Violence in healthcare settings | Risky jobs

Violence is exploding in the healthcare network, with the number of employee victims of events having doubled over the past 10 years. Moreover, it is in the health care environment that there are the greatest number of incidents.


The life of Marie*, beneficiary attendant in a CHSLD at the CIUSSS Mauricie-et-du-Centre-du-Québec, was turned upside down on October 7, 2019. During a dinner with the residents, a man suffering from Alzheimer’s and known for his aggressiveness approached her from behind.

“He put his left hand on my chin and his right hand on my neck he forced my head to the left. The patient tried to kill me by breaking my neck,” she recalls. In shock, Marie did not scream. “I quietly slid my fingers between his wrist and my neck and tried to get him to let go. »

The woman was transferred to a hospital where a year and a half of rehabilitation and therapy followed to treat cervical injuries and post-traumatic stress disorder. Even today, she lives with chronic pain. “I feel like my life has been stolen from me. I can’t do anything anymore, ”she confides, swallowing back her sobs.

“Troubling” statistics

The number of employees in the health sector who received compensation from the Commission for Standards, Equity, Health and Safety at Work (CNESST) related to violence suffered at work increased from 933 in 2012 to 1994 in 2021. Almost all of the cases involved assault or violent acts.

“These statistics are disturbing and I believe that the reality is much harsher,” says professor at the School of Management Sciences at UQAM and specialist in emotions and violence in organizations Angelo Soares.


Workers in the health and social assistance sector are by far the most numerous to report having suffered violence at work. They made more than half (55%) of the number of declarations made in Quebec in 2021. The education sector ranks second with 16% of declarations.


These figures probably represent only the tip of the iceberg, believes Professor Angelo Soares. “During a research project, a nurse told me that if she filled out a form each time she experienced an episode of violence at work, she would do just that,” he illustrates.

Hard on support staff

Health service support staff, such as orderlies and patient service associates, are the most affected by this violence. This group accounts for 52% of reports made in the health sector in 2021. Nursing professionals follow with 9% of cases.

Administrative agents, responsible in particular for registering patients at the hospital, are also targeted. “Violence once morest administrative officers has always existed because they are on the front line, but it has really gotten worse with the pandemic. It can go as far as death threats, blows in the window, it goes very far, ”observes the head of communications for the union of workers of the CISSS des Laurentides, Valérie Lapensée.

We talk very little regarding how traumatic it can be to receive a patient who hits the window so hard that you think he will succeed in breaking it.

Valérie Lapensée, head of communications for the union of workers of the CISSS des Laurentides

A widespread evil

The problem is widespread across the province. “In the emergency rooms of the hospitals of Joliette and Pierre-Le Gardeur, we have recorded a hundred cases of violence in the last year,” said the president of the union of workers of the CISSS of Lanaudière, Simon Deschênes.

In Quebec, assaults are the main cause of reporting accidents at work, argues the head of the union of workers of the CIUSSS of the Capitale-Nationale, Jean-Renaud Caron. Posters reminding users to be respectful with staff are also making their way into Quebec hospitals.


PHOTO ALAIN ROBERGE, LA PRESSE ARCHIVES

In the emergency room of the Sacré-Coeur hospital in Montreal, all users must now submit to an inspection of their bag and their coat in a context of increased armed violence.

Professor Angelo Soares notes that some of this violence is caused by people suffering from psychiatric or cognitive disorders, such as dementia. “But it’s far from everyone and it should be remembered that the majority of people who have mental health problems are not violent,” he says.

The state of the health system, including “the many hours of waiting”, accentuates this violence towards the nursing staff, estimates the professor of psychology of work and organizations at the University of Montreal Luc Brunet.

If people wait too long, they become aggressive. Wait times in the system must be reduced and the public must be made aware so that they understand that it is not the personnel who are responsible.

Angelo Soares, professor at the School of Management Sciences at UQAM

Prevention to review

Since the number of cases of violence has continued to increase over the past decade, “that means that prevention measures are not working,” argues Professor Angelo Soares. “The employer is responsible under the law for providing a healthy workplace. He is not able to provide that,” he said.

Called to react, the Ministry of Health and Social Services (MSSS) indicated that the management of the prevention of accidents at work is rather the responsibility of each establishment. However, it says it makes available various training courses relating to civility, harassment and violence, in particular through the Joint Association for Occupational Health and Safety in the Social Affairs Sector (ASSTSAS).

However, Valérie Lapensée regrets that the training offered by the ASSTSAS is difficult for workers to access. “This training is given less and less, because the lack of personnel means that we are not able to release people for four days so that they can follow it,” she underlines.

For its part, the CISSS des Laurentides indicated that it had implemented a new pilot training program in September 2022 on the prevention and intervention during violent behavior designed for smaller groups and broken down into different sessions to offer more flexibility.

“It worries us a lot because we don’t have the luxury of losing workers in the midst of a staff shortage,” said Réjean Leclerc, president of the FSSS-CSN. He would like there to be more prevention with health personnel and for messages to be sent to the population. “The government needs to make it clear that violence is not tolerated. »

*Name has been changed to preserve anonymity.

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