Code White: Canadian Nurses Won't Blow the Whistle

Posted by Amanda Nieweler

on November 2, 2015

HospitalThere’s a code of silence that our healthcare workers live by

A “Code White” means a healthcare worker is being assaulted. Usually by a patient. And nurses refuse to blow the whistle.

Unfortunately it’s happening everyday in hospitals across Canada. With assaults in the thousands, nursing is one of the country’s most dangerous professions – that is if the nurse chooses to continue working. Many quit their jobs, while others leave the
healthcare profession altogether as a result of violent events. It’s not a stretch to say that Canada is losing its nurses.

In fact, nursing has the fifth highest number of reported violent incidents of any profession with more violent events in 2014 than reported by corrections officers.

Across Canada, between 2008 and 2013, there were more than 4000 assaults on nurses, serious enough to prevent them from going to work – more than police officers, and firefighters. Unfortunately, these 4000 reported assaults don’t even come close to the real number of attacks that are occurring in hospitals across the country. 

An investigation was launched across Canada on violence towards those who are “on the front lines”. And it’s shocking. Many nurses don’t report abuse to their employer. In this six month investigation into violence against nurses, dozens across the country had their input. Many say they blame themselves for the violence so they don’t come forward. Others say they are scared that speaking up will get them fired. So they don’t report. It’s part of a professional code of silence that is successful in accomplishing just that – silence. Keeping this important issue out of the spotlight.

Like many employees the country over who witness, or are victims of, any form of wrongdoing, they stay silent. They suck it up. They don’t talk. Like many employees, nurses believe they will lose their jobs if they come forward.

But nurses, like corrections officers and police, are already in a unique situation by their very profession. They are the first person a patient sees when admitted into the hospital. And shockingly, it’s not necessarily the patient administering the abuse, and if it is it a patient, they aren’t necessarily suffering from mental health issues. In many cases, it’s the family of the patient who is acting out violently. In fact, many nurses have been threatened with being tracked down and followed home by family members of the patient.

So you can imagine the concern over the lack of reporting these incidents. Nurses say they are afraid of stigmatizing their patients. They say reporting won’t make any difference, and if they do report, nothing changes so why bother.

There should be a zero tolerance for this kind of violence

Unfortunately for thousands of nurses across Canada, physical abuse is routine. They get stabbed, beaten, spat upon, and verbally assaulted. It’s easy to say that every ethical workplace should do everything in its power to protect its employees, especially healthcare workers. Where does the responsibility lie? At the employer’s front door, that’s where.

Under Ontario’s Occupational Health and Safety Act, the C-Level and board members can be charged for not keeping their employees safe. With other industries, we see in the news all too often CEOs jailed, directors charged. So why not in the healthcare industry? One problem is 1) lack of reporting, and 2) in the vast majority of cases, nobody gets charged or fined, which circles right back to the ‘why bother’ attitude.

Every employee, everywhere, should deserve the same amount of protection. This investigation contacted every labour agency in every province across Canada. Only a handful of provinces have handed down any sort of punishment. BC’s enforcement agency, WorkSafeBC, fined 9 health authorities between 2003 and 2015. The largest fine was $97,500.

Since 2010, the Ministry of Labour in Ontario has only charged 3 hospitals – two with multiple counts under the violence provision of its act, and a third with multiple counts under the non-violence provisions of its act, for failing to put proper procedures in place to protect its staff from violence.

The unfortunate reality threaded throughout these incidents of abuse is the culture behind the healthcare profession, that if you became a doctor or nurse, you are expected to go into violent situations where there’s a potential for getting hurt.

What can the healthcare industry do to help protect its workers? In theory, each employer can make a change in a huge way. The easiest is to stress to nurses that it’s expected that they speak-up and report incidents of violence. With that expectation, also comes the hand-over-heart promise to all employees that every incident will be investigated with an absolutely zero chance of backlash towards the reporter.

If every single healthcare institution across Canada were to stand up and say enough is enough, let’s protect our employees, perhaps the level of reporting would increase, resulting in smart processes initiated within that organization to better protect its employees.

Ontario’s Labour Minister says that if employers lay out retribution towards an employee for coming forward, that’s illegal and the ministry doesn’t tolerate that.

Hospitals and healthcare institutions should be going high-tech to fight violence. They should have an arsenal of weapons being deployed, with strict procedures in place, to address the violence. Security cameras on every floor, security personnel stationed directly within reach of the most vulnerable areas, and personal high-tech alarms that all employees wear.

Also, it’s equally important that the organization implement an ethics reporting program where all employees can come forward and report on abuse and violence.

It’s time for the healthcare industry to create a speak-up culture.

eBook: 5 Steps to Create a Whistleblower Culture