Increase in violence against Quebec hospital staff

Events of violence against hospital staff at the CHU de Québec-Université Laval have been on the rise in the past year. Even if the establishment says it is doing more to prevent violence, an expert believes that the issue is more deeply rooted in the health system.

The total number of reported violent events increased from 325 to 367 between 2022-2023 and 2023-2024. The number of accidents requiring work stoppage, however, decreased from 29 to 27. The increase is not unique to the Quebec region. In March, the CIUSSS of Mauricie and Centre-du-Québec made a similar observation.

This is the tip of an iceberg because several workers that I have interviewed since at least 2008, they keep telling me that if they filled out forms each time to report events of violence, they would only do thatnotes Angelo Dos Santos-Soares, professor at the Department of Organization and Human Resources of theUQAM. There are many cases that are not even reported.

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Reports of violent events include a variety of events. Here are some examples: having an object thrown, biting, gestural insult like the finger, fist in the air, verbal violence, injury linked to the physical control of a user, etc.details the CHU in writing.

The establishment is not able to provide data for financial years preceding that of 2021-2022 since it has changed the way it compiles it. This could affect the data comparisonhe indicates.

It is inevitable that this has an impact on morale and workload.

The increase in recent years still seems to be consistent with what the Association of Emergency Nurses of Quebec observes. The frequency of interventions continues to increase over the years. In several emergencies, we saw an increase of more than 20% in interventionsrelates the president of the Association, Josiane Arsenault.

Without being able to say whether the situation has deteriorated, a nurse from Quebec attests that violence is part of everyday life. I couldn’t compare, but I can say that, unfortunately, we experience it every day. It’s something we have to learn to reconciletestifies Pascale-Alison Lachance, a clinical nurse in neurology.

She qualifies her testimony by adding that the frequency of violent events also depends on the care department. There are some where you will be more likely to be around violent people, whether in the emergency room or with patients who are more confused.relates the nurse.

More prevention

The CHU and the Association maintain that measures have multiplied in recent years to tackle the issue. For several years, establishments have begun to put in place much more structured plans to deal with the increase in violence observe Josiane Arsenault.

For its part, the CHU provides in writing a list of different training courses put in place to equip staff and help them protect themselves from violent behavior as well as different prevention approaches to better adapt interventions and prevent reactive behavior from customers.

For the 2022-2023 financial year, 1,302 workers took training in violence prevention. For the 2023-2024 fiscal year, 1,785 workers took training in violence prevention and 378 workers participated in clinical simulations

Even with the various measures put in place by establishments, Pascale-Alison Lachance would like to have more support. There is a big shortage of staff in terms of the help we can receive when there are patients who are violent.she maintains.

From his experience, Angelo Dos Santos-Soares does not believe that the means put in place by the institutions really bear fruit. I am deeply sorry to see that the employer is not taking violence prevention measures effectively, because this reality has existed for at least 20 yearshe pleads.

The source of violence

For the professor, we should go further than prevention and awareness. The major problems are in the organizational context, in the labor shortage and in the work overload that people experiencehe summarizes. The government’s logic for several years has been to do more with less.

It is very often in these contexts that frustration ends up appearing. Inevitably, there are issues related to the aggressiveness which increases in relation to the waiting time then in relation to dissatisfaction. Unfortunately, our emergency rooms remain crowded. This is not a phenomenon that dates back to yesterday, so obviously it has an impact on tensionsalso notes Josiane Arsenault.

Users and their loved ones more often turn this frustration towards front-line employees. Mr. and Mrs. Everyman, when they feel rushed because the care is going to be longer, they will not think about the fact that these are management choices and that it is the organization of work which builds this pressure relationship for healthcare employeesunderlines the professor.

He suggests reviewing the system more in depth to stem the phenomenon of violence due to this pressure. In my opinion it is fundamental to change the organization of work and management philosophies. You have to listen to the people who do the work and who know better than anyone else the resources they needdefense Angelo Dos Santos-Soares.

With information from Marie-Claire Giffard and Jérémie Camirand