Sample Workplace Violence Prevention Plan
ABC Department
Site/Facility
This document is a sample workplace violence prevention plan provided by Safety
Programs.
Components of the plan can be incorporated into your department specific workplace
violence prevention plan ensuring the components adopted meet the needs and
requirements of your department and violence risk assessment.
This document contains many examples that can be used as guidelines to address specific
situations or circumstances identified on your risk assessment. It can be modified by
deleting or adding information that is not relevant or is relevant, respectively.
Additional Information on prevention measures can be found in the Managers’ Guide to
the Violence Prevention Program Document
If you required assistance in completing your Violence Risk Assessment or Plan, you can
contact Safety Programs Department.
A violence prevention plan is required if the risk assessment determines a risk designation
score of moderate (5-6-7) or high (8-9).
A risk designation of low (3-4) does not require a plan; however, this sample plan
incorporates important information that all staff should be provided.
Prepared by:
Revised: February 14, 2013
John Doe
Jane Doe
Page 1
Table of Contents
Note: Sections 1, 2, 3, 4, 5, 6 and 9 are required by the Violence in the Workplace
Regulations, 2007, if the risk designation is determined to be moderate (5, 6 or 7) or high
(8 or 9) and a violence prevention plan is required.
Section 1
General Information
Section 2
Risk Assessment – the nature and extent of the
risks and any factors that may increase or
decrease the extent of the risk including
measures taken to minimize or eliminate the risk
of violence
Section 3
Workplace Violence Policy Statement
Section 4
OHS Act Rights and Responsibilities
Section 5
Recognizing Situations with Potential for
Violence
Section 6
How to respond to Workplace Violence and How
to Obtain Assistance
Section 7
Safety Tips
Section 8
How to Report and Document Workplace
Violence
Section 9
Review – Program, Risk Assessments and
Violence Prevention Plans
Section 10
Additional Resources:
 Legislations
 Capital Health Policies
 CH Violence Program Information
Revised: February 14, 2013
Page 2
SECTION 1
GENERAL INFORMATION
All information in this section that is not highlighted must be
included in your plan.
Highlighted areas in this section are examples and can be
changed to meet your needs.
[ABC Department]
[Section 1: General Information]
Section 1 - General Information
1. What is Violence?
The Violence in the Workplace Regulations define “violence” as any of the following:
i. threats, including a threatening statement or threatening behaviour that gives an employee
reasonable cause to believe that the employee is at risk of physical injury,
ii. conduct or attempted conduct of a person that endangers the physical health or physical
safety of an employee.
Violence can be directed at an employee by patients, visitors or other employees (co-workers).
Personal Relationships of an employee such as a parent, brother, sister, spouse, boyfriend, girlfriend,
acquaintance, etc. are included in the classification of visitor. If the personal relationship is also an
employee, this will be treated as staff on staff behaviour (bullying or harassment) and could include
violence.
2. Definitions
Employee: refers to any employee, physician, other practitioner, volunteer, student, contractor,
associate of Capital Health or employee of a Capital Health Foundation.
Disrespectful Behaviour: behavior towards others that is undesirable, unsuitable or improper. This
behavior may be written, verbal, electronic or behavioral. It may also include bullying which usually
involves repeated incidents or a pattern of behaviour that is intended to intimidate, offend, degrade
or humiliate a particular person or group of people. It has also been described as the assertion of
power through aggression. (Canadian Centre for Occupational Health and Safety)
Harassment: Typically means any offensive or inappropriate persistent implicit or explicit
behaviour by a Capital Health staff member that is directed towards any Capital Health staff member
or staff group and which a person knew or ought reasonably to have known to be unwelcome.
For the purpose of this Policy, harassment in the workplace includes, but is not limited to, sexual
harassment, behavior that creates a hostile or offensive workplace, discrimination and abuse of
authority.
Patient: refers to any individual receiving care in a Capital Health Facility or through one of
Capital Health’s Programs.
Visitor: refers to any individual who is not an Employee or a patient, who is on Capital Health
property or is contacting an Employee in their work capacity. Visitors include: patients’ family
members, patients’ friends, visitors, trespassers and personal relationships of staff members.
Revised: February 14, 2013
Page 4
[ABC Department]
[Section 1: General Information]
Workplace: means any place where an employee is or is likely to be engaged in any occupation and
includes any vehicle or mobile equipment used or likely to be used by an employee in an occupation.
3. Why is Violence Prevention and Important Issue?
Violence is an issue that affects the safety and security of employees, patients and visitors at Capital
Health. Violence claims a high personal cost from the emotional trauma and physical injury
experienced by victims, their families and co-workers. Violence also brings high costs to the
employer, including: increased absenteeism, lost productivity and high employee turn-over.
4. Responsibilities
CEO/Vice Presidents:
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Ensure the establishment of a Workplace Violence Prevention Program and
Ensure the continued support of the Workplace Violence Prevention Program
Directors/Managers/Supervisors:
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Ensure that risk assessments are conducted and appropriate controls are identified and
implemented in their area(s) of responsibility to eliminate or reduce the risks.
Ensure Violence Prevention Plans, if required, have been developed and implemented in their
area(s) of responsibility
Ensure all employees who are exposed to a significant risk of violence in the workplace are
informed of the results of the risk assessments
Ensure required information and training is provided
Ensure Capital Health policies and procedures for reporting, documenting and investigating
incidents of violence are implemented and performed
Provide copies of the complete Risk Assessments and the Prevention Plan (if required) to the
applicable Joint Occupational Health and Safety Committee (JOHSC) or Workplace Safety
Team (WPST) and to Safety Programs Department
Review the Risk Assessments and Prevention Plan as required
Provide employees affected by workplace violence support and advise of counceling through
EFAP or a practitioner of the employee’s choice.
Employees:
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Report all incidents of violent behaviour to Manager/Supervisor and SAFE (473-7233)
Report any deficiencies, hazards or concerns to Manager/Supervisor and SAFE (473-7233)
Attend training sessions as required.
Co-operate in an investigation of Workplace Violence.
Participate in risk assessments and violence prevention plans.
Follow procedures established for the prevention of violence.
Consider accessing post incident counseling services when offered by the employer.
Revised: February 14, 2013
Page 5
[ABC Department]
[Section 1: General Information]
Joint Occupational Health and Safety Committee/Representatives/Workplace Safety Teams:
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Assist in the risk assessment process as required.
Monitor follow-up actions to the Risk Assessments.
Provide input into the Violence Prevention Program.
Review violent incident investigations and make suggestions/recommendations, as necessary.
5. A risk assessment has been conducted for the ABC Department to identify and document the risks
associated with the hazard of violence; and, the current and potential prevention measures (controls)
that are or will be implemented to eliminate, reduce or minimize these risks. The risk assessment is
included in the Plan.
6. The Capital Health Violence Prevention Statement will be posted in the receptions areas, staff
lounges and meeting rooms throughout the ABC Department. Refer to Section 3 for a copy of the
Violence Prevention Statement.
7. Training and education for employees on the ABC Department’s Workplace Violence Prevention
Plan will be provided as follows: (The following are examples of ways to provide information,
education and training for employees)
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Education Sessions (These are examples on how you could provide information).
o All staff will review the Workplace Violence Risk Assessment and Violence Prevention
Plan (This is the minimum that must be done.)
o Capital Health Workplace Violence Prevention Education session will completed by all
current staff and all new staff, (on our website - Minimal risk areas)
o All staff required to provide community based services will receive training in the capital
health workplace violence prevention education session, community based safe practice
(mental health) education session, NVCI,
Safety talks discussing components of the Plan will be scheduled once per month.
15 minutes of each staff meeting will be dedicated to staff discussions on violence and
preventative measures.
All information, education and training will be recorded on each employee’s department file and/or
on the orientation checklist an in the ABC Department database.
8. As per Policy CH80-022 all incidents or potential incidents (including conduct, behavior and threats)
of violence will be reported to the Manager/Supervisor and SAFE (473-7233). See Section 9 – How
to report and document workplace violence
9. Upon receiving a report of a violent incident, based on the severity, an investigation of the incident
will be conducted by the supervisor/manager. Refer to Capital Health Policy CH80-022 Employee
Hazards and Incidents – Reporting, Investigation and Documentation.
This will include:
Revised: February 14, 2013
Page 6
[ABC Department]
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[Section 1: General Information]
a debriefing with the affected employees.
Identification and implementation of prevention measures (controls) to further reduce or
minimize the risk.
Completing the incident investigation report form and forwarding a copy to the JOHSC/WPST
and to SAFE (fax –473-2765).
Employees will be informed of the actions taken to minimize/reduce the risk.
Review and update the Risk Assessment and Workplace Violence Prevention Plan as required.
See Appendix D – Review of violence risk assessment and violence prevention plan.
10. Staff who identify deficiencies in this plan or any physical conditions that may affect the
effectiveness of this plan will: (the following are suggestions on how to provide this information)
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For physical conditions; submit a work order with Engineering Services via on line work order
system or with the locksmith and advise manager. Or report condition to supervisor/manager for
repair.
All identified deficiencies or concerns with the workplace violence prevention plan will be
reported to the supervisor/manager.
As part of Capital Health’s Informal Inspection Process, all staff members are responsible to
monitor areas for items that could be potential safety concerns and remove or secure, where
possible. Report these deficiencies to the Supervisor/Manager.
11. Staff have the right to participate in health and safety initiatives and can exercise this right by
providing any suggestions on how to improve safety from violence by speaking with their supervisor
or manager.
Revised: February 14, 2013
Page 7
SECTION 2
RISK ASSESSMENT FORM
Risk Assessment Forms
Insert your Completed Violence in the Workplace Risk Assessment here.
The risk assessment form is on legal size paper. To print a letter size copy: in the
print window, click on the scaling field and select letter, then print. Note the print
will be smaller if you choose this option.
SECTION 3
VIOLENCE PREVENTION STATEMENT
Revised: February 14, 2013
Page 10
Workplace Violence Policy Statement
Capital Health is committed to providing a healthy and safe workplace that is free of
harassment, violence and threats of violence. We believe that physical and emotional
safety is the right, and responsibility, of every person.
Capital Health acknowledges that violence in the workplace is an occupational health and
safety hazard that can cause physical and emotional harm. We view any acts of violence
or threats of violence in the workplace as unacceptable. We are committed to working to
prevent workplace violence and to responding appropriately if workplace violence does
occur. All members of the company are responsible for creating and maintaining a safe
environment.
Any acts of violence or threats of violence are unacceptable and will be responded to
immediately. This includes, but is not limited to, the following:
 threats, including a threatening statement or behavior that gives a person cause to
believe they are at risk of injury,
 conduct that endangers the health or safety of a person.
In all situations, if you witness or experience violence or threats of violence, take
precautions to assure your own safety and the safety of others. To report an incident,
please do the following:
 To report an accident or incident (non-emergency), contact Manager/Supervisor
and 473-SAFE (7233).
 In an emergency within Capital Health, please follow Emergency Code White
procedures for your facility.
Revised: February 14, 2013
Page 11
SECTION 4
OCCUPATIONAL HEALTH AND SAFETY
ACT
RIGHTS AND RESPONSIBILITIES
Revised: February 14, 2013
Page 12
Nova Scotia Occupational Health & Safety Act
Right and Responsibilities
Capital Health facilities must comply with all aspects of the Act. The legislation is based on the Internal
Responsibility System and ensures three fundamental rights to all Nova Scotia employees.
The Right to Know what hazards you are expected to work with and what preventative measures are in
place to protect your health and Safety. You are entitled to training and information to allow you to
work with the hazards safely. You also have a right to information on issues that may affect your health
& safety or the health & safety of other persons in your work place.
The Right to Participate in decisions regarding health & safety in your workplace, by voicing your
concerns or opinions on any issues affecting health and safety at the workplace and by reporting unsafe
conditions. As well, you can participate as a safety representative on Joint Occupational Health and
Safety Committee, Workplace Safety Teams/Representative (QEII) or in the selection of these safety
representatives. Additionally, you can participate in safety initiatives such as: inspections, the hazard
assessment process and/or the development of safe work procedures.
The Right to Refuse work that you believe is will endanger the health and safety or yourself or others.
If you choose to exercise this right, advise your immediate Manager or Supervisor. They will guide you
through the specific process (CH 80-045 Refusal to Work Situation).
KNOW YOUR RIGHTS – EXERCISE YOUR RIGHTS
The Internal Responsibility System means that every employee in Capital Health, from front-line
workers to the senior executive is responsible for workplace safety:
Your responsibilities include:
 Ensure your work activity and behaviour does not, through act or omission, place at risk your own
health and safety or the health and safety of others
 Report any and all workplace hazards and incidents, with or without injury/illness, to the
manager/supervisor in a timely manner and document these events/situations by dialing 473-SAFE
(1-902-473-7233)
 Follow established safe work procedures and use/wear personal protective equipment as required and
instructed
 Use machinery, equipment and materials only as authorized and trained
 Participate in defining safe job procedures and in opportunities to protect and promote health and
safety on the job
 Co-operate with the employer, the Capital Health Joint Occupational Health & Safety Committee (s),
Workplace Safety Team(s), Capital Safety Officer(s), Occupational Health Services, Emergency
Response and Fire Safety Department and Officers of the Department of Labour and Advanced
Education
Revised: February 14, 2013
Page 13
SECTION 5
RECOGNIZING SITUATIONS WITH A
POTENTIAL FOR VIOLENCE
AND
HOW TO RESPOND
This section provides information on situations and the prevention measures (controls) enacted to prevent
violence. It will prepare employees for different situations.
Review the procedures carefully and ensure samples are modified for your requirements, as staff members are
responsible to follow these procedures.
This Violence Prevention Plan provides information on how to recognize potential violent behaviours
factors or situations, what actions should or must be taken to reduce the potential for violence and how
to obtain assistance. Situations outlined in this section could occur at Capital Health.
1. In the health care setting there are various factors that can increase the potential for aggressive or
violent behavior. The Violence Risk Assessment completed for your area identifies what factors
could have an impact on violence in the area where you work. Situations and circumstances could
include, but are not limited to:
 Interacting , in person or other forms of communication (via phone or email), with public,
patients and co-workers.
 Interacting in person or providing physical care to known aggressive or violent
patients/persons.
 Handling of drugs or valuables
 Illness and injury
2. You may not always be alerted to a potentially violent/aggressive person
3. When notified that a patient/person is known to be aggressive or violent, does not always mean that
they will be aggressive or violent.
4. You do not have to wait until a situation escalates to physical violence, you can activate a “Code
White – Violent Person” at any time you feel you are in danger.
5. Violence in the workplace is a hazard. It is dependent on other persons behaviours and may not
always be eliminated. Supervisors and managers are taking every reasonable precaution to prevent
aggressive and violent behavours to reduce potential injury and illness. Employees must report any
hazardous conditions, acts or incidents, no matter how insignificant, to allow for an investigation and
ensure appropriate prevention measures are identified and implemented.
Therefore, it is important for staff to continuously monitor situations and be prepared in case of any
situation.
Staff should ensure any items that could be potential weapons such as scissors and staplers should be out
of reach of patients or placed in a drawer or secure area.
When caring or interacting with a known aggressive or violent person you could consider arranging for
security to stand by as a precautionary measure. Contact your immediate supervisor to discuss this
option or other options should the need arise. (if available at site or facility)
For work during the evening, weekend and holidays staff should ensure they are wearing their panic
button (if available) and if concerned ask security (if available) to increase rounds to the area you are
working, and communicate with the employee when there.
If this information is acceptable, keep it or modify it to meet your needs.
RECOGNIZING A POTENTIALLY VIOLENT PERSON, HOW TO RESPOND
AND HOW TO OBTAIN ASSISTANCE
The following information can be used to help in recognizing a person who is in crisis or could be
potentially aggressive or violent and how to respond appropriately Refer to Section 7 – Safety Tips for
information on effective communication (verbal and non-verbal).
1. Signs of a potentially Violent Person (this could be a patient, visitor or co-worker)
Use caution if someone exhibits one or more of the following signs and call for auxiliary team (coworkers) and/or activate a Code White response for your facility, if assistance is needed:
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Flushed or pale face
Sweating
Pacing, restless and/or repetitive movements
Signs of extreme fatigue (dark circles under eyes)
Trembling or shaking
Clenched jaws or fists
Facial grimacing
Exaggerated or violent gestures
Change in voice
Loud talking or chanting
Shallow, rapid breathing
Scowling, sneering or use of abusive language
Glaring or avoiding eye contract
Violating your personal space (they get to close)
Destroying property
Any combination of the above behaviours increases the risk for physical violence.
2. Recognizing a person in crisis (this could be a patient, visitor or co-worker). Often in health care
settings, individuals experience increased anxiety, frustration or stress due to varying factors such as:
lack of information, fear of unknown, bad news, lack of control over their or a family members
situation, previous bad experiences with health care and mental or physical injury or illness. Section
7 of this plan provides safety tips for effective communication (verbal and non-verbal) with
individuals who are in crisis.
a) Non Physical/Non-verbal – These are typical signs of anxiety or the beginning stages of a crisis
individual and a supportive approach from staff may help de-escalate the situation.
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Flushed or pale face
Sweating
Revised: February 14, 2013
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Facial grimacing
Sighing
Page 16
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Signs of extreme fatigue
Trembling or shaking
Clenched jaws or fists
Finger tapping
Pacing, restlessness and/or repetitive
movements
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Shallow, rapid breathing
Avoiding eye contact
Glaring
Frustration
Low mumbling under breath
b) Verbal - a potentially escalating crisis individual. If staff do not recognize the beginning stages
of crisis or they are unable to support/assist the crisis individual, their behaviour will continue to
escalate. The following are signs of an individual who is continuing to escalate or is at a
heightened crisis level. Continue a supportive approach, avoid power struggles, set limits
keeping them simple and clear. Be prepared to enforce limits, terminate interaction and if
necessary request assistance from Auxiliary Team (Co-workers) or “Code White” procedure.
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Questioning that can be in the form of information seeking or challenging. (Example:
Questioning - how do I fill this out, where do I get this form or Challenging - who are you to
make me do that or What are you going to do)
Confrontational/argumentative
Loud talking, chanting or screaming
Scowling, sneering or use of abusive language
Change in voice
Verbal threats – all threats, especially threats of physical harm or death, are to be taken
seriously, seek assistance immediately.
c) Physical - If the individual continues to escalate in their crisis they will proceed to the physically
acting out level. If any individual is physically acting out you must initiate a “Code White”
response immediately (refer to item 1 - signs of a potentially violent person).
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Exaggerated or violent gestures
Destroying property
Hitting
Punching
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Throwing objects
Biting
Kicking
Grabbing
STRANGERS AND SUSPICIOUS PERSON(S)
1. Dealing with strangers
In health care settings, not every strange person is a threat. It could be a patient, staff member or
visitor who is going to an appointment or meeting and is lost or were given wrong directions and
trying to locate where they are supposed to be. In situations where you do not feel threatened:
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Adopt a non-threatening, non-confrontation manner toward visitors and ask “May I help you?”
If appropriate and not uncomfortable escort the stranger to the location or the person they
identify as their destination.
Note the appearance of people who are not familiar to you, in case something does happen.
Do Not open the door to strangers in secure areas or unauthorized areas.
Revised: February 14, 2013
Page 17
2. Dealing with Suspicious Persons
Suspicious Person(s) are usually a stranger who enters a workplace to commit theft or a crime and
they have no legitimate reason to be at the workplace. A suspicious person is someone you do not
recognize from the building and they do not have a CH ID. They may appear to be wandering and
nervous, wearing odd clothing for the season, are unwilling to ask for assistance and when assistance
is offered, they may give vague answers with little or no eye contact. A suspicious person could be
on the property or in one of Capital Health’s site or facilities. Staff should be on the alert for any
suspicious activity or persons.
If a person is on Capital Health Property and seems suspicious then:
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Do Not Confront or follow the person(s)
Note the appearance of the person(s)
Note the direction they are heading
Contact security or police (if facility does not have security on site)
When safe to do so, report any incidents to your manager/supervisor and contact 473-SAFE
(473-7233).
THREATS AGAINST EMPLOYEES
Threats can be defined as any conduct or behaviour directed towards an employee or Capital Health
property. Threats include a threatening statement or gesture that gives a person reasonable grounds to
believe they are at risk for physical violence. Incidents of stalking are included as a threat. Current or
former patients, patient’s family members, visitors, trespassers, the public, co-workers or personal
relationships of employees such as an acquaintance, friend, boyfriend/girlfriend, spouse or relative of an
employee can make threats. Bullying and harassment (employee to employee) can, also, increase the
risk for physical violence.
Threats can be made in person, on the phone and via email or other social media. The different levels of
threats are:
•
•
•
Direct Threats – clear statement of what will happen. (eg: I’m going to come there and hurt you, I
will kill you.)
Conditional Threats – if a particular condition is or is not met, there will be consequences. (eg: If
you don’t move, I’ll kick you; if you tell anyone or get me in trouble, I will do something.)
Veiled Threats – a statement (eg: I know where you live or park your car; how are you going to
make me) or body language or behaviour which shows an intent to harm. (eg: shaking fist motion,
hand signal like a gun)
Take all threats seriously. If a threat has been received, immediately inform the targeted employee, your
supervisor/manager and SAFE (473-7233) about the threat. If the threat is received after hours
(evenings, nights, weekends), notify the Administrative Coordinator (QEII or DGH), Site Responsible
Person in charge or Manager-on-call who will contact the Area Duty Administrator as necessary.
If an immediate danger exists, activate the Code White (Violent Person) protocol for your facility.
Revised: February 14, 2013
Page 18
The supervisor or manager must complete an immediate investigation to determine the legitimacy of the
threat (Refer to Workplace Employee Hazard and Incidents – Reporting, Investigating and
Documentation CH80-022.). If during the investigation by the supervisor, manager or Person in Charge,
the threat is assessed and there is a potential for the threat to be acted on:
 Contact the police to investigate the allegation.
 If the threat is made by a Capital Health staff member, place the staff member on administrative
leave pending an investigation by People Services.
If police involvement is required, notify Legal Services. Legal Services and Safety Programs
Department can be contacted for assistance, if needed.
Depending on the circumstances, some or all of the following procedures may be implemented to
prevent a possible incident arising from the threat:
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Remind all employees not to give out personal information about other staff.
Screen in-coming phone calls for the threatened employee.
Assist with safe transportation, have security or someone (buddy system) escort the employee to
their vehicle.
Make sure all staff in the office or area are aware of the threats so team supports can be put in place.
Provide a description of the person who issued the threat.
If the threat was made by a client/patient, one of the following preventative measures may be
necessary:
o Transfer the client’s file to another location and formally advise the client that he or she is not to
return to your office or contact the threatened employee again.
o Re-assign the employee to another case or assignment to avoid further contact with the
threatening client/patient.
o Re-assign the employee to another office or geographic area, either permanently or until the
threat is reduced.
o Incidents of aggressive or violent behaviour by a patient are to be noted on the patient’s health
record. Any remedial actions which are implemented and that may affect the patient’s care or
access are also to be recorded on the patient’s health record.
Security or surveillance may need to be increased.
Support the employee if he or she is laying police charges and/or applying for a restraining order. If
this action is taken, Capital Health Legal Services must be involved.
Provide a debriefing and/or counseling to the employee and his or her family, if necessary.
Revised: February 14, 2013
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TERMINATING A POTENTIALLY VIOLENT INTERACTION OR NEGATIVE
INTERACTION
While working at Capital Health, you may encounter situations where using your best judgment you
must terminate a negative interaction with a visitor, patient or co-worker. Based on the situation, the
following guidelines can be used:
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Interrupt the conversation firmly, but politely. Advise the person that you do not like the tone of the
conversation and you will end the conversation, if necessary. Be specific about the behaviour.
Tell the person that you will ask them to leave the building, or that you will leave (if working offsite).
If the behavior persists, end the conversation.
Ask the person to leave the building. If the person does not agree to leave, seek assistance from your
co-workers or supervisor. Remove yourself and others from the scene, if necessary. Advise other
staff and have them leave the immediate area.
If you are working off Capital Health property or in the community, leave yourself.
Do not return to the person if you believe they pose a physical threat.
Call security to escort the person off the property or activate your facility’s “Code White” procedure,
if necessary.
Report any incidents by advising your manager/supervisor and SAFE (473-7233).
RESPONDING TO AN ABUSIVE TELEPHONE CALL
There may be occasions when a Capital Health staff member receives an abusive telephone call.
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Interrupt the conversation firmly, but politely.
Remind the caller that you will not accept abusive treatment or language.
Advise the caller that you will end the call if the caller does not stop using abusive language. Be
clear about the behavior that must be stopped.
Record the call or use a speaker phone, so that others can hear and help identify the caller.
If you have call display, note the number and/or person identified.
If the abusive call is left in the form of a voice message, save the voice message and advise
manager.
If the caller calls back, interrupt the conversation firmly, but politely. Advise the caller that you
will transfer the call to your manager/supervisor or patient representative, if necessary.
Put the caller on hold and contact your manager or supervisor and transfer the call to them. The
manager supervisor should take appropriate action to resolve any misunderstanding and reinforce
with the caller that abusive language or behaviour toward employees will not be tolerated and
consequences could occur.
Report any incidents to your manager/supervisor and contact 473-SAFE (473-7233).
If you receive an abusive or threatening communication via email or social media:
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Save and print the email or message.
Provide a copy of the email or report the incident to your supervisor/manager and contact 473SAFE (473-7233).
Revised: February 14, 2013
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Refer to section on Threats against employees or Capital Health Property
INTOXICATED PERSONS
Intoxicated is defined as the state of being poisoned by a drug or other toxic substance or the state of
being inebriated as a result of an excessive consumption of alcohol (Capital Health Policy CH80-091
Intoxicated Persons).
At times staff members may encounter a person who is suspected to be or is intoxicated. This could be a
patient, visitor or co-worker and could occur when providing care to an emergency department patient,
during outpatient services, or during your travels throughout the facility. An intoxicated person is not
always violent; however, it can increase the potential for aggressive or violent behaviour.
Security Services must be notified in all situations when an individual is intoxicated or suspected of
being intoxicated. If Security Services is not available at your facility/site then notify the immediate
supervisor or person in charge, and if determined necessary notify Police.
If an individual is unconscious, he or she must be transported to an Emergency Department. This can be
initiated by contacting your emergency phone number for your facility “insert phone number” and
depending on your facility’s emergency responses, request a “Code Blue – Medical Emergency” or EHS
to scene.
All reports of intoxication by staff members will be addressed through Capital Health Policy: CH80-090
Drugs and Alcohol in the Workplace.
PERSONAL PANIC ALARMS or SECURITY MONITORING SYSTEMS (other
than facility response systems)
If you have personal alarms (panic alarms) or a security monitoring system in your work area, you
should include information on the alarm system, who monitors, how and when to activate, the expected
response, testing, etc. If you have a written procedure already, insert it in this section. The following is
an example of information that should be included, but not limited to:
The staff members who work night, evening or weekend shift are required to wear a personal alarm.
The personal alarm or panic buttons are located (include where). The following routes are to be strictly
adhered to for your own safety during evening, night or weekend shifts:
 Remain in the work area at all times if possible
 Include a statement to have staff restricted to well trafficed routes of travel through work
area
 Always use the elevator if it is functioning. If the elevator is out of order, use ONLY the
main stairwell. The back stairwell is not to be used.
 Consider restricting going to areas that could put a staff person in a compromising
position where assistance may not be available, such as a file room.
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The personal alarm is only effective for activation (sometimes they do not work in areas and if this is
the case list where the personal alarm will or will not work and/or restrict going to these areas).
Please note: The personal alarm is used to activate a response in an emergency situation when
contacting the emergency phone number “473-3333” or “911” (include your facility’s emergency
number) is not possible. As soon as safe to do so, you should contact the Emergency phone number for
your facility, “473-3333”, “911”, etc.
Once pressed, it will ring to (who monitors). The Alarm Company (include name) or Facility Security
will call (who – security, police, a managers, etc).
What will happen after the alarm is pressed.
The alarm is tested on a monthly basis for deficiencies; however, if staff recognizes any issues (not
working properly, unable to locate it, etc.) they must report it immediately to their Supervisor.
STAFF WASHROOMS
During evening, nightshift or weekend hours, staff should use washrooms located in or close to the
secure work areas.
ENFORCING RULES OF CONDUCT
Signage has been posted throughout the department indicating quite zones, restricted assess, visiting
hours, no smoking, violence prevention statement and code of conduct.
If you have to enforce any of these rules:





Advise the person(s) of the rule(s) and the consequences of not complying.
If the person continues to break the rule(s), enforce the rules and implement consequences of not
complying.
If a staff member has concerns that an individual’s (patient, visitor or staff member) behaviour
will escalate, notify Security or the Person in Charge as necessary for assistance.
If at any time you believe you are at risk for violence, activate a Code White (473-3333) as
needed.
Advise your supervisor/manager.
ESCORT TO VEHICLE (if available at facility)
If you are a shift worker and you are concerned about your safety to your vehicle you can contact
Security at (XXXX) and request an escort to your vehicle in the parking lot.
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Staff members who work evenings, nights or weekends can park in the main parking lot after (what
time). If a staff member has a personal parking spot, they should move their vehicle to the main parking
lot during the supper break,
If possible arrange to enter and leave the facility with a co-worker (buddy system).
See Section 7 - Safety Tips for more information on elevator safety, walking safety, parking lot safety
and driving safety, etc.
PROVIDING PHYSICAL CARE TO KNOW VIOLENT PERSONS OR
PATIENTS
Capital Health recognizes that some instances of aggressive or violent behaviour may be related to
injury or illness. In such instances, Capital Health will strive to address the behaviour in a manner that
ensures the safety of staff members, patients and visitors while also meeting CH's responsibility to care
for individuals in need of our healthcare services. The following information can be used to create a
procedure for staff, and must be modified to meet the needs identified on the Violence Risk Assessment.
Situations that could impact this information are the types of interactions to occur: inpatient, outpatient,
patient residence, etc.
SCENARIO FOR INPATIENTS or PROVIDING PHYSICAL CARE TO KNOWN VIOLENT PATIENTS:
There are situations where other employees may have to enter a patient’s room or provide physical care
to a known aggressive/violent patient, such as phlebotomists, xray techs, respiratory techs, ECG techs,
etc., porters, housekeeping, food and nutrition and maintenance. These employees/departments do not
normally or always have access to the patient chart or care plan. They could be instructed through their
department’s violence prevention plan to inquire at the nursing station of any potential threats and
prevention measures or they should be notified before entering the patient’s room.
1. Only staff who are trained and have experience will provide care to known violent patients.
2. All staff who are required to provide care at shift change will:
 Receive an update of patient’s behaviour from staff member of previous shift,
 Review kardex or Patient Horizon Folder to determine the patient’s care plan and identify
triggers of violent behaviour.
3. Two staff members will attend to the patient, if identified as a control in patient Kardex or Care Plan.
4. Some patients are known to be physically violent and departments have secured bite sleeves or
jackets (PPE) that can minimize the injury as the result of this behaviour. If it is identified in a
patient chart or care plan (Kardex), then staff members must wear the protective equipment (PPE).
5. While providing care if patient becomes agitated the staff member will:
 Stop what you are doing, unless emergency care
 Talk to the patient to determine what is wrong
 Attempt to correct the situation, otherwise explain why you cannot
6. If the patient continues to escalate seek assistance (call out) from auxiliary team (co-workers).
Ensure a Team Leader is designated, as only one person should speak with the patient. Continue to
deescalate the situation by being supportive. If the patient threatens the Team Leader than the team
leader will request another co-worker to move into Team Leader position.
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Auxiliary team members (co-workers) will assist by:

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providing assistance as requested by Team Leader, or as obviously needed
assist with removing other patients at risk from the area or stopping others from entering the area
observe the area for safety concerns and if possible, address the concerns and/or remove any
items which could be used as potential weapons
7. If the patient physically act outs, call for auxiliary team and activate the Code White Procedure
(3333), immediately.
8. Code White (refer to section 6, How to obtain assistance):
 Team Leader and Team Members will remain at situation and provide directions, assistance or
information to the Code White Response Team.
 When the Code White Response Team arrives the team leader will give instructions to the Code
White Team (eg: stand-by while attempt to further de-escalate, restrain and what type, the all
clear when event is over, etc.).
 If police were called, provide information to police when they arrive.
9. When the incident is over:
 Seek First Aid, if necessary
 Record information on Kardex,
 Report to supervisor/manager who will investigate the incident and hold debriefings
 Report to SAFE (473-7233)
 Update staff members responsible for patient at shift change.
OUTPATIENT SCENARIO
Several factors that have contributed to situations where a person in the outpatient setting becomes
frustrated, anxious or upset include, but are not limited to: long wait times, being late for an
appointment, were lost and didn’t know where they should be, were provided inadequate information,
couldn’t find adequate parking, or are fearful of the procedure. These situations can easily escalate to
the next level of crisis. Reception staff and registration clerks are usually the first to encounter
potentially aggressive or crisis individuals and are in the best position to deescalate the situation.
1.
2.
3.
During the registration process, registration staff will:
 Monitor the waiting area for increased agitation or aggression
 Monitor the wait times to ensure it is not getting excessive; if it is in excess of xxx
hour/minutes, the registration staff will notify the supervisor/delegate
 If your area has a wait time board, monitor to see if the wait time board is not accurate or
requires updating and advise the person responsible to change.
Using your NVCI skills attempt to deescalate the behavior by being supportive:
i. Remember your body stance, how you are talking to the patient (volume, tone and
rhythm). Don’t sound condescending or impatient. Be alert at all times in case the
patient’s behavior escalates. Refer to section 7 for effective communication tips (verbal
and non-verbal).
Refer all patient inquiries regarding any fast tracking processes to alleviate anxiety for waiting
patients to the supervisor/delegate. (sometimes areas have fast tracking procedures where
patients come in after other and receive tests/care first. Other patients who have been waiting
long get upset/angrier when this occurs – you could consider signage to warn patients.)
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4.
Refer all patient inquiries regarding the enforcement of rules ie: no children/pets permitted,
fasting required for tests, no scent policy, restricted areas, etc to the supervisor/delegate.
10. Registration staff will verbally notify clinicians or techs. of any issues or alerts of aggressive
behavior identified during the registration process (STAR)
DEPARTMENT OF JUSTICE/CORRECTIONS OR POLICE SUPERVISED
PATIENTS
At Capital Health, we often receive patients who are under the direction/supervision of Department of
Justice/Corrections or Police (RCMP or HRM). This does not mean that they will be aggressive or
violent. If patients are presenting through the Department of Justice (Corrections), the patient may be in
restraints. The corrections officer(s) will be present during the procedure and will intervene as required.
They may require assistance or you can assist by removing other persons from the area.
If your department area have special procedures for this include them here.
Auxiliary Team (co-workers) or Team Supports
If a co-worker is meeting or in situations where you identify your co-worker may need support because
the conservation becomes load, there is yelling or screaming, use of offensive language, or loud noises
and you are concerned with your co-workers safety, or want to ensure everything is all right, some of the
following options are available to you:
 Walk by and look in the office if possible (open door or window that is not obscured).
 If the door is closed and you are not able to see in a window, knock on the door and ask a
question that will allow you to check in on your co-worker and could provide the co-worker with
support or an option/distraction to exit, if needed:
o Are we still on for lunch/break?
o Do you know where the xxxx file is? I couldn’t find it, can you show me where it is?
o Where can I find xxxx?
o We have an urgent call at the main desk you need to take?
o If the situation is a crisis, then provide a loud noise to distract the person so your coworker can safely exit.
 providing assistance as requested by your co-worker, or as obviously needed
 assist with removing other patients at risk from the area or stopping others from entering the area
 observe the area for safety concerns and if possible, address the concerns and/or remove any
items which could be used as potential weapons
 Assess the situation and if additional assistance is required
o get the person-in-charge, supervisor or manager
o call out for help
o have someone activate a Code White for your facility, necessary
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SPECIAL PRECAUTIONS FOR STAFF WORKING EVENINGS, NIGHTS AND
WEEKENDS
Include in this section any information that staff should know or must be doing during
these times such as:
 wearing a personal alarm, (also include in the plan somewhere information on the
Peronal alarms, panic buttons, security system, etc.)
 ensure unit/facility remains locked
 restricting their work to specific areas
 using specific traffic routes, exits, entrances, washrooms, etc.
 if a security system is in place and must be activated or deactivated (also include in
the plan somewhere information on the security system)
Sample Scenarios (include info here that staff must or should be doing):
To maintain security and safety of staff, the door to the Unit/facility/waiting room is to remain locked
between the hours of 1800 and 0600. Staff member must have Capital Health ID, FOB or personal codes
to gain entry into the unit/facility. Before entering or exiting check for suspicious activity in the area.
Once inside, lock the door behind you. If during these hours, the door to the unit/facility is open when
you arrive or return and you suspect suspicious activity; you must do a visual inspection to ensure there
is no suspicious activity. If you are concerned about entry, you should call security or police to conduct
a search of the area before entry. If you are concerned, do not enter/exit, wait and contact
police/security. Any compromises in the security of the unit which could result in unsafe activity, must
be reported to the Supervisor, who will follow up on the issues including reminding staff and other
departments to ensure door is closed/locked after 1800. (i.e.: remind staff when they leave the secured
area they must ensure the door is closed behind them. When they return to an open door, this could
possibly mean that an unauthorized individual has gained entry to area).
To ensure safety, staff should make certain that the doors are locked and windows are closed.
To ensure safety of staff there are increased security rounds between 2300-0600.
To ensure safety, all staff members are required to use the elevators or main stairwell during evening,
night and weekend shifts.
When working after hours, you have a concern with your safety or suspicious activity, you can contact
Security to request additional rounds or for an escort (222-6377). In an emergency you should activate a
response by contacting “473-3333” or activating your panic alarm.
For additional information, refer to Section 7, Safety Tips.
Include any other special precautions here.
WORKING IN THE COMMUNITY OR AT A CLIENT’S RESIDENCE
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(Guidelines – review and change accordingly to ensure appropriate for your department/area/facility)
When working off-site you must exercise extra caution. The following preventative measures will be
used to prevent risks associated with working off-site.
1. Only staff members who have received the Community Safe Practice Training Session (mental
health training) and NVCI will be allowed to work in the community. If you have not received this
training inform your manager/supervisor so they may make arrangements for you to attend.
2. All staff will have access to a cell phone. Staff must ensure when required to work off-site that the
cell phone is fully charged and operational. Keep the cell phone in your pocket or on your person so
it is easily accessible. Before entering the residence or meeting place check phone to ensure you
have cell service.
3. This is an example of a check in procedure. All staff are to prepare a daily/weekly work plan and
leave with reception staff or designated individual to ensure contact is available in emergency
situations. Pre-determine check in times may be arranged to ensure the day is going as planned and
everything is ok. If changes to the work plan occur an updated plan will be submitted to the
receptionist or designated individual.
4. All staff will use the established check-in procedures to ensure a timely response in case of
emergency situations.
Refer to Section 7 – Safety Tips for more information.
5. In emergency situations:
a.
b.
c.
d.
e.
Remove yourself from the scene, to a safe place
Contact “911” for emergency assistance
Seek first aid/medical assistance, if required
Contact manager/supervisor, person in charge to report the incident
Call SAFE (473-7233) to document
MEETINGS AND VISITS TO CLIENT’S RESIDENCES
1. Be well prepared for an appointment.
a. Review available information about the individual(s) you are meeting, including the STAR
Alerts and the Patient Chart (HPF) (include here any other sources of information).
b. Schedule known difficult patients during daytime hours when other staff/support are
available, not at the end of the day or end of the week.
c. Arrange the meetings in a public place you are familiar with or a safe environment.
d. If you have any concerns regarding a meeting with a specific individual(s) or a client in their
residence advise your manager/supervisor well in advance of the meeting. The
manager/supervisor will assess the situation and implement preventative measures to reduce
or eliminate the risks, if required.
i. Actions could include: declining care in the residence, scheduling meeting at a CH
facility/site, sending 2 persons.
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2. Before entering a residence or meeting place:
a. Check cell phone for service (dead zones) and keep phone in pocket or on self for easy
access is needed.
b. Do a visual check of the site for safety concerns such as unrestrained pets, suspicious activity
or persons.
c. Visualize ahead of time the appropriate responses to various situations or what you will do if
an individual becomes aggressive.
d. Do Not enter a situation or location where you feel threatened or unsafe, contact your
manager/supervisor immediately.
3. Entering the residence or meeting place;
a. Check for escape routes and position yourself near an escape route or exit.
b. Meet with the person in a common area such as the kitchen or living room. Avoid restricted
access areas such as the basement or rooms that can be locked.
c. Take control of the seating arrangements. If possible seat yourself near the door.
d. Maintain a “reactionary gap” between you and the person – out of reach of the average
person’s kicking or strike distance, if possible.
e. Be alert and aware of your surroundings at all times.
Preparing for a potentially violent meeting
There are times when you may have concerns that a meeting may have negative impact or you know that
you may have meet with a potentially aggressive/violent person. Common situations include:



A meeting providing negative or bad news
Supervisors meeting with staff for corrective actions
Referral and notification that a person is known to be violent
The following provide information on how to prepare for such meetings:
1. Conduct a background check. Check client background information, Check STAR for staff alerts,
the patient/client’s health record/chart, reports from fellow employees. Keep in mind individual
confidentiality and employee safety issues.
2. Arrange the meeting in a room that has an appropriate setup, in case the situation escalates.
a. Consider minimizing the opportunity for physical contact by using wider tables or desks.
b. Arrange furniture to prevent being trapped and to maintain a minimum distance of
approximately 4 to 6 feet between the person and the employee.
c. Minimize the amount of furniture in the room.
d. Provide rolling chair for staff and stationary chair for the person.
e. Assess the room before the meeting and remove, relocate or secure items which could be
used as weapons or projectiles (eg: unsecured chairs, lights, pictures, staplers, pens and
pencils)
3. Consider having two employees meet with the patient/client or co-worker.
4. Arrange to have security (if available) nearby, but not visible, if at all possible.
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5. Notify other staff that trouble may be anticipated.
6. Set up a communication system to use to check on interaction.
7. Establish a recognizable “help” signal to alert other staff members that you need assistance, for
example a special paging code or placing a coloured file folder in a visible location.
Additional Information:
Refer to Safety Tips, Section 7 for more information.
Section 7, Item 1 provides tips for communicating/dealing with a potentially aggressive or violent
person.
Refer to Section 10 for a list of relevant legislation, Capital Health Policies and other sources of
information.
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Workplace Violence, Bullying or Harassing by Capital Health Employees Against
Employees
Although this program deals with physical violence, workplace harassment, bullying and disrespectful
behaviours cannot be excluded as a contributing factor that could increase the risk of physical violence
between employees. Refer to Policy CH 40-085 Harassment (Staff Behaviour) and CH40-106
Respectful Workplace for procedures.
1. Common Characteristics of Violent Incidents Between Employees

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Violence usually begins as a verbal dispute and almost always involves people who know each
other.
Disputes often appear to have relatively trivial causes.
The dispute pattern is usually not random and unique; rather, it builds, intensifies and continues.
Victims may behave in an irritating manner prior to violent incident. Frequently they misjudge
their own ability to arouse hostility in others, and are unaware that they are provoking a serious
response to their behaviour.
2. Warning Signs of a Troubled Employee
It is important to understand that these behaviours do not necessarily predict violence, however they
may indicate that an employee is experiencing periods of high stress. Take note if:
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Crying, sulking or having temper tantrums
Excessive absenteeism or tardiness
Pushing the limits of acceptable conduct, disregarding the safety of co-workers
Increased operating errors
Increasing unsatisfactory work quality
Faulty decision-making
Testing of limits to see how much he or she can get away with
Swearing or emotional language
Making inappropriate statements
Forgetfulness
Inability to focus
Confusion and/or disorientation
Disrespect for authority
Handles criticism poorly
Holds grudges, especially against his or her supervisor. Verbalizes hope that something negative
will happen to the person against whom he or she has the grudge
Refuses to acknowledge job performance problems
Blames others for mistakes
Complains of unfair personal treatment
Is disgruntled more than usual about work and fixates on perceived injustices.
Talks about the same problems repeatedly, without resolving them
Insists that he or she is always right
Misinterprets communication from supervisor or co-workers
Revised: February 14, 2013
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
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Socially isolated
Sudden and/or unpredictable change in energy level
Complains of unusual and/or non-specific illnesses
Shows signs of substance abuse, such as alcohol on the breath
Harassment and bullying (staff against staff) can be a contributing factor that could increase the risk of
physical violence between co-workers.
All Capital health employees have a responsibility to report incidents of harassment and bullying.
Warning signs of harassment and bulling can include but are not limited to:
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Unjust criticism and trivial fault-finding
Belittling a person’s opinions
Intimidation
Any form of communication (works, gestures, e-mails, and/or actions) that embarrasses or
humiliates the person privately or publicly
Unpredictable, explosive outbursts that threaten or intimidate
Rude, abusive and/or sexist language
Fostering rumors, gossip and innuendos about an individual
Practical jokes which repeatedly target a single person
Tampering with someone’s personal belongings or work equipment
Intentionally and repeatedly isolating someone (heckling, failure to listen, refusal to associate,
denying information and assistance when needed)
Making jokes that are obviously offensive” by spoken work or email
Taking credit for another’s ideas or successes
Undermining or deliberately impeding a person’s work
If you are a victim or recognize a potential situation of harassment or bullying:



Discuss concern directly with person believed to be engaging in the inappropriate behavior by telling
him/her to stop unwelcome behavior or conduct. Be specific about the exact behaviour to be
stopped as this ensures the aggressor knows what conduct is unacceptable.
If uncomfortable or unwilling to address the issue with the alleged harasser directly; or if the
behavior continues after discussing the matter, report the problem by “Filing a Complaint”
If at any time the Capital Health Employee’s behaviour becomes physical activate “Code White”.
How to report Workplace Violence, bullying or harassing by Capital Health Employees
“Filing a Complaint” of workplace harassment by one of the following:
1. Advising Immediate Manager/Supervisor or Human Resource Consultant responsible for your
department at 473-5757 (option #4).
2. Reporting to SAFE Line at 473-SAFE (7233).
3. Submitting a report in writing to SAFE, your Manager or Human Resource Consultant as follow
up.
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For complete Policy and Procedure refer to guiding policy; CH 40-085 Harassment (Employee and
Physician Behaviour) and CH - Respectful behaviour
Revised: February 14, 2013
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SECTION 6
HOW TO RESPOND TO WORKPLACE
VIOLENCE
AND
HOW TO OBTAIN ASSISTANCE
HOW TO RESPOND TO WORKPLACE VIOLENCE AND HOW TO OBRAIN
ASSISTANCE
1. Where involved in or encountering aggressive or violent behaviour:





Assess the safety of yourself and others in the area of the incident.
If no immediate danger exists, notify the aggressor that his/her behaviour is unacceptable and
unwelcome. Be specific about the exact behaviour to be stopped as this ensures the aggressor
knows what conduct is unacceptable.
Avoid being placed in a position of unnecessary physical risk.
Remain calm and in a non-confrontation, non-threatening manner try to de-escalate the
situation by being supportive. Refer to Section 7 Safety Tips – Item one for tips on
communicating/dealing with potential violent persons.
Based on the assessment of the situation engage the help of Auxiliary Team (Co-workers)
where possible, activate the panic button or a “Code White – Violent Person” response at any
time.
In health care environments, patients may experience stress and anxiety associated with their illness
and may direct frustration, anger or aggression toward others. These individuals, however, need to
be made aware the violent behavior is not acceptable. Consider the underlying cause behind abusive
behaviour and manage the situation in a professional manner.
2. Code White
If the situation becomes physical or if there is a weapon involved, or the situation is life
threatening, leave the situation immediately and get help as follows:
QEII, Dartmouth General Hospital and Nova Scotia Hospital:

Call the internal emergency number (473-3333) and advise the operator of a “Code White”
event; this activates the Code White response.
All Other Sites and Staff Working in Community Based Settings

Activate the local Emergency “Code White” protocol; where no Code White protocol exists,
notify Police (9-911).
SECTION 7
SAFETY TIPS
1. Tips for Dealing with a Potentially Violent Person
a. Tips for verbal communication:

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







Focus your attention on the person to let them know you are interested in what they have to
say.
Remain calm and try to calm the other person.
Do not allow the other person’s anger to become your anger. Remain professional.
Remain conscious of how you are delivering your words.

Speak slowly, quietly and confidently.

Avoid sounding condescending or inpatient.

Speak simply.

Avoid communicating a lot of technical and complicated information when
emotions are high.
Listen carefully. Do not interrupt or offer unsolicited advice or criticism.
Encourage the person to talk.
Do not tell the person to relax or calm down.
Remain open-minded, objective and non-judgemental.
Use silence as a calming tool.
Acknowledge the person’s feelings. Indicate that you can see he or she is upset.
b. Tips for non-verbal behavior and communication:

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

As soon as you know or recognize you are dealing with a person who is in crisis or a
potentially violent person, you should prepare yourself and adopt non-threatening, nonchallenging, safe stance. Position yourself at a right angle rather than directly in front of the
other person which could be seen as challenging or threatening. Weight bear on both feet in
case you have to move away quickly.
Give the person enough physical space… this varies depending on the individual, but
normally 1 –2 metres is considered an adequate distance. This distance also allows you to
stay out of the strike zone should the person escalate to physically acting out.
Use calm body language – relaxed posture with hands unclenched, attentive expression.
Do not glare or stare, which may be perceived as a challenge.
Arrange yourself so that your exit is not blocked.
Get on the other person’s physical level. If they are seated try kneeling or bending over,
rather than standing over them. Avoid standing directly in front of them.
Do not pose a challenging stance such as:
- Standing directly opposite someone
- Putting your hands on your hips
- Pointing your finger
- Waving your arms
- Crossing your arms
- Hiding your hands, keep them in plain view
Do not make sudden movements that can be seen as threatening.
Do not fight. Walk or run away.
4. Tips for problem solving
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Try to put yourself in the person’s shoes, so that you can better understand how to solve the
problem.
Ask for his or her recommendations.
Repeat back to the person what you feel he or she is asking of you, to clarify what you are
hearing.
Accept criticism in a positive way.
Be honest. DO NOT make false statements or promises you cannot keep.
Be familiar with your organization’s complaint procedures and apply them fairly?
If a patient has an issue that you are unable to assist with direct them to your supervisor/manager
or if required, to the Patient Representative.
Remain professional and take the person seriously.
Be respectful.
Ask for small, specific favours, such as asking the person to move to a quieter area.
Break a problem or an issue down into smaller units and offer step-by-step solutions so that the
person is not overwhelmed by the situation or issue.
Be reassuring and point out choices, including consequences of each choice.
State positive choices before negative.
Try to keep the person’s attention on the issue at hand.
Try to avoid escalating the situation.
Find ways to help the person save face.
Establish ground rules if unreasonable behaviour persists.
In a calm and non-threatening manner, clearly state that violence is unacceptable and will not be
tolerated.
Calmly describe the consequences of violent or aggressive behavior
Suggest alternative to violent behaviour.
Avoid issuing commands and making conditional statements.
If the nature of the situation involves punishment or sanctions (e.g. enforcement); delay the
punitive action until you have backup or the situation is safer.
Do Not;
o Take sides or agree with distortions.
o Reject their person’s demands or position from the start.
o Attempt to bargain with a threatening individual. If necessary terminate the interaction.
o Make promises you cannot keep.
5. Tips for working with patients and their families
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Approach patients and their family members in a non-threatening, respectful manner.
Provide the right information at the right time. Do Not overload patients or family members with
too much medical or technical jargon.
Clearly and fully explain to the patient and/or family, before and during procedures what is
involved, how long it will take and whether it will hurt.
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Review the patient’s profile/chart prior to meeting with the patient and/or family. Take note of
any potential concerns and take appropriate precautionary measure, for example use the buddy
system or increase natural surveillance.
If you feel threatened, Do Not conduct intimate examinations of patients alone. Arrange to have
a colleague in the room or close by.
If a patient resists and becomes hostile during a procedure:
- Stop what you are doing, if possible.
- Ask the patient what is wrong.
- If you can, correct the situation. Otherwise, explain why you cannot.
Open the door during any potentially violent consultation with either the patient or family
member, allowing visual or verbal contact with other staff.
If you are concerned about the actions of a family member:
- Let them know in clear and simple terms what is expected of them.
- If their behaviour continues or escalate, ask them to take a seat in the waiting room.
- Initiate “Code White” procedures for your facility
Record instances of abuse so details are not forgotten when reporting the incident to
supervisor/manager or SAFE.
DO NOT give information to outsiders regarding the condition or status of hospitalized victims
of violence.
Limit information given to outsiders regarding the condition or status of hospitalized victims of
violence.
6. Emergency Preparedness
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Know your emergency exits and procedures, including safe areas of refuge.
Know where your telephones are located.
Know your emergency phone numbers (including for cell phones – have to dial first 3 digits)
Imagine appropriate responses to various situations you may find yourself in.
Decide ahead of time how you will respond to various situations.
7. Trusting your instincts
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Keep personal information at a minimum when talking with anyone who makes you feel
uncomfortable (where you live, hour of work, breaks, vacation times and plans, etc.)
Be aware of your surroundings.
Do Not engage in conversation that makes you feel uncomfortable. Excuse yourself and walk
away.
Be firm and confident and do not permit any kind of harassment.
Be alert for signs of anxiety, anger or hostility. Being supportive, de-escalate arguments
whenever appropriate.
If you feel you are being threatened, intimidated or harassed:
Tell the person to stop
Report the incident to your manager/supervisor
Report any inappropriate behaviour toward yourself or your co-workers to your manager/supervisor
and SAFE (473-7233)
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8. Elevator Safety
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Do Not get on an elevator with anyone who makes you feel uneasy. Wait for the next elevator.
Observe all passengers in elevators.
Board the elevator last and select floor buttons last
Get off the elevator if a suspicious looking person gets on with you.
If possible, stand near the control panel when entering an elevator.
If someone or something makes you feel uncomfortable, push the button for the next floor or
push the alarm
If attacked, push the alarm and as many floor buttons as possible. Keep your back to the
sidewall.
9. Driving Safety
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Keep your car in good repair.
Keep your gas tank at least ½ full.
Always check your tires.
Always have your office keys or car keys ready for quick access to car or building.
Always check the inside of your car (especially the back seat) before entering.
Always check around your vehicle.
Always lock your car even when you are in it.
Plan your route and carry a map. Avoid dangerous areas.
If you need to drive in unfamiliar areas, then do not drive alone if possible.
Do Not pick up hitchhikers.
Go to a service station or store to ask for directions if you get lost.
Carry a cell phone and keep it handy.
Carry a person safety alarm on your key chain. Use it to attract attention, if necessary.
Use your vehicles’ security system, if it has one.
Drive away from anyone who makes your feel uncomfortable.
Avoid eye contact with an aggressive driver.
Stay cool. Do not react to provocation.
Keep away from drivers behaving erratically.
Do Not identify your keys with your car plate number, name or address.
Do Not open your car window more than one inch to speak to someone approaching your car.
If you suspect another care is following you car:
- Note the license plate number of the other car.
- Do Not go home or to your place of business, drive to a service, police or fire station.
- Stay in your car.
- Honk the horn in short repeated blasts until someone helps you.
If your car breaks down:
- Put on your 4-way flashers.
- Stay in the car with windows closed and doors locked.
- Place a “help or call police” sign in the window.
- Do Not raise the hood of your car as it reduces your ability to see someone approaching
the car.
- Only open the window one inch to speak to anyone other than the police.
Revised: February 14, 2013
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Do Not accept unsolicited help. Ask the person to call the police or your towing service.
When help arrives ask for identification.
Make sure someone knows your plans, your route and your estimated arrival time.
10.Parking Lot Safety
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Park near the building in a highly visible and well-lit area.
Park near other vehicles.
Do Not use more than one parking space as it may anger other motorists.
Avoid parking next to vans, pick-ups and other large vehicles.
Use the main entrance. Avoid rear or secluded entrances and exits.
Keep valuables, including purses, out of sight in your car.
Do Not hide a spare key in your car.
If someone is loitering near your vehicle, avoid them and walk to a safe place such as a lighted
store, house or other building. Call police.
As you approach your vehicle, look to see if someone is hiding underneath it.
Scan the area for menacing individuals before you leave your vehicle or your place of business.
Have a back-up plan if there is danger.
Park near the attendant or exit if you use underground parking lots.
11.Walking Safety
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Plan your route and carry a map. Know exactly where you are going.
Familiarize yourself with the area.
Take a taxicab or get a ride with a friend if your place of business is in an unsafe area, or after
dark.
Wear comfortable, flat shoes, such as running shoes.
Scan your route. Be observant and aware of your surroundings.
Walk with confidence
Keep your head up, look around and directly at people to assess them, but do not stare.
Stay on well-lit streets, in the centre of the sidewalk, away from hiding spots such as bushes,
doorways, alleys and park cars. Cross the road if necessary.
If you know you are being followed:
- Walk directly and quickly, without running or looking back, to a safe place.
- Do Not go to your car or your house.
- Call 911.
If someone approaches you, say “no thank you” in a strong voice and keep moving.
Walk around groups of people rather than through them.
Use the main entrance of your place of business as much as possible. Avoid rear or secluded
entrances.
If you are using a stairwell, be sure it is well lit and that you can quickly exit to a safe place.
Trust your instincts when you feel something is not right.
Do Not act lost or be obvious when using a map.
Do Not reduce your ability to be prepared:
- By digging in your purse.
- Wearing headphones.
- Carrying heavy briefcases or items.
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Do Not carry any type of weapon, including pepper spray. Weapons can just as easily be used
against you.
Secure packages by carrying them under your arm or with straps across you body.
Carry a person safety alarm:
- On your key ring
- Pinned to your clothing
Report any suspicious incidents to your manager/supervisor, security (if on-site).
SECTION 8
HOW TO REPORT AND DOCUMENT
WORKPLACE VIOLENCE
Revised: February 14, 2013
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HOW TO REPORT AND DOCUMENT WORKPLACE VIOLENCE
Reporting all potential acts and acts of violent behaviour (verbal, physical, threats or conduct or
behavior to give staff reason to believe they are at risk for physical violence) is the responsibility of all
employees. As soon as possible after event:
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Seek First Aid/Medical Attention, if required
Contact Manager/Supervisor to report incident (or for harassment, contact the Human Resource
Consultant responsible for your department at 473-5757, choose option #4)
Contact SAFE (473-7233) to document
If your manager/supervisor or the SAFE Operator is not available leave a message indicating: your
name, your contact phone number and a brief description of the event.
For complete Policy and Procedure refer to guiding policies:
CH 80-095 Violent Behaviour by Patients or Visitors
CH 80-022 Reporting Workplace Injury/Illness
CH40-085 Harassment Employee and Physician Behaviour
SECTION 9
Conducting a Review of the Violence Risk Assessment and Violence
Prevention Plan
a. The Violence Prevention Program will be reviewed by Safety Programs Department in
consultations with the Joint Occupational Health and Safety Policy Committee.
b. Directors/Managers/Supervisors will review and update their area Risk Assessments accordingly
in any of the following circumstances:
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You become aware of a type of violence occurring in similar workplaces that was not taken
into consideration when the previous violence risk assessment was conducted
There is significant change in any of the following:
- circumstances in which work takes place;
- in the interactions that occur in the course of performing work;
- the physical location or layout of the workplace;
- construction of a new facility or renovation
An investigation identifies deficiencies in the assessment or plan.
An employee reports deficiencies or offers input for improvement of the assessment or plan.
The employer is ordered to do so by an officer of the Department of Labour and Workforce
At least every 5 years
c. Directors/Managers/Supervisors will review and update their Workplace Violence Prevention
Plans if:
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review of the Violence Risk Assessment identifies a need
SECTION 10: Additional Resources
Legislation
Occupational Health and Safety Act, 1996
Violence in the Workplace Regulations, N.S. Reg. 209/2007)
Capital Health Policies
The policies can be accessed by following the link below (CTRL and Click on link) then typing or
cutting and pasting the policy name in the keyword field. Click on Go.
http://policy.nshealth.ca/Site_Published/dha9/policy_search.aspx
CH 80-095
CH 40-085
CH 80-022
CC 05-030
CH100-065
CH 80-090
CH80-091
CH 100-035
CH 40-106
CH 40-115
CH 80-023
CH 40-045
CH 80-045
Violent Behavior Against Employees by Patients, Visitors and Employees
Harassment (Employee and Physician Behavior
Employee Hazards and Incidents: Reporting, Investigating and Documentation
Least Restraint
Interacting with Law Enforcement Agencies
Drugs and Alcohol In the Workplace
Intoxicated Persons
Patient Safety Reporting System
Respectful Workplace
Employee Assistance Program (EAP)
Employee Emergency/First Aid Treatment
Corrective Action
Refusal to Work Situation
Forms
Violence in the Workplace Risk Assessment Form
http://chdintra.cdha.nshealth.ca/departmentservices/peopleServices/wellnessAndSafety/safety/violence/i
ndex.html)
Violence Prevention Plan – Sample:
http://chdintra.cdha.nshealth.ca/departmentservices/peopleServices/wellnessAndSafety/safety/violence/i
ndex.html)
Other
A Guide to CH’s Workplace Violence Prevention Program, Violence Risk Assessment Form, Sample
Violence Prevention Plan and other resources are available at:
http://chdintra.cdha.nshealth.ca/departmentservices/peopleServices/wellnessAndSafety/safety/violence/i
ndex.html)
General Power Point Presentation from Safety Programs – Violence in the Workplace
(Standard Violence Training Presentation )