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Call for change as more workers at state-run medical facilities claim to have been injured

State House Bureau

September 25. 2017 9:06PM
New Hampshire Hospital in Concord. (Union Leader photo)

CONCORD ­— Efforts are under way at the State House to strengthen protections for health care workers in the wake of injury reports by nurses and other staff at state-run facilities like New Hampshire Hospital and the Sununu Youth Services Center.

NHH registered nurse June Garen of Gilmanton set the process in motion after she saw her name published in a New Hampshire Union Leader article last month, citing her workplace injury and four others that occurred in late June and early July.

“While seeing my name in print in that context caused me more than a little sense of intrusion and panic, I feel that it opened the door to opportunity for improvement,” she wrote in an opinion piece in the Union Leader and other publications. She called for better legal protections for nurses and other practitioners.

Garen’s identity and the nature of her injury were revealed in documents presented by the Department of Health and Human Services to the Executive Council, which has to approve the continuation of pay and benefits for workers “injured in the line of duty.”

The council will consider another such request on Wednesday, when DHHS will present the case of Larry Ellis Jr., a Sununu Center youth counselor who suffered a dislocated ring finger after being assaulted by a resident on July 25. He has yet to return to work.

Brian Hawkins, government relations coordinator for the State Employees Association, says "there’s definitely been an increase" in assaults on health-care workers, particularly at New Hampshire Hospital, the state’s psychiatric facility. He said addressing the problem is a "top priority" for the union.

Hawkins was among those present for an informal meeting of stakeholders hosted last Thursday by Sen. Jim Gray, R-Rochester, who was prompted to act after being approached by Garen, one of his constituents.

In addition to the state employees union, the meeting included representatives of the state Hospital Association, Nurses Association, physicians and DHHS.

Party-line vote in 2016

Much of the meeting with Gray focused on a Senate bill introduced in 2016 by Sen. Jeff Woodburn, D-Whitefield, which Garen hopes to see reintroduced. SB 516 would require all health care facilities in the state to establish violence prevention programs and to conduct violence prevention training for employees.

The bill failed in a straight party-line vote of 14-10, with all Republicans opposed, after hearings in which representatives of the hospital association expressed opposition, citing existing OSHA regulations.

“We do not believe this bill is necessary,” said Paula Minnehan, NHH vice president for government regulations, at the 2016 hearing. “The hospitals are already complying with the requirements outlined in the bill.”

Judith Stadtman, a field director with the AFL-CIO, says OSHA provides guidelines, but not requirements that come with fines or legal consequences for non-compliance. Some hospitals have great programs, she said, others do not.

“OSHA does have a very comprehensive guideline that they publish regarding best practices for preventing violence in health care workplaces, but it’s not statutory. It doesn’t have any weight in terms of requiring health care facilities to put these practices in place,” she said.

Seeking a solution

Gray said he is looking for a solution that will win widespread support, and not meet the same fate as SB 516 did last year.

“There was no one associated with state government or any of the hospitals or any of the nursing homes who think it’s acceptable to have workplace violence where staff or visitors are subject to injury,” he said of the Thursday meeting. “The question is what to do?”

According to others who attended the meeting at Gray’s invitation, a consensus emerged around the need for better reporting and tracking of the incidents.

“From our perspective, violence prevention training programs are already going on, and what we would like to support is more reporting,” said Pam Dinapoli, chair of the Commission on Government Affairs for the N.H. Nurses’ Association. “The phenomenon is way under-reported, and nurses think it’s part of their job in caring for people who may get violent. We are looking for mandatory reporting, like hospitals do for falls and infections.”

The 12-member commission is meeting tonight to further consider its position.

Hawkins said the state employees union is hoping to work with the new CEO recently appointed at New Hampshire Hospital to work on solutions outside the legislative process. “There may be legislation, or not, but we’re not waiting for that,” he said. “We want to go ahead and try, at least at the state-run institutions, to go ahead with a collaborative effort.”

Fear of speaking out

According to the American Psychiatric Nurses Association, the rate of workplace violence is highest among hospital workers, at 8.3 incidents per 10,000 workers compared to two incidents per 10,000 workers on average across other industries.

Garen cites statistics like that when calling for something more aggressive than an improvement in reporting protocols. She said she was surprised to find the 2016 vote on SB 516 had fallen along party lines. “When I started this journey, I really didn’t think of this as a partisan issue,” she said.

Gray plans to convene another session with stakeholders in October, before deciding how to proceed. “The fact that Sen. Gray has interest gives me hope that we can break the logjam of partisanship and find a way to move forward,” said Woodburn.

More front-line nurses would come forward to support legislative measures if not for fear of speaking out, according to Garen. “People are afraid of losing their jobs,” she said. “The first thing I was asked is, ‘What could you have done to prevent this?’ Obviously if there was something I could have done, I would have done it.”

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