Another round of OSHA’s most interesting cases

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Workplace violence

An assault on a nurse led to the discovery of other incidents at a behavioral health facility.

Presented by Christopher Stitcher, safety specialist, Jacksonville, FL

OSHA’s investigation was initiated after three online complaints were submitted in one week. The complaints all stemmed from one incident, in which a patient punched a nurse in the back of the head, knocking her unconscious.

Although the facility had “extensive records” of workplace violence, Stitcher said those records were considered confidential under the Patient Safety and Quality Improvement Act of 2005.

With the investigation starting at “square one,” Stitcher obtained a subpoena for a list of past and present employees, which included their phone numbers. OSHA could then use the list to connect names with dates and injuries revealed during its interviews with employees.

OSHA’s investigation found seven additional incidents of workplace violence, but only four within the six-month jurisdictional window of an agency investigation. That included one incident that occurred during the investigation. (An interim director of nursing was kicked in the groin.)

General Duty Clause citations, all serious, were issued for the four incidents.

Investigation details

The investigation revealed that the employer had a training program on workplace violence prevention, “but” it was a “check the box” program and ineffective at simulating real-world situations.

Employees had a way of getting help during a workplace violence incident, “but it was to simply yell.”

Stitcher said: “This wasn’t always effective, such as when a patient would get an employee in a chokehold, which was shown to happen, or if [an employee was] far from the nurses’ station or they’re alone in a room with a patient.”

The employer had a workplace violence committee, “but” the makeup of the committee gradually became heavy on senior management and supervisors. The workers “had no voice in which to bring up safety issues,” Stitcher said.

The employer also had a system of notifying incoming employees during shift changes about any workplace violence incidents that occurred during the day, “but” it was inconsistent. Employees often wouldn’t receive adequate information about patients’ violent incidents or behaviors.

“The biggest issue was the employer’s aloofness,” Stitcher said. “They were filling out forms and recording these incidents, but they were doing nothing to prevent them. They felt violence was just part of the job.”

Resolution

The employer took abatement “very seriously” after the investigation. Among the steps taken:

• Developed a 177-page abatement plan that “wasn’t just fluff.”
• Retrained all employees.
• Issued “zebra phones” or panic buttons.
• Hired a consultant to review the workplace violence prevention program.
• Established a workplace violence prevention committee comprising frontline employees.