This story contains personal accounts of harassment and abuse in the healthcare sector and violence in the workplace, which may be triggering to some readers.
Ten years after she was assaulted at work, Pam Owen still remembers her attacker’s empty eyes as he pinned her backwards over a washing machine and beat her head.
“There was just nothing there, he was not registering anything,” said the former recreational therapist, who worked with mental health and addictions patients for Vancouver Coastal Health.
The pain of being wrenched backwards was so blinding Owen did not realize the attacker had strangled her and punched her repeatedly in the face until he was pulled off by three nurses, five long minutes later. Within days, she was diagnosed with the worst case of whiplash most of her doctors had seen. It took years for the full extent of the damage to become clear: neck and shoulder injuries, symptoms of a traumatic brain injury and post-traumatic stress disorder, all of which have permanently altered Owen’s life. “For the first year, I was seeing my doctor, my massage therapist, my psychologist, my chiropractor, my physiotherapist two to four times per week,” recalls Owen. “It took over my entire life.”
The highly publicized attack on Owen and a damning 2014 investigation by WorkSafeBC brought renewed attention to an ongoing epidemic of violence against health-care workers in British Columbia. From 2010 to 2021, B.C. nurses reported nearly 4,500 injuries related to the use of violence or force that caused them to miss work to WorkSafeBC.
“I don’t know if I could count. It really depends on the week,” Rhonda Bruce said. Bruce is a representative of the Hospital Employees’ Union and a rehabilitation assistant who has worked in long-term care for more than 30 years. She’s lost track of how many times she’s faced violence on the job. “Sometimes it could be weekly. Sometimes it could be monthly. Sometimes it could be hourly,” Bruce said.
Violence is too common
Research from Canada and the United States estimates violence affects more than 95 per cent of health-care workers through the course of their careers. Emergency health workers bear a disproportionate amount of that. In a 2014 study of paramedics in Canada, about 75 per cent reported experiencing violence in the last year, three times the estimated average for other health-care workers.
Violence has become so common, multiple sources told us, workers see it as part of the job and not a problem to report. And if they do report it and nothing changes, they’re unlikely to report future incidents. “This isn’t acceptable behaviour in banks or grocery stores in any public forum,” Grewal said. “Yet it’s been so normalized in nursing and in health care.” In late October, B.C. Health Minister Adrian Dix pledged to place 320 security staff at 26 acute care sites across the province where attacks are most common. “This is not a situation we can afford or justify, and it is certainly one that we cannot endure,” Dix said at the time, hoping that health-care workers would “take comfort” in the announcement.
Code white crisis
When Grewal began work as a nurse 35 years ago, she would occasionally hear a “code white”—a hospital alarm about a violent or aggressive person.
According to WorksafeBC data, 16 per cent of time-loss claims submitted by nurses working in acute care in 2010 to 2021 were related to violence or aggression. The proportion for long-term care was even higher at 18 per cent.
Aly Devji, CEO of the Langley Care Society, said anger from families about their loved one’s care or being unable to visit or not wear a mask due to pandemic precautions can also boil over into verbal or physical violence.
It’s led to many care aides and nurses off on medical leave or leaving the profession altogether, he said.
“The pandemic has been an exacerbating factor, but [violence] has always existed,” said Devji, who works with the industry-funded non-profit SafeCare BC to provide violence prevention training to long-term care workers, managers and families.
Recent research from a Simon Fraser University professor suggests women health-care workers in particular bear the brunt of distress and moral injury, damage caused by being forced to act in ways you feel are against your moral and ethical obligations, on the job. But they also often have the least power to make structural change that would alleviate it.
Violence is a huge part of that. Researcher Julia Smith spoke to one B.C. nurse who said she placed a red dot on the calendar for every day her unit had a violent or aggressive incident. After one month, the calendar was a sea of red and she stopped tracking it. “Most of the solutions proposed focus on the individual, like counselling and therapy, and not at the systemic level which would require proper staffing levels and decision-making powers for staff to run units in the best interests of their patients,” said Smith, an assistant professor in the SFU faculty of health sciences. Placing the burden on the individual to prevent violence and heal when it does happen, rather than the system to change, is what allows this violence and distress to continue, said Owen.
Owen has mixed feelings about the announcement of more security staff.
“It’s what should have happened 10 years ago,” she said. “They knew what was needed when I got attacked, and it took them this long to act.” Owen says preventing the violence in the first place would take a systemic shift.
“We have to ask ourselves, why are people violent in the first place?” Owen said. “If there was more compassionate care, maybe they wouldn’t lash out.”
In 2015, Owen quit her job and moved to Victoria, a fresh start. She had been in fight mode so long, she only realized how truly, deeply burnt out she was when she was away from it all. Taking in new information and listening to music was difficult and still is. She often felt her mind go completely blank, overwhelmed by a conversation or a new task. At times, she struggled with suicidal thoughts.
“It took me a year to begin to feel even a little OK,” said Owen. Once a high-level soccer and ultimate frisbee player, Owen had to stop sports due to her injuries. She still has chronic neck and shoulder pain. And when she began training her dog Indi out of her behavioural issues, Owen realized she had to regulate herself if she was going to help the pup.
That realization spawned what has been a healing second career, training hundreds of dogs with behavioural issues and supporting their owners. “Most people work with the dogs, but I work with the people,” said Owen.
Owen credits the attack with leading her to a better path. Her fears for other health-care workers, however, still haunt her. Leaving was her only option, but she knows many others don’t have that opportunity.
“All people ever hear about is the incident, not the full impact of how it absolutely changes your life,” said Owen. “But if this happens to you, nobody else really cares. All they care about is that I’m gone. And don’t ever think it’s not going to happen to you.”