The trusted source for
healthcare information and
Workers must be able to recognize, react, and report
The July horror played out in a Meridian, MS, Lockheed Martin plant was a stark reminder of the ever-present threat of workplace violence. The good news is that a growing number of employers have taken important steps to help reduce the likelihood of such events. The even better news is the increased recognition of the critical importance of employee involvement in prevention — and that means all your employees.
"I think it’s paramount that you involve all employees in the effort to prevent workplace violence," says Eugene A. Rugala, supervisory special agent with the FBI’s National Center for the Analysis of Violent Crime at the FBI Academy in Quantico, VA. "No group [of professionals] can do it on its own."
Rugala says he has seen this proven in the 10-plus years he has dealt with workplace violence, and that employee involvement also will be cited prominently in a monograph the FBI will publish this fall, the product of a multidisciplined group the agency convened to address workplace violence prevention.
"Without the involvement of the employees, there’s really no way to prevent workplace violence," adds Jane Lipscomb, PhD, RN, associate professor at the school of nursing, University of Maryland in Baltimore. "The problem is extremely complex. There are many causes, regardless of the type of violence; and the direct line worker, whether in health care or manufacturing, knows the work process, knows where there are needs for greater security, and what policy changes or education are needed. Without them, you operate in a vacuum."
In fact, if you look at OSHA’s workplace violence prevention guidelines (www.osha.gov), you will see that the very first element is management commitment and employee involvement. "We know this is a process that works," says OSHA’s workplace violence program coordinator. "We believe it is extremely important to have employees involved in the process when it is set up and when it is implemented. This way, you will not only have their commitment to the program, but their ideas as to where the risk factors are, what they are experiencing, and how it should be addressed. Many times, employees know things management may not."
To have the help of employees, say the experts, you need their buy-in. The best way to ensure this, says Lipscomb, is to make them part of the process.
"A structure of a joint labor-management health and safety committee is a wonderful vehicle to begin that process," she recommends. "Begin with a genuine expressed interest and respect for the worker’s position on this issue, and acknowledge their important role. It’s not a case of employees reporting to management, but rather a way of providing them with a forum, [a way] to treat them as equals, as well as demonstrate a commitment on the part of management." She notes that OSHA’s guidelines include specific examples of employee involvement.
Management commitment is essential
Management commitment is essential for employee buy-in, adds Rugala. "A lot of what’s to be done has to be driven by upper management; that’s the big key," he asserts. "They have to buy in to the fact that this is a good program. Then, that buy-in has to be forced down to the lower levels of the organization. It has to be constant and reinforced in a variety of ways — training, posters, brown-bag lunches, and management meetings."
In order to successfully roll out a workplace violence prevention program, you have to lay the proper infrastructure first, he continues. "It must be logical, and it must seem to make sense in the particular workplace, so when the bell does ring people know who to call and what to do. Invariably, you will get calls, and if employees find out that the program was not rolled out completely, or that something is lacking, or the perception is that management is not listening, you will not get a lot more reports and you may ignore issues that perhaps shouldn’t be ignored."
Finally, he notes, the program "has to be rolled out to all the employees."
Know what to look for
When it comes to training, one of the most important things you can teach your employees is how to spot potential problems. "Look at it this way — the typical offender has a very clear and distinct profile about them as a person. They are very consistent in what they do and say, and how they act," says Paul Viollis, MPA, senior managing director and practice leader for New York City-based Citigate Global Intelligence & Security. "Prior to acting they hit their one deepest sense of powerlessness and feel there is no other choice but this act. Workplace violence, other than the case of the lone gunman coming in a store and opening fire, is clearly avoidable and not spontaneous."
It is critical to teach employees what to look for, he continues, because "if you say you don’t know where the act came from, you weren’t looking and listening. This person is going to tell you what they are going to do. So, when you enlist the services of employees, the key is to train them to know what workplace violence is, what it looks like, who typically perpetrates it, and what behaviors they will display. Once your employees are educated, they can report to management, who can enlist services of the EAP [employee assistance program] or a clinician who is trained to address these issues. Thus, you can mitigate a conflict prior to it becoming an incident," Viollis says.
Employees must be armed with the knowledge they need, adds Lipscomb. "They must know about the problem of workplace violence and what the risk factors in their particular [job and industry] sector are," she notes. "They need to understand what the history of their particular workplace has been, and if there have been past incidents."
You should make sure that employees understand and then agree with the policies and procedures that have been set out by management, she adds. "A lot of companies have policies and procedures on paper only, but they are not understood and/or agreed upon by the people who are supposed to carry them out."
Rugala agrees. "Employees have to learn what the policy is, and what it’s there to prevent," he says. Early on, he notes, most companies had zero-tolerance policies, but he’s not so sure that’s the best way to go. "If you lump someone who brings a gun into the workplace with someone who made an off-handed comment, both cases have to be investigated, but the punishment must fit the crime," he says. "Zero tolerance may be an easy tool for management because it doesn’t require much thinking, but you have to be careful."
What else should employees be trained to do? "The key to successful training is, number one, that it has to speak to what workplace violence is," says Viollis. "There are so many different vehicles — from stalking e-mails to violent events to product contamination." Employees should be trained to know where violence comes from, he continues. "What is the profile of the offender, and what are the behavioral red flags?" he poses. "Employees should know how and when to intervene safely."
Employees should also be taught proper listening skills, says Viollis. "We are very poor listeners," he asserts. Last but not least, there is conflict resolution training for managers. "This key," says Viollis. "This guy lives in world of powerlessness. Clearly, this is someone who can be helped, but you have to do it in a timely manner.
An ounce of prevention
Timeliness is critical, says Viollis. For example, "The [occupational health] clinician is a key player in mitigating and diffusing workplace violence, but the problem is a majority of employers don’t educate their managers about the involvement of health care as it pertains to this particular issue."
If you get to the troubled employee early enough you can get optimal results, he continues. "When you have an incident and you hear people say that employee was sent to anger management, when did they do it? Not only don’t you help the employee [if you wait too long], but you put the health care worker at risk, too."
The bottom line, he says, is to provide thorough training, and a sound policy culture that does not tolerate threats and educates managers about how to involve the health care clinician at the early stages. "When we do that, we start to win the game," he asserts.
He cites a recent example where such an approach worked exactly as intended. "The risk manager for a mid-sized city in Florida called me and asked me to do some workplace violence prevention training," Viollis recalls. "They did not have a policy in place, so we created one, and then conducted employee training sessions. A month or two later I got a call from him and he was ecstatic. One of his employees recognized certain behaviors in a fellow employee from the profile [i.e., making idle threats]; and when he saw him slamming doors shut, he realized he had to act right away. He reported it to the supervisor, who followed procedure to a T’; they got the EAP involved and they were able to diffuse the situation. This guy admitted what he was going to do if he did not get the help he got; he even told them the violent act he was planning. But since then, he has become a model employee."
How can you consistently ensure this type of result? Can you really increase the odds that your employees will comply with the prevention policy you create and with the training you provide? Experts say there are a number of strategies that will help improve your chances of success. "Make the training program mandatory," offers the OSHA official. "Make sure that all employees — old and new — get it. And it should be repeated — not necessarily every year, but maybe biannually, with some recurrence so people have a refresher and remember."
"Training needs to be constant because of turnover," adds Rugala.
That training also may include such topics as diffusing angry behavior and conflict resolution, the OSHA official adds. "In addition, you need to definitely make sure you have a reporting mechanism in place. The employee needs to know there is a way to report an incident, and that they will be responded to."
This means, of course, compliance on the part of management and supervisors. "If necessary, it can be an anonymous reporting system because sometimes people are afraid," the OSHA representative adds. "Consistent with that would be the need to let employees know there will not be reprisals against them [for reporting]."
"You clearly want to encourage reporting and create an environment where it is acceptable that employees report incidents and that reports are taken seriously," adds Lipscomb. Above all, she advises, lay the proper foundation. "Have a health and safety committee that’s truly proactive, where workers have an equal voice with management — that’s the foundation that is needed. Everything else flows from that."
That "everything else" is a safer, more productive workplace. "This is for the protection of your own employees, as well as for limiting your potential liability as an employer," says Rugala. "No one wants to see death or bodily injury occur in the workplace."
For more information, contact:
• Eugene A. Rugala, Supervisory Special Agent, FBI, National Center for the Analysis of Violent Crime, FBI Academy, Quantico, VA 22135.
• Jane Lipscomb, PhD, RN, Associate Professor, School of Nursing, University of Maryland, Baltimore, MD. Telephone: (410) 706-7647. E-mail: email@example.com.
• Paul Viollis, MPA, Senior Managing Director and Practice Leader, Citigate Global Intelligence & Security, New York City. Telephone: (321) 254-7879. E-mail: firstname.lastname@example.org.