The problem of longstanding violence against healthcare personnel has been overshadowed by the pandemic, but it is receiving more attention from the Occupational Safety and Health Administration (OSHA).

A federal administrative law judge has determined that a Bradenton, FL, behavioral healthcare center and its management company exposed workers to more than 50 attacks in a 2.5-year period, OSHA announced.

“Residents kicked, punched, bit, scratched, pulled, and used desk scissors as a weapon,” OSHA stated. “Both entities deserved to be sanctioned for destroying surveillance videos showing this workplace violence.1

The ruling names Premier Behavioral Health Solutions of Florida Inc., which operates as Suncoast Behavioral Health Center.

“The judge’s decision follows an OSHA investigation at Suncoast in 2017 after a patient jumped over a nurse’s station and stabbed an employee with a pair of scissors,” OSHA stated. “OSHA determined UHS of Delaware and Suncoast exposed employees to workplace violence hazards that included physical assaults and attacks on staff. OSHA cited Premier Behavioral Health Solutions and UHS and proposed penalties totaling $71,137.”

The judge found existing violence prevention measures were inadequate, and assessed a penalty of $12,934. The employers were ordered to pay $9,600 in attorney’s fees for the destruction of video surveillance evidence.

UHS and Suncoast should implement abatement measures, including:

  • creating a comprehensive workplace violence prevention program;
  • staffing all shifts on all units with specialized security personnel to monitor patients and respond to acts of patient aggression;
  • performing practice drills to respond to acts of patient aggression;
  • reconfiguring the nurse’s station to prevent patients from jumping over it.

COVID-19 Standard Under Final Review

As this story was filed, OSHA had completed a proposed emergency temporary standard to protect healthcare workers and other employees from SARS-CoV-2 occupational infections. The standard is under further government review, and the specific regulatory requirements have not been revealed in any detail.

“In response to the [pandemic] devastation, President Biden issued an executive order that directed the Department of Labor to consider whether any emergency temporary standards were necessary to keep workers safe from the hazard created by COVID-19,” OSHA stated.2 “On Monday, April 26, OSHA sent draft standards to the Office of Management and Budget’s Office of Information and Regulatory Affairs for review after working with its science-agency partners, economic agencies, and others in the U.S. government to get the proposed emergency standard right.”

OSHA further stated that $100 million in additional funding granted under the American Rescue Plan of 2021 will be used in part to hire more than 160 new critical personnel, including compliance safety and health inspectors.

“The health and safety movement has been fighting for mandatory COVID rules in the workplace since this pandemic started,” said Jessica Martinez, co-executive director of the National Council for Occupational Safety and Health. “There is no public agency that is tracking the number of workers who have died from workplace exposure to COVID.”3

Martinez urged rapid implementation of the measure in a recent national commemoration for workers.

“We are hopeful that it is comprehensive and provides sufficient protections,” she said. “At the very minimum, we are aware that the standard mandates that employers must have a [COVID-19] prevention program in place that allows for workers to provide input.”

An argument still could be made against mandates seen as draconian, as more workers are vaccinated. Even if they do not take the vaccine, some have argued they are more at risk in the community than the controlled healthcare environment. However, OSHA has considerable political momentum, not the least of which is President Biden’s working-class roots. They certainly could argue a standard now would protect workers in the next pandemic, as CDC guidelines were ignored and politicized when the pandemic started in the United States in 2020.

Then, there are the personal stories from workers who lost co-workers. Pascaline Muhindura, RN, a critical care nurse at a hospital in Kansas City, MO, and a member of National Nurses United, spoke at the national commemoration for workers.

“I am here today to remember my colleagues and all the nurses and frontline workers who have lost their lives because our employers did not give us the protections we needed for the COVID pandemic,” she said. “In January 2020, nurses urged our employers to prepare for COVID. They didn’t.”

Muhindura blames the lack of readily available N95 respirators for a COVID-19 exposure from a patient, which led to the fatal infection of her co-worker, Celia Yap Banago, in April 2020.

“Despite Celia’s death, the hospital continues to ration N95s,” she says. “Management is still forcing us to unsafely reuse the same N95 for our entire shift.”3

Nurses need mandatory rules, not voluntary guidelines, she said.

REFERENCES

  1. Occupational Health and Safety Administration. Federal judge finds Bradenton behavioral healthcare center exposed workers to more than 50 attacks by residents, allowed destruction of video evidence. May 4, 2021.
  2. Occupational Health and Safety Administration. U.S. Department of Labor observes 2021 Workers Memorial Day as agencies look ahead to stronger worker safety, health protections. April 28, 2021.
  3. National Council for Occupational Safety and Health. Life-saving COVID-19 emergency temporary standard (ETS) must be “rapidly approved and rigorously enforced.” April 27, 2021.