healthcare workers

Vicious attacks: 80,000 US healthcare workers assaulted in a year

cmonforton — Fri, 15 Apr 2016 14:30:54 +0000

Vicious attacks: 80,000 US healthcare workers assaulted in a year

Nurses and other healthcare workers joined Members of Congress yesterday at a news conference to discuss violence on the job in the healthcare industry. Ms. Helene Andrews, RN recalled being assaulted by a 25 year old psychiatric patient at Danbury Hospital. She was handing him mediation and a drink of water when, she explained:

“Without warning, the patient suddenly became viciously violent. He punched me with his full strength in my jaw, hurtling me backward onto the floor. The impact of my body crashing down shattered my left leg at the hip.’’

If that wasn’t bad enough, Andrews later learned that staff at the hospital were not consistently told which patients had violent histories. The News Times’ Dan Freedman notes that in Andrews' case,

“her attacker’s mother had visited — something that could easily trigger a violent assault.”

The news conference was called by Senator Patty Murray (D-WA), Rep. Bobby Scott (D-VA), Rep. Frederica S. Wilson (D-FL), and Rep. Joe Courtney (D-CT) to announce a new report from the Government Accountability Office (GAO). They’d asked GAO to investigate the efforts by the Occupational Safety and Health Administration (OSHA) and state agencies to address workplace violence in health care facilities.

GAO used data from three different federal agency sources to estimate the number of non-fatal workplace violence incidents in 2011. The incidents included those perpetrated by patients (the most common incident) and patients’ family members. The most common types of assaults were hitting, kicking, and beating, such as these reported by hospitals staff from emergency departments:

Worker hit in the head by a patient when drawing the patient’s blood and suffered a concussion and a permanent injury to the neck; and
Worker knocked unconscious by a patient when starting intravenous therapy on the patient.

And this from a residential care facility:

Patient became upset after being deemed unfit to return home and attacked the worker

How serious is the problem? Among other things, GAO reported for the year 2011:

Data from HHS’s National Electronic Injury Surveillance System indicates for example, more than 64,000 hospital employees sought treatment in an emergency room for violence-related injuries.
The Department of Justice’s National Crime Victimization Survey estimated that nearly 81,000 healthcare workers were assaulted on the job.
The Bureau of Labor Statistics estimates the rate of lost-time violence-related injuries in 2011 was five times higher for individuals who are employed in hospitals and other in-patient facilities when compared to the rate for all private-sector workers.

These numbers certainly understate the problem. GAO held discussions sessions in five US cities with a total of 54 healthcare workers. They heard a variety of reasons that many healthcare workers don't report violence-related incidents, such as "fear of being blamed for causing the attack."

GAO also noted that nine states (California, Connecticut, Illinois, Maine, Maryland, New Jersey, New York, Oregon, and Washington) have laws that require health care employers to establish a program to protect workers from on-the-job violence. Here, for example, is the law passed in 2011 in Connecticut and here for the State of Illinois.

At the news conference announcing the GAO report, Senator Patty Murray said:

“Violence should never be part of any job description.”

Rep. Bobby Scott (D-VA) said:

"...OSHA should move forward and develop an enforceable violence prevention standard to help protect our nation’s healthcare workers."

His congressional colleagues at the event shared that opinion, as did those with the Service Employees International Union, AFSCME, National Nurses United, the Steelworkers, and other organizations that represent healthcare workers.

OSHA officials told GAO that they are

"...not planning at this time to develop a workplace violence prevention standard because it has identified other workplace hazards that are higher priorities for regulatory action."

The agency has used its "general duty clause" authority to issue 17 citations from 2010 through 2014 in the healthcare industry for violence-related hazards (e.g., here, here.)

OSHA has also sent "Hazard Alert Letters" (i.e., sort of a "you have a problem" but "we can't cite you for it" notice) to 48 healthcare employers with recommendations to implement violence-prevention measures. [OSHA doesn't seem to have these particular letters posted on its website.] GAO criticized OSHA, however, for not routinely following up with the employers who received the hazard alert letters (HALs).

"OSHA has a centralized information system, but has not systematically used it for tracking the status of HALs. While OSHA’s information system is capable of tracking the status of HALs, OSHA officials are not sure if regional offices are consistently entering updated information. ...Without a uniform process to follow up on these HALs, OSHA will not know whether the hazards that placed employees at risk for workplace violence at these facilities continue to exist."

Healthcare workers are a special breed. They are compassionate and called into a career to care for the sick. Most are underpaid for their skills and the services they provide. The National Crime Victimization Survey suggests that each day in the US at least 200 of them are assaulted on the job. The healthcare industry has done a good job keeping this secret. It's a disgrace that healthcare workers are the most assaulted workers in the country.

Thanks to the Members of Congress who are responsible for requesting the GAO report. It sheds light on a horrible problem.

cmonforton Fri, 04/15/2016 - 10:30

Tags

government

healthcare

Occupational Health & Safety

OSHA

safety

Bobby Scott

Government Accountability Office

Those U.S. health care workers should be packing heat!

I am a Registered Nurse for a local Miami, Florida hospital and violence is a common hazard for nurses and other health care workers. The hospital reports at least one verbal or physical threat occurs during each shift at the hospital’s emergency department.
When this issue is examined globally, we are able to quickly determine that better strategies should be developed to aid frontline health workers in developing countries. The collaborative approach from governments and health systems to addressing violence in the health sector must be promoted throughout the world.

Those U.S. health care workers should be packing heat!

You should be ashamed of your stupidity.

“Code Silver”: Beware of violent hospital patients, visitors

cmonforton — Wed, 22 Jul 2015 14:41:01 +0000

“Code Silver”: Beware of violent hospital patients, visitors

A physician from the Houston area taught me a new phrase: “Code Silver.” Dr. Stella Fitzgibbons had an op-ed in the Austin American-Statesman yesterday about assaults and other violence in US hospitals to healthcare workers. She begins:

“You’ve been waiting in your hospital bed for pain medicine or some ice water, and are starting to get cranky about the nurse’s delay. Then you find out that it happened because another patient tried to strangle her with her stethoscope. Or you hear ‘Code Silver’ on the overhead speakers, and a nursing assistant comes in, wedges the door shut, and helps you get out of your bed and hide behind it. …Hours later, you find out that ‘Code Silver’ means ‘active shooter on hospital property’ and that an intensive-care patient’s relative pulled a gun on the staff.”

Dr. Fitzgibbons goes on:

“Healthcare facilities deal regularly with drug users demanding narcotics and with criminals who need little reason to become violent. …While we doctors are only rarely targeted…we and our patients depend heavily on the people who keep healthcare running: nurses, therapists, X-ray techs, and the little-noticed people who keep the place clean.”

With her op-ed fresh in my mind, a news report from St. Peter, Minnesota popped up in my email yesterday:

"A 16-year-old patient at the Minnesota Security Hospital in St. Peter, Minn. violently assaulted a female staff member… The male patient bashed her head into a brick wall, then kicked her repeatedly. The woman reportedly began suffering seizures..."

I suspect the image most people have about hospitals are white coats, clean floors and the smell of antiseptics---not nurses aides getting beat up.

An article some months back in Scientific American showed the hodge-podge of requirements and prevention measures across the States to protect healthcare workers. Few states require healthcare employers--or any employers for that matter--to have violence prevention programs. (About half the states, however, focus after the fact with special penalties for offenders who assault nurses and other care providers.)

Fitzgibbons argues that the accrediting body--the Joint Commission --and OSHA should do more to sanction hospitals that fail to protect their employees from workplace violence. OSHA doesn't have a regulation to address violence. The agency has used its "general duty clause" to cite healthcare employers--with willful violations (e.g., here, here)--for failing to protect its workforce from assaults and other acts of violence. The State of California is considering a regulation specifically on violence against healthcare workers, which would be enforced by Cal/OSHA.

Worker safety and health are rarely the topic for op-eds. That's probably the reason that Fitzgibbons' piece caught my attention. Here's to her for bringing "Code Silver" to our attention.

cmonforton Wed, 07/22/2015 - 10:41

Tags

Gun Control/Violence

healthcare

Occupational Health & Safety

OSHA

safety

Code Silver

Dr Stella Fitzgibbons

It would be interesting to survey nurses and others who have worked in hospitals over a period of decades, as to what year they can first remember a violent incident in their hospital, that was not clearly a symptom of a patient's diagnosis.

I'm inclined to think it's a relatively recent trend, as in, this century, and correlates with a generalized increase in violence in the culture. Our culture is pathologically violent, as reflected in crime rates and in the media. So it is not surprising to see the violence extend into places that one would have thought were sanctuaries. Such as schools, churches, and hospitals.

G: If you're talking about time periods as long as centuries then the modern age is the least violent of historical eras. We just talk about the violence more.

For example: it is no longer acceptable to beat your child in public, or hang a person for a perceived crime, or to whack a churchgoer on the head for the crime of falling asleep (colonial US).
What's different is that now that violence is not acceptable, it's on TV, so there is more awareness.

"...it is no longer acceptable to beat your child in public, or hang a person for a perceived crime, or to whack a churchgoer on the head for the crime of falling asleep "

And could this kind of disciplinary softcockery be responsible for falling social standards?

JustaTech @2:

What I had in mind was a period of decades spanning from the mid 20th century to the present. Clearly some types of violence have decreased, or are less tolerated such as child beating. Just as clearly, other types of violence have increased, such as mass murders (per FBI definition, four or more victims in one incident).

So: is today's prevalence of security signage and police officers in hospitals due to an increase in violence in hospitals, or due to a decreased tolerance for violence in hospitals? That's a choice between two hypotheses, testable even though imperfectly so (survey research and news clippings). Anyone who is alive today to speak to this issue would have worked in a hospital at any time from the 1950s through the present.

Craig @ 3: We'll assume you're being sarcastic rather than supporting brutalism.

Is equating physical negative reinforcement with "brutalism" definitely improving society?
Why are people attacking nurses and ambulance workers?

Workplace violence is any act or threat of physical violence, harassment, intimidation, or other threatening disruptive behavior that occurs at the work site. It ranges from threats and verbal abuse to physical assaults and even homicide. It can affect and involve employees, clients, customers and visitors.

According to Bureau of Labor Statistics data, the rate of workplace violence-related nonfatal occupational injuries and illnesses involving days away from work for health care and social assistance workers was 15.1 per 10,000 full-time workers in 2012. For private industry overall, the rate was 4.0. (And please be mindful of the fact that this is only what is reported/captured by the BLS).

The issue of workplace violence in healthcare settings has been well studied and documented for the better part of 25 years in the United States, and there is no federal OSHA regulation. The General Duty Clause, and in California - the IIPP (CCR 3203), all have their loop holes.

While Unions and worker advocates are supporting the California Safe Care Standard Campaign, the well funded California Hospital Association has, as anticipated, began a political game to push back on regulating this known hazard. They are doing that by identifying, among other things, that the healthcare industry has accepted, over time, that violence comes with the job. It is a "necessary evil." Clearly that is not true when the greatest number of violent incidents is preventable. The campaign in California, in fact, leans on the rationale that: If it is predictable -- it is preventable.

Worth reading: Ebola, family planning and "the conversation that matters most"

lborkowski — Mon, 20 Oct 2014 16:49:00 +0000

Worth reading: Ebola, family planning and "the conversation that matters most"

A few of the recent pieces I've liked:

Nancy Shute at NPR's Shots blog: Nurses Want to Know How Safe is Safe Enough with Ebola

Maryn McKenna at Superbug: What Would Keep Ebola from Spreading in the US? Investing in Simple Research Years Ago. (Check out the last paragraph for links to other great recent pieces on the disease.)

Atul Gawande at Slate: No Risky Chances: The conversation that matters most

Catherine Rampell in the Washington Post: Is sex only for rich people?

Laurie Abraham in Elle: Abortion: Not easy, not sorry

Ta-Nehisi Coates at The Atlantic: To Raise, Love, and Lose a Black Child

lborkowski Mon, 10/20/2014 - 12:49

Tags

Public Health - General

Highlights of occupational health and safety research published in the last year

cmonforton — Wed, 03 Sep 2014 12:08:58 +0000

Highlights of occupational health and safety research published in the last year

Researchers who assess the impact of working conditions on health have had a busy year publishing their findings in the peer-reviewed literature. The final section of our report The Year in US Occupational Health & Safety: Fall 2013 – Summer 2014---which we wrote about on Monday and Tuesday---profiles some of the best papers published in the last 12 months that provide insight into the scores of different workplace hazards and their relationship with injuries and illnesses.

Especially prominent in the literature were studies involving Latino workers, healthcare workers, construction workers, and those who responded to the 2001 World Trade Center attacks. In all, we provide brief summaries of 25 studies that address these four worker groups. We include, for example, a study by von Ehrenstein and colleagues who investigated the relationship between maternal occupation and birth outcomes. Using data from births in Los Angeles County, the authors report that work in food prep and serving, production jobs, among others, increased the odds for Latina mothers by as much as three times of having a full-term, but low birth weight newborn. We also provide citations to more than 75 papers as a way to tip our hats to OHS researchers and recognize their contribution to public health. The diversity of their topics of research is impressive and includes:

Trends in back injuries among drywall installers
The influence of shift work on female workers getting recommended cancer screenings
Physical assaults among education workers
Perspectives of workers on providing biospecimens for research
Effect of production pressure on injury reporting

"New Research on Worker Health and Safety" (p. 37-46 and 49-53) is the section of our annual report where we also recap publications from non-profit organizations and a few papers published in law reviews. These include reports by the UC Berkeley Labor Center and U of Illinois Urbana-Champaign on the economic impact on public assistance programs (e.g., Medicaid, TANF, SNAP) of low-wage work in the fast-food industry; Public Citizen’s report on the cost of unsafe construction projects in New York City; and a US Senate majority staff report on labor law violations by companies with major federal contracts. The latter is a topic that was addressed in July 2013 by a new Executive Order signed by President Obama (which is also described in The Year in US Occupational Health & Safety: Fall 2013 – Summer 2014.

The previous posts in this series are:

A Labor Day look back at the year in worker health and safety (here)

A Labor Day look at state and local actions for worker health (here)

cmonforton Wed, 09/03/2014 - 08:08

Tags

Occupational Health & Safety

Year in US Occupational Health & Safety

Research

Thank you for the post, the publication is excellent. Especially the effect of workplace shifts effecting woman health and recommendation for cancer screening is very surprising.

Occupational Health News Roundup

lborkowski — Mon, 22 Jul 2013 07:46:51 +0000

Occupational Health News Roundup

Many of us have been complaining about the heat that’s blanketed much of the country for the past couple of weeks, but the situation is especially severe for those who work outdoors or in spaces without adequate cooling.

The Occupational Safety and Health Administration is investigating the death of James Baldassarre, a 45-year-old postal worker who collapsed on the job and died in Massachusetts last week. Baldassare had worked for the US Postal Service for 24 years; his wife, Cathy, told WCVB News, “"I have a bunch of texts from Jimmy all day long, saying, 'I'm going to die out here today. It's so hot.’”

Cal-OSHA is investigating the death of 37-year-old farmworker Juan Ochoa, who collapsed and died while working in a lemon orchard owned by Etchegaray Farm. Ochoa’s brother, Alejandro, was working in the same orchard and attempted to revive him after he collapsed. He told Eyewitness News KPAK/KBFX they did not have company-provided shade or water.

The story of a Manhattan McDonald’s employee with apparent heat-related illness ends less tragically. Salon’s Josh Eidelson reports:

Workers at a Manhattan McDonald’s and a Chicago Dunkin’ Donuts mounted strikes today to protest alleged unsafe heat. The single-store strikes are the latest in a wave of fast food walkouts, and could represent an additional front in low-wage workers’ struggle against the mammoth industry.

“I felt dizzy and sick” working in the heat without air conditioning, McDonald’s employee Luisa Dilla told Salon in Spanish. “My co-workers were afraid, but I wasn’t,” because “I just wasn’t going to work that way.”

Dilla and three other workers walked out of their store around 10 AM, after they say a co-worker fainted from the heat and had to be wheeled to an ambulance by paramedics. Dilla alleged that that when the worker – who had repeatedly said she didn’t feel well – went downstairs to vomit in the bathroom, a manager followed her there to order her back to work. Dilla said that when she went to check on her co-worker, “She was laying down on some chairs and vomiting and then she fell and fainted. Her eyes were rolling back … That’s when we said, enough is enough.”

OSHA’s Campaign to Prevent Heat Illness in Outdoor Workers stresses the importance of water, rest, and shade, and notes, “Employers are responsible for providing workplaces that are safe from excessive heat.”

In other news:

Center for Public Integrity: Farmworker advocates came to Washington, DC to urge EPA and members of Congress to improve protections for agricultural workers exposed to pesticides. EPA administers the Worker Protection Standard covering farmworkers and pesticide handlers, but the agency hasn’t seriously updated these protections in 20 years.

Washington Post: The Senate has confirmed Thomas Perez as Secretary of Labor and Gina McCarthy as EPA Administrator, as part of a deal to head off changes in the chamber’s filibuster rules.

OSHA and Public Citizen: The Occupational Safety and Health Administration has launched an outreach campaign to raise awareness of hazards that can cause musculoskeletal disorders in healthcare workers. Public Citizen has just released a report on healthcare workers’ high injury and illness rates and the inadequacy of federal protections for workers who care for patients’ health.

Courthouse News Service: A New York appeals court ruled against wholesale supermarket supplier C&S Wholesale Grocers, which had a policy of dismissing workers who sustained preventable injuries during their first 90 days on the job. The ruling affirms a Workers’ Compensation Board decision that the company’s policy violated workers’ compensation law.

New York Times: Lawmakers in Bangladesh have amended the country’s labor law to require employee-welfare funds and confidentiality for protections for workers who vote form unions. Worker advocates say the changes don’t go far enough to address health and safety problems and could actually make unionizing harder.

lborkowski Mon, 07/22/2013 - 03:46

Tags

Confined Space @ TPH

Occup Health News Roundup

Fair pay for home healthcare workers

lborkowski — Wed, 02 Jan 2013 09:00:03 +0000

Fair pay for home healthcare workers

While we’re on vacation, we’re re-posting content from earlier last year. This post was originally published on March 6, 2012. The final rule on home health workers has not yet been published.

By Liz Borkowski

Back in December, the Department of Labor’s Wage & Hour Division published a proposed rulethat would extend minimum-wage and overtime pay protections to the home care workers who assist elderly and disabled patients with their daily needs. The Fair Labor Standards Act requires that nonexempt workers be paid minimum wage (currently $7.25 per hour) and 1.5 times their pay for hours worked above 40 hours in a week. (It also prohibits most forms of child labor, but allows children to work in agriculture, as Celeste has discussed.) Many of us are exempt from these requirements because we’re salaried executive, administrative, or professional employees. There are other FLSA exemptions based on industry or job type, and one of those exemptions is for “companions for the elderly.” Under this exemption, home care workers who help clients with bathing, dressing, eating, wound care, and other essential activities are denied minimum-wage and overtime pay. The result is predictable: In 36 states, average hourly wages for Personal Care Aides are below 200% of the federal poverty level wage for full-time workers in one-person households.

As that statistic suggests, home health workers’ earnings can vary depending on the state where they work. Sixteen states (California, Colorado, Hawaii, Illinois, Maine, Maryland, Massachusetts, Michigan, Minnesota, Montana, Nevada, New Jersey, New York, Pennsylvania, Washington, and Wisconsin) already extend minimum wage and overtime protection to home healthcare workers, and five states (Arizona, Nebraska, North Dakota, Ohio, and South Dakota) and DC extend minimum-wage, but not overtime, protection. The Obama administration’s proposed rule would extend FLSA protections to all home health workers, and this change would have the most impact in the 29 states that don’t currently require minimum and overtime wages for home health workers.

The main rationale for this rule change is that Congress’s intent in exempting “companions for the elderly” from FLSA protections was to make it easy for neighbors and friends to help out the elderly in their communities — not to keep two million home care workers from earning fair wages. But the Economic Analysis accompanying the proposed rule also describes some larger benefits that may not be immediately obvious.

Who will pay?
Of course, if home care workers start earning more money, someone’s going to have to pay for that, and the transition won’t be painless. According to DOL’s economic analysis, Medicare and Medicaid together cover about 75% of the payments for home healthcare services. Growth in Medicare costs certainly isn’t anything to cheer about, but DOL puts it in perspective: the additional costs are unlikely to amount to more than half of one percent of the program’s total expenditures. Medicaid expenses are shared between states and the federal government, and some states will likely struggle to cover the additional costs for home healthcare — but they might also see some savings, which I’ll get to in a minute.

More than half of the additional costs from extending the FLSA to home healthcare workers would likely be borne by reduced profits for the agencies that employ them, DOL predicts. USA Today’s Kelly Kennedy notes that the home health industry was one of the few to be profitableduring the recession, and that one of the industry’s leading companies spent a large sum fighting the proposed rule.

Another 20% of home health expenditures come from the private sector — some are paid by private insurers, and others out of pocket. Families paying for home health services entirely out of pocket would be hardest hit by the rule change, and DOL predicts that many would purchase less care. In some cases, this would mean a greater burden on unpaid family caregivers, who already face serious financial and other hardships. Some clients would shift to purchasing home healthcare in the “grey market,” which likely means that the workers would have less training and supervision and lack access to the unemployment, disability, and Social Security benefits they’d receive if they were working officially and paying payroll taxes.

Who will benefit?
The most important outcome of DOL’s proposed rule change will be higher wages for home healthcare workers who are currently receiving less than the minimum wage and no overtime pay. Some will also benefit from the FLSA requirement that they be reimbursed for time they spend traveling between clients.

These benefits to workers can in turn help their families, communities, and clients, DOL’s analysis finds. Because most of these workers have low incomes, they’re likely to spend much of their extra earnings, which will generate more local economic activity. Home care workers’ current low earnings also make many of them eligible for public programs; recent research finds that around 40% of home health workers currently get public assistance in the form of food stamps and Medicaid, for an average total of $14,800 per worker who’s getting assistance for her family. So, some of the Medicaid programs facing higher costs for home-health services might also see their beneficiary rolls diminish as formerly eligible home health workers earn more income.

Higher wages, overtime pay, and payment for travel time can also help attract and retain workers to an industry that currently has a high rate of turnover — from 44% to 100% per year, according to different studies cited by DOL. Reducing the turnover rate can save employers money and also give stability to clients, who benefit from being able to develop long-lasting relationship with the workers who attend to some of their most intimate needs.

DOL’s economic analysis also predicts that home health agencies will prefer to spread job-hours among more workers (including some additional hires) rather than pay overtime to workers who are currently putting in more than 40 hours per week. Reducing overtime can result in health benefits for both workers and their patients, DOL explains:

Many studies have shown that extended work hours result in increased fatigue, decreased alertness, and decreased productivity, negatively affecting employee health and well-being. A 2004 National Institute for Occupational Safety and Health report found that “12-hour shifts combined with more than 40 hours of work per week reported increases in health complaints, deterioration in performance, or slower pace of work.” One study that analyzed 13 years worth of data and nearly 100,000 job records notes that “long working hours indirectly precipitate workplace accidents through a causal process, for instance, by inducing fatigue or stress in affected workers.” It is therefore telling that “[d]irect care workers have the highest injury rate in the United States, primarily due to work-related musculoskeletal disorders.” The rate of days away from work (work days missed due to on-the-job injuries) for nursing aides, orderlies and attendants was almost four times greater than the all-worker rate–449 per 10,000 compared to 113 per 10,000 for all workers. One of the results of the FLSA’s overtime pay requirement is to induce employers to hire more people to work fewer hours each. Doing so in those circumstances where excessive overtime hours are worked may therefore result in fewer injuries and illnesses incurred.

Extending FLSA protections to home healthcare workers will not only correct a long-standing injustice, but provide significant benefits to workers, their families, state economies, and home health clients. While the burdens that the rule change will place on agencies and family caregivers should not be ignored (and, in the case of caregivers, should be addressed by other policies), they should also not stand in the way of achieving a stronger home healthcare workforce.

The Department of Labor has extended the public comment period for this proposed rule through March 12.

lborkowski Wed, 01/02/2013 - 04:00

Tags

healthcare

Occupational Health & Safety

Occupational Health News Roundup

lborkowski — Fri, 24 Jun 2011 13:30:00 +0000

Occupational Health News Roundup

Deborah Sontag's New York Times story about the murder of 25-year-old mental health worker Stephanie Moulton, allegedly at the hands of schizophrenic patient DeShawn Chappell, is a moving exploration of two grieving families and the many challenges facing the mental health care system.

Deborah Sontag's New York Times story about the murder of 25-year-old mental health worker Stephanie Moulton, allegedly at the hands of schizophrenic patient Deshawn Chappell, is a moving exploration of two grieving families and the many challenges facing the mental health care system in Massachusetts and across the country. Sontag writes:

The "shattering event," as one former state mental health official called it, occurred days before Gov. Deval Patrick, a Democrat, released his proposed budget, which would slash mental health spending for the third year in a row. And it raised the timely but uncomfortable question of whether such continuous belt-tightening had played a role in Ms. Moulton's death.

Many people wondered aloud whether the system had failed both the suspect and the victim. How had Ms. Moulton ended up alone in a home with a psychotic man who had a history of violence and was off his medication? How had Mr. Chappell been allowed to deteriorate without setting off alarms? Should he have still been living in a group home, or did he need the tighter supervision of a hospital?

"People are reeling right now," Dr. Kenneth Duckworth, a former medical director for the State Department of Mental Health, said after the killing. "Will this case be the canary in the coal mine? Will it signal that we've gone too far in reducing client-staff ratios, in closing hospitals, in pushing independence for people who may still be too sick?"

...State mental health departments, serving vulnerable populations with little political clout, almost always get disproportionately squeezed during tough times. During the current fiscal crisis, many states have sharply reduced both inpatient and community-based mental health care.

Sontag reports that Massachusetts has closed a state hospital, laid off one-fourth of its case workers, and transferred mentally ill patients to younger, lower-paid workers employed by private companies. Stephanie Moulton likely got "at least a week's training." Deshawn Chappell's mother, Yvette Chappell, told Sontag that Moulton listened to the concerns she voiced about her son being off his antipsychotic medication and promised "to get Deshawn back on track."

In other news:

Washington Examiner: In the US, when a maid, nanny, or other domestic employee reports being abused by an employer and an investigation supports the allegations, officials will usually press charges against the employer - unless that employer is a high-level foreign official with diplomatic immunity.

Globe and Mail: Tens of thousands of migrant workers who labored in South African gold mines during apartheid developed silicosis and tuberculosis, and many fear they'll die before their case against mining company Anglo American is resolved.

Charleston Gazette: The Occupational Safety and Health Administration has issued several citations (one willful and 16 serious) in the case of the AL Solutions Inc. recycling plant in New Cumberland, WV, where an explosion killed three workers in December. OSHA investigators found that the plant had combustible materials stored near open flame and inadequate systems for detecting flammable gases and suppressing fires.

AFP: After dozens of employees fainted at a Cambodian factory that supplies products to sportswear giant Puma, an independent investigation blamed the unwellness of 101 factory employees on the supplier's failure to follow Puma's standards on work hours and other elements of occupational safety and health.

New York Times Opinionator Blog (Mark Bittman): In Florida, the Coalition of Immokalee workers has won improvements for tomato workers, including shade tents in break spots and reduced pesticide exposure. Several restaurant chains and food service operators have signed the agreement that specifies these improvements, but several large supermarket chains - including Kroger and Trader Joe's - have so far refused to do so.

lborkowski Fri, 06/24/2011 - 09:30

Tags

Confined Space @ TPH

Occup Health News Roundup

Occupational Health & Safety

Violence Against Healthcare Workers in Nursing Homes and Psychiatric Hospitals

lborkowski — Fri, 05 Nov 2010 15:49:16 +0000

Violence Against Healthcare Workers in Nursing Homes and Psychiatric Hospitals

Researchers from the National Institute for Occupational Safety and Health analyzed data on nursing-home employees from the 2004 National Nursing Assistant Survey and learned the following about on-the-job violence:

Thirty-four percent of nursing assistants surveyed reported experiencing physical injuries from residents' aggression in the previous year. Mandatory overtime (odds ratio [OR] = 1.65; 95% confidence interval [CI] = 1.22, 2.24) and not having enough time to assist residents with their activities of daily living (OR = 1.49; 95% CI = 1.25, 1.78) were strongly associated with experiencing injuries from assaults. Nursing assistants employed in nursing homes with Alzheimer care units were more likely to experience such injuries, including being bitten by residents.

Violence against healthcare workers is alarmingly common (see this past post about violence in the ER), and nurses and other personal care workers are most affected. A 2008 New York Times article, citing Bureau of Labor Statistics numbers, reported that nursing homes and psychiatric units are the most dangerous settings for healthcare workers.

A recent tragedy highlights the risk for psychiatric-unit workers. Last month, Donna Gross, 54, a psychiatric technician at the Napa State Hospital in California, was strangled to death, and a patient from the hospital is being held on suspicion of murder.

lborkowski Fri, 11/05/2010 - 11:49

Tags

Occupational Health & Safety

healthcare workers

nursing homes

psychiatric hospitals

violence