Prevention is the Cure to Epidemic of Violence, Nurses Say

Nurses are very pleased with the Cal/OSHA Board's proposed regulations for workplace violence prevention, announced the California Nurses Association/National Nurses United today.

The proposed regulations, released last Friday, will implement SB 1299, the Healthcare Workplace Violence Prevention Act, which was sponsored by CNA and signed by Gov. Jerry Brown in 2014. Cal/OSHA's notice marked the beginning of a 45-day written comment period. Cal/OSHA will hold a public hearing on the proposed regulations in Sacramento on December 17.

“I am proud to have authored SB 1299 and to have worked closely with the 86,000 registered nurses of CNA who sponsored the bill," said former State Senator and current Secretary of State, Alex Padilla. "This legislation was approved by the Legislature with bi-partisan support and requires Cal/OSHA to adopt standards requiring hospitals to establish workplace violence prevention plans to protect health care workers and other facility personnel from aggressive and violent behavior.”

"Hospitals and other employers must take proactive steps to prevent workplace violence and the proposed regulations lay the groundwork for that," said Zenei Cortez, Co-President, California Nurses Association. "When implemented these new rules will help RNs completely focus on the health and healing of our patients without feeling vulnerable because we work in a workplace that is unprepared."

"The proposed regulations will serve as a national model and we are very proud of the part we have played to bring them to fruition," said Deborah Burger, Co-President, National Nurses United and the California Nurses Association. 

The proposed regulations are very comprehensive in scope, covering healthcare workers in all health facilities, outpatient medical offices and clinics, home health care and home-based hospice, paramedic and emergency medical services, field operations such as mobile clinics and dispensing operations, drug treatment programs, medical outreach services, and other off-site operations, including retail outlets that are providing healthcare services.

The regulations define workplace violence broadly to encompass actual acts of violence as well as the threat of violence. The regulations require employers to develop a Workplace Violence Prevention Plan that emphasizes prevention and involves worker participation.

Among other things, that plan must include:

• Procedures to identify environmental and patient-specific risk-factors
• Procedures to correct workplace violence hazards, including engineering and work practice controls such as implementing adequate staffing, removal of sight and communication barriers, provision of surveillance systems, use of a buddy system, reconfiguration of facility spaces, removal or securing of objects that may be used as improvised weapons, installation of alarm systems, and other effective means
• Procedures for post-incident response and investigation, including providing individual trauma counseling to all employees affected by the incident
• Employee involvement in the development, implementation, and review of the plan

The regulations require employers to provide an initial training for all employees, which emphasizes preventative measures such as how to recognize the potential for violence, how to counteract factors that lead to the escalation of violence, how to seek assistance to prevent or respond to violence, and strategies to avoid physical harm. The regulations also require the employer to conduct an annual review of the Workplace Violence Prevention Plan and to correct any problems that are uncovered.

The California Nurses Association sponsored SB 1299 in response to workplace violence as a serious occupational hazard for RNs and other health care workers. According to the U.S. Bureau of Labor Statistics, a worker in health care and social assistance is nearly five times more likely to be the victim of a nonfatal assault or violent act by another person, than the average worker in all other major industries combined. In 2007, nearly 60% of all nonfatal assaults and violent acts by persons occurred in the health care and social assistance industry. A 2007 report commissioned by the National Institute of Occupational and Environmental Health found that nurses are at particularly high risk, with the highest rate of victimization among occupations in the healthcare industry.