Attacks on Ottawa Hospital staff trigger provincial investigation

Violent patients at the Ottawa Hospital this yearhave used furniture as weapons,repeatedly punched nurses and seriously injured a security guard incidents that have triggered changes at the Civic campus and an ongoing Ministryof Labour investigation.

CBC News has learned the province is currently investigating four incidents this yearinvolving mentally ill patients whoattacked three nurses and a security guard on separate occasionsbetween January and May.

The recent attacks have forced managementto increase security at the Civic's psychiatric emergency service unit the most volatile unit ofthe hospital.

Ontario Nurses' Association president LindaHaslam-Stroudsays suchassaultshave been aproblem at the Ottawa Hospital for several years.

Since April 2011 the Ministryof Labour has investigated The Ottawa Hospital for workplace violence 12 times. Provincial inspectors conducted 43field visits and issued 26orders tothe hospital.

Security guard breaks leg duringstruggle

The first attack at the Civic campusthis year occurred on Jan.8.One of two security guards wasseriously injuredwhile trying to restrainand moveanaggressive patient back to hisroom,according to the Ministry of Labour report.

While the guards struggled to control him,all threefell to the ground, breaking the legof one guard in the process.

The report states the patient had been brought into ER under police escort a day earlier and while in theemergency psychiatric unit the patient had ripped downthe night-vision light from the ceiling of his room.

In his report, the labour inspector found staff didn'tknow about the man's previous history of violence at other hospitals and thatone of the security guards was also not trained in the hospital's violence policy. The guards are non-unionized hospital employees.

The ministry ordered the hospital to consult with its staff on improving training programs and review workplace violence policyand safety measures.

You cannot give order after order after order without ensuring things are improving for nurses at the Ottawa Hospital.Linda Haslam-Stroud, Ontario Nurses Assoc.

While the Ottawa Hospital was in the process of complying with these orders, more attacks on staff in the emergency mental health unit occurred.

On Feb.2two nurses were repeatedly punched by a male patient, who also picked up a chair and charged at the nurses. One nurse fell backwards and injured her back before security guards were able to subdue the attacker.

Same nurse attacked twice in 6 weeks

This incident wasn't reported to the ministry, but the nursing manager was informed. An internal memo obtained by CBC shows that staff weren't sure where the panic button was. A unit manager was notified, but a complaint in the memo states that the manager'sresponse involved drawing a "star on the desk" to indicate the location of the alert button.

The third incident involving one of nurses in the Feb. 2 incident took place a month later on March 17 and involved a male patient who was "young, very belligerent, large and paranoid and exit-seeking," according to an internal staff e-mail.

Theattack occurred after the nurse and a nursing student tookthe patient out of his four-point harness so he could eat his dinner.

According to an internal staff e-mail, the patient stood up and lost his balance, the nurse moved to steady himand that was when she was punched in the "face, head shoulder and left breastwhile the man screamed 'you f--king bitch, you kept me down for six hours!'"

The assault lasted 45 seconds and was captured bysurveillance cameras.The Ministry of Labour report notes that four security guards were required to pull the attacker off the nurse and restrain him.

In her interview with union representatives, the psychiatric nurse believed she could have died if the drugs used to chemically restrain the patient had worn off.

The student nurse didn'tintervene and was not injured.

Nurse suffered broken nose in latest incident

The fourth assaultoccurred on May 12at 1:30 a.m. andleft a nurse with a broken nose, swollen eyes and sore knee.

While a visitor was in the hallway, apatient with a known history of violence had come out of one of the rooms.The nurse was attacked after she stepped out of thelocked,plexiglass-enclosednursing stationto ensure the safety of the visitor.

We need to do a lot better when it comes to health and safety.Debra Bournes, V.P. Clinical Services, The Ottawa Hospital

The union said the nurse was punched three to four times, knocked to the floorand was punched several more times before escaping her assailant andmaking it back to the lockednursing station to push the panic alarm.

Provincial inspectors have yet to interview the nurse, who has been diagnosed with PTSD.

Union says ministry not doing enough

The province only investigates when serious injuries occur, but according to data compiled from three unionsthere have been more than 50 complaints of workplace violence and harassmentacross the Ottawa Hospital just this year alone.

The incidents involve nurses, orderlies andsecurity guards who have been kicked, punched and spat on and required medical attention but did not meet the ministry'sthreshold for investigation.

Despite dozens of site inspections over the years,Haslam-Stroudbelievessome of these attacks could have been prevented if the ministry was more diligent in enforcing safety.

While the ministry has issued orders, no chargeunder the Occupational Health and Safety Act has ever been laid against the hospital.

"The Ministry of Labour hasn't been helpful in trying to ensure our nurses are safe. You cannotgive order after order after order without follow up and ensuring things are improving at the Ottawa Hospital for nurses," saidHaslam-Stroud.

Ottawa Hospital adds security

The Ministry of Labour'sinvestigations into the recent attacks on nurses have led to changes at the hospital.

"We have to take the position that any violent episode is one too many violent episodes andwhat it's done is lead the hospital to think we need to do a lot better when it comes to health and safety," saidDebra Bournes, Vice-President of Clinical Services.

"We're really good about paying attention to patient safety, but staff safety has often not been as much of a focus in health care, and I don't think that our hospital is any different than anywhere else," she said.

"But over the last two years the Ottawa Hospital has hada major focus on how we improve the organizationof the health and safety for the staff, she said.

Bournes says what happened to these nurses have "kept her up at night," and that thehospital hasimproved security measures inside the emergency psychiatricunit of the Civic since the March assault.

A security guard is now stationed in the psychiatric unit 24 hours a day, seven days a week. Prior to the attack, security guards were only onsite during evening and overnight shifts.

The panic buttons have also been moved from under the desks to on top of the work stations where they can be easily seen.

Management is also looking at giving nurses personal alarms attached to their clothing like their counterparts at theOttawa Hospital's General campus.

The hospital is alsoupdating itsworkplace violence policy and restraint protocols.

To reach the reporter:Judy.Trinh@cbc.ca, @JudyTrinhCBC