budgets have not kept up with the pressures that include inflation and an aging population.

2,000 vacancies

In many cases, there are too few nurses to fill in when people are sick or on leave. For example, McPherson said, Burnaby Hospital was running its operating room six nurses short of its usual staff level on April 15.

Abbott also raised the lack of nurses as part of the problem. "When we have 2,000 nurse vacancies in the province as we do today, the chances of a nurse having to work overtime, to do more nursing duties, produces extra opportunities for the unfortunate encounters that are presently being referenced in the StatsCan numbers."

The B.C. Liberal government has doubled the number of training spaces for nurses, Abbott said, adding that under the NDP government in the 1990s, the number of nursing graduates dropped by 32 per cent.

The BCNU started a non-partisan campaign today with a launch event outside Burnaby Hospital to highlight concerns about the nursing shortage and advocate for better public healthcare and improved care for seniors.

Related Tyee stories:

[Tyee]

Assaults, abuse blamed on workplace climate, cuts and staff shortages.

18 Comments:

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  • Fiat lux

    3 years ago

    Recently, I had to spend 5

    Recently, I had to spend 5 weeks in hospital. It was a brutal eye opener for what this government has done to our health services, doing their best to make peoples' lives miserable as possible through the closing of facilities and the cutting of staff, services, wages and standards.

    The wards are now dark, curtained holes, with men and women jammed into the same rooms, devoid any privacy and human dignity. Some of the food we received in intensive care was good and still cooked locally, but for the wards, most of it is now cooked hundreds of kilometers from the hospitals, then trucked for hours, warmed up in microwaves that destroy all food values, with the vast majority ending in the garbage.

    The trucks are wasting millions of kilometres on fuel, wear and tear, while spewing thousands of tons of carbon into the air. All in the name of “savings” and “fiscal responsibility".

    Then we have the chronic, shortages of nurses and other medical staff. The care we received from the doctors, medical personnel and nurses was outstanding and absolutely first class. But a large percentage of the nurses are middle aged, many definitely close to retirement, with a small percentage of young people and students.

    Because of the shortages, the nurses are always on the run during their twelve hour shifts.

    The students have to pay somewhere between $5, and 6,000 per year for their schooling, with hardly any help. We have a government that spends literally billions on fancy show projects, while young people, who would be happy to train for lifesaving profession, are denied the chance, because they can't afford the tuition fees.

    The government could easily pick up the yearly fees of a thousand prospective nursing candidates for about $6. million, that could make a tremendous difference to the shortages, within a couple of years. It would be a drop in the bucket in comparison to the hundreds of millions wasted on showbiz projects.

    Then there are the other, absolutely necessary medical services personnel , the Xray technicians, labs., pathology testing, ultrasounds, pharmacists, physiotherapists, medical records, etc. all suffering extreme shortages, with no newly trained people in sight and no government help.

    The wages of all these people, as for the vast majority of the working force, have fallen way behind the over 1,000 percent inflation rate in the past 40 years. In the case of the technicians, the government negotiators simply walked away from the table, as they have done with the paramedics. Our foreign investors need the dough, and so to hell with the public, now being propagandized to give them four more years so they can cut more services, while selling off the ground from under our feet.

    Ed Deak.

  • G West

    3 years ago

    Well said Ed

    And, sadly, I know your experience was not unique. I've seen and heard similar descriptions here on Vancouver Island - and it's the rule - not the exception.

    So glad you're on the mend and doing what you do best here at Tyee and in other independent media outlets around BC.

    Keep it up!

  • LarryBC

    3 years ago

    Nurse abuse survey is just opinion, not fact

    This is just a survey of nurses, like a poll, but more biased because the source is one specific group not the general public.

    There is no basis of fact or proof in this story that nurses are so terribly abused, other than their own word, and no facts to back their claims up. The nurses interviewed did not have to give any details about the "abuse" incident(s) they claimed to have experienced (time, place, person(s), situation, evidence, witnesses). I'd take this survey's results (and this story) more seriously if it was based on actual incidents reported to authorities (WCB or police). Otherwise, this is just dressed-up hot air.

    Another problem is that this survey data is all anonymous. So, it's way too easy for someone to simply claim that they are being poorly treated. Although the story (and the survey) doesn't say, this story implies the abusers are patients, family or the public.

    Also, if you go to StatsCan's website you can actually look at the survey form itself, and you will see that the questions were very wide ranging. It included questions about complaints from families, whether the nurse feels she is too busy, whether their cafeteria serves good food to staff, whether their organization takes good precautions to prevent infectious outbreaks, whether the nurse has taken sedatives or narcotics, etc.

    In fact, the survey runs 72 pages. There are only 3 main questions about abuse: Y/N, did the nurse experience a physical assault or emotional abuse, and was it from either a patient or a staff person or some other person. That’s it. Yet the StatsCan study focuses only on this one tiny part of the survey. Cherry-picking???

    I'm not unsympathetic to nurses who are mistreated, but I think in most cases nurses (and other health care providers) have the upper hand with patients and with families in BC's health care system. Many, many people are treated with disdain and disrespect by health care practitioners in BC, including nurses.

    Didn't the BCNU just settle a nice raise with the government? And isn't it interesting how the BCNU's campaign is being launched at the same time as the StatsCan survey is being released. Coincidental? I don't know.

    I know and respect some very good nurses, but sadly, the medical professionals and their political bodies, I have no respect for anymore.

  • G West

    3 years ago

    LarryBC

    Still nothing but your own particular opinion - I'll take nurses testimony - anonymous or otherwise - added to my own experiences in hospitals and care homes AND with relatives in the medical business - and say, what's the big deal Larry?

    You sseem to have a bit of an aganda yourself.

    Upper hand?

    What's THAT all about my friend? I'd like to see you after a 12 hour shift in one of this city's 'fine' care homes....

  • danneau

    3 years ago

    New to Nursing

    Waiting for spaces in nursing programs can be as much of a block to entering the profession as the tuition fees, so why not spend more time training on the job, perhaps in an apprentice-like program that would pay trainees to train and send them to rotations of intensive classroom work to do the theoretical portions of the program? Seems to me that we could do the same thing with teachers, lawyers, doctors and who knows who else as well. We can still demand thorough training and theoretical grounding, encourage those who want to stay in the profession, flush out those unsuited and graduate professionals who aren't burdened by the stress of huge debt. If there are co-op programs for, say, industrial chemistry, it seems folly not to have that option for a wide variety of callings

  • Van Isle

    3 years ago

    This article gave a stat

    This article gave a stat about emotional abuse. What about the stats for emotional abuse by supervisors/administrators?

  • freebear

    3 years ago

    Great Career promo!

    I wonder why anyone would consider nursing for a career now!

    Did the recent MLA's who had hospital stays (cancer treatments, etc.) have similar experiences to Ed?

    Glad you are better Ed; I appreciate how you make 'swiss cheese' of the capitalism scam!

    I shudder to think what level of healthcare will exist in nthe next 20n years when more of us 'boomers' will need it!

  • Skywalker

    3 years ago

    People seem to think ...

    ...that if they have a complaint about the health care system they need to take it out on nurses. Nurses are intimidated to not speak out on any health issue and this started in earnest after 2001. So a nurse on the front lines of the service hears and experiences the frustration first-hand. They need to speak out more. Nothing will change until they do.

  • alive

    3 years ago

    Sorry but

    Skywalker:
    Nurses and LPN's have been told to not speak out, in fact they have to sign a form to that effect!
    The only way to make a point is to talk to your MLA, and ------ wait for it: ------ To vote for the right party at election time

  • bcliberals_suck

    3 years ago

    The Abuse is Real

    I work in a health care setting, know people who work in other settings and have had relatives receive care as well. I guarantee you, nurses get abused on the job, as do all other frontline workers.

    You want to bring up WCB, they have been so downsized as to losing relevance with a large portion of workers across sectors in BC. A lot of the claims, in the area of frontline work are in the area of mental stress, or psychological injury. It is distressingly difficult for people impacted by these debilitating impacts of work to have their WCB claims accepted. In one well known case, the ambulance attendant was turned down for a MS/PI case because they should have _expected_ to deal with the stress involved in the death of the suspect in a hostage taking where the ambulance had to stand by for hours, because that was an occupational hazard.

    Give me a friggin' break, every day in this province, emergency and frontline workers sacrifice their personal health and well-being to take care of others and get abused and hurt on the jobs sometimes - nurses, cops, ambulance, social workers, search & rescue, firefighters... This government doesn't seem to understand that professionals who want to do this kind of challenging and difficult work don't grow on trees. They need to be supported, helped and treated with compassion. Most of all, they need adequate staffing and decent workloads.

    One thing I find just fascinating is how BC Liberal MLA's can justify in their own minds and conscience the profound degradation and corruption of the health care (and social service) systems that they and their family members, their friends and colleagues have to deal with. They don't all go to private clinics, although I'm sure some do. But really, how can they morally justify to themselves and others the fact that hospitals have been downsized and downgraded in their communities? That seniors are without help, or support, and can't get into assisted living, or even get a damn home care support worker to come in to help them shower once a week? Shell games with health care dollars doesn't cut it and I don't know how they can still represent such shameful health care policies?

    We all deserve so much better, those who need the care and services and those who commit their lives to helping and serving others.

  • tricia58

    3 years ago

    To LarryBC

    First I will start by commenting to Larry. Who else should they poll but nurses since it was a survey about abuse of nurses. Should they poll those who abuse us? Think they are going to stand up and say "Yes I abused a nurse."?
    Some of the abuse we suffer is not directly the patients fault. We have a growing elderly population who suffer dementia or delirium while in hospital. They are not totally aware of what they are doing.
    I am a LPN in acute care. My lastest case of abuse, which is only one of many, was with my care of a man suffering from delirium. I had cared for him for many shifts and usually he was confused but pleasant man. I have had violence prevention training but did not expect to need any of it with him. Delirium can be very unpredictable. I went to lean over his bed to pull the covers up and settle him for the night. Out of the blue he reached up and slapped me across the face and told me next time it would be full force. In the morning when he woke up he told me of someone coming in his room the night before that was attacking him and he had to defend himself. He would not believe it was me he slapped. At this point he recognized me as a nurse he liked. I did fill out the proper paper work related to the assault. When I talked to my direct manager about it she said her first response was to look for a picture of boxing gloves to send me. That is the support we get when these incidents happen and we report them. That is part of the reason these assaults are greatly under reported. To my manager it was all a joke.
    I love my job and I do it despite these assualts. I give good quality care despite how I get treated. I do resent that I am supposed to just accept that assault is part of the job. If it is just a natural part of the job then I am greatly underpaid. Actually regardless I am greatly underpaid but that is another story.
    We need to change the climate where abuse of nurses is an accepted part of the job. The first step to doing that is to educate the public that it is happening. And it is happening more in the last few years than was 20 years ago when I entered nursing.

  • tricia58

    3 years ago

    Another Point

    I am on the JOH&S (joint Occupational Health and Safety) committee. WCB or now known as Worksafe BC is aware of the assualt of nurses and the Health Authorities have to come up with plans to deal with it. VIHA is implementing further training for us on this issue. Do you think they spend that money just for the fun of it? No they spend it because Worksafe BC has seen a problem and it needs to be addressed. So Larry check your facts before speaking. Some not enough of these incidents are reported. Enough were reported for Worksafe BC to become involved.

  • srfl

    3 years ago

    Spending...

    Good points, tricia58.

    Spending has gone up Abbott says. Where is the money being spent? Have a look at the top heavy Health Authorities who are spewing out job postings for various "management" postions on a regular basis. They don't seem to be running out of job titles.....wonder who has the job of thinking them all up. Only God must know what they do, besides go to meetings about meetings, because we don't, and certainly see nothing positive or concrete for the betterment of the health care system coming our way.

    Spending is not reaching the front lines, at least in the facility where I work.

  • RickW

    3 years ago

    Good one, srfl!

    It goes to show that all any business needs are managers and senior staff to function "properly"..........

  • RickW

    3 years ago

    Ed Deak

    Quote:
    But a large percentage of the nurses are middle aged, many definitely close to retirement

    And, being so close to retirement, they quite often feel trapped (and doesn't management know it!) by the enticement of the pension. All they have to do is endure for just a few more years.........

  • Awake in Victoria

    3 years ago

    Dredging 5 year old opinions

    Am I the only one to bother checking that the self-submitted survey opinions (not to be confused with a reliable objective data set) that this report is based on is from 2005?
    Which begs two questions: First, why are we paying federal civil servants to issue analysis of 5 year old data? Second, why is the Tyee reporting this stuff like it was some new scientific discovery?

  • Awake in Victoria

    3 years ago

    To Tricia58

    So which of the gentleman's medications were likely to have provoked his so-called delirious behaviour? Or does LPN training not include informing you of the predictable side effects of each and every one of your abundant arsenal of chemical restraints?

  • jeanbirch

    3 years ago

    More than Registered Nurses.

    Debra McPherson and BCNU does not represent the large number of frontline nursing staff in Healthcare, only the Registered Nurses of BC.
    There are thousands of Licensed Practical Nurses and Nurse Aides(Long Term Care aides) that suffer far more abuse than the Registered Nurse does. (Sometimes verbal abuse can be from the Registered Nurse they work alongside)
    If the WCB stats are checked I think you will find that, compared to Registered Nurses, the Practical Nurse and Care Aide are, by far, injured more often.
    Not that anyone should suffer any kind of abuse on the job and Healthcare, of all workplaces, should be the last place for abuse to happen.
    BCNU is not the representative of all who work in Healthcare and should not be seen as the spokespeople for the rest of us.
    Hospital Employees' Union, Health Sciences Association, British Columbia Government and Service Employees' Union, United Food and Commercial Workers Union are some of the other unions who represent Nurses and other Healthcare workers and their story needs to be told through their eyes.

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