Healthcare Worker Violence-With @the.nurse.erica

Transcript

0:00

High rates of workplace violence. Thanks for joining us. I'm Rod Carter. I'm Angela Taylor. Sadly, the problem worsened during the pandemic. Just yesterday, two health care workers were shot and killed in a Dallas hospital. And over the summer, a Duke Hospital nurse here in Raleigh was assaulted by a patient Hospital administrators I spoke to say this is not a new problem, but it is getting worse. That's why they're looking at everything from new warning signs at hospital entrances to updating screening programs. I've had people reach out to me and say, I want to get out of health care. Or should I get out of health care? What are my options? This really rocked my world when I've had medical students. Reach out to me and say, I don't think I want to do this anymore, but violence is becoming evidently a tipping point where people tell me, well, they put up with the other travails of our current health care workplace, but when they were assaulted, or their family member, their spouse was assaulted, who's also healthcare worker all this seems to be that's a bridge too far. I've had enough. I want to leave. ER nurses make up 50 percent of all workplace assault victims. The Emergency Nurses Association or E N A says most nurses felt that rate increased during the pandemic. The ENA joined Wisconsin Senator Tammy Baldwin to promote legislation, protecting healthcare and social services employees from violence senator Baldwin says the legislation is long overdue. It's such a regular occurrence. It's, it's horrible to say, but it's such a regular occurrence that work doesn't feel safe. that should never be, the case, especially for a workforce that is committed to helping heal and treat. The bill already passed the House. Senator Baldwin says she's bringing the bill to the Senate floor this week. Deal with it. Period. How did we even get there? that's the piece that's missing for me. how we even got there that this event could even happen, if it was back where I used to work and there was a locked unit, I could understand that. But the med surgeons Why can they not hire security to be in the room? If you want to admit the patient for some type of MI evaluation and you don't feel safe enough transferring them, then maybe that's something that needs to be enacted. there needs to be some, policy that states if somebody is threatening physical violence or seems mentally unstable and you cannot transfer them out. that just has to happen. Because, I'm sorry, a little CNA sitter, sitting in the room, isn't gonna be able to do shit. If this man just starts going off the hinges, what good is that gonna do? Welcome to pulse check, Wisconsin. Good morning, good evening, good afternoon, whatever it is for you. This is Dr. Ford with Pulse Check Wisconsin, and I wanted to thank you for joining us here today. We have a very special episode here, uh, with one of our experts, nurse Erica, who will be sharing with us some of the work that she's doing around the topic of discussion today, which is healthcare worker violence, as we've seen in recent years. There has been a surge in healthcare worker violence, and we really saw, uh, it surge during and after the pandemic. Here in the state of Wisconsin, we've seen in the media healthcare worker violence in which. Nurses have been affected, techs have been affected, doctors have been assaulted uh, and in Chicago, as we all know. We saw where there was a physician who was almost fatally wounded from healthcare worker violence. What we know by the numbers is healthcare worker violence not only affects the healthcare workers themselves, going to work every day trying to protect themselves, wondering if anyone will attack them today. But also the psychology of what's going on Healthcare workers are afraid to go to work. I work with many people who have been assaulted. I myself have been assaulted. I don't know anyone in my own personal network that has not, that works in emergency medicine or works in the hospital systems. Because of that, there has been a lot of. Talk about this issue. There has been some federal legislation, as you heard from the intro about how we better protect healthcare workers. However, as you also heard, it's state by state, right? So a lot of states will have some. Legislation in place that will force the hands of some healthcare systems to provide certain securities, to have cameras available, to have body cams in some places. All these things that are in place and some hospital systems don't to be frank, and that allows for these violent acts to take place. Now, what does that do? Well, as nurse Erica will talk to us about here in the interview, I won't get every, everything away, but this has long standing and long-term effects on healthcare in general. You're gonna have more people who are gonna be unwilling to take care of patients, so people not going into the healthcare fields, you're gonna have people who are going to burn out. As we talked about with Dr. Ferguson in our previous. Interview, uh, healthcare burnout is a reality, and if you have this trauma squared around the healthcare experience, you're gonna have a lot of people who don't want to come back to the hospital systems anymore. And that in itself is not only an issue for healthcare providers. But it's a issue for all of us, right? You're gonna have less people willing to take care of you in the hospital, which means you're gonna have longer hospital waits. Your quality of care is gonna go down because people are going to be guarded when they're taking care of you. You're gonna have people who aren't thinking clearly when they're making medical decisions'cause they don't know if somebody's gonna assault them or they just have been assaulted. I can't tell you how many people I know that had been assaulted at the beginning of their shift and then had to continue on with the shift. Seeing patients still. In very high intensity situations. So this is an issue that I'm really excited to break down. Really excited to get into. So happy that we have Nurse Erica here with us. So with that being said, go ahead and sit back and we wanna welcome Nurse Erica

Chris: 7:14

We have nurse erica here with us Uh, thank you so much for being with us a lot of my colleagues hipped me to your instagram page and all the videos all the things that you're doing all the amazing things in health care But for those listeners that may not be as familiar with you Can you give us a little bit of information about yourself?

Erica: 7:29

Say I've been working in nursing since the Jurassic era, since right out of high school as a CNA and then eventually RN. Added some alphabet soup behind my name along the way, lots of certifications. My background is primarily pediatrics, pediatric oncology, everything peds related. Uh, and then I eventually transitioned into management and leadership. And from there transitioned into hospice with a focus in pediatric hospice.

Chris: 8:00

Awesome. And so, you know, a lot of your advocacy and a lot of things that we're seeing coming out of your content that you're putting out is really based in that, you know, all those things that you just talked about, right? Experiences and different facets of nursing, which is, you know, why I tell my nursing colleagues all the time, I'm really envious of you guys to be able to jump from place to place to place, but it really provides you a different context and a different perspective of healthcare, especially when it comes to some of the issues that we're going to talk about today.

Erica: 8:28

Yeah, absolutely.

Chris: 8:29

One of the, we talked about before, one of the things that, that I really became knowledgeable about your, your work and your content was about an incident that we had here in the state of Wisconsin, one of our hospitals in Menomonee Falls, where unfortunately it was a nurse and a staff member that was assaulted. Uh, by a patient, not even a patient, it was a patient visitor at that time. A lot of the content that I saw from you was just about your call to action for things that we need to do with healthcare worker related violence. Why do you think? Why do you think violence against healthcare workers is so prevalent in your experience as a nurse?

Erica: 9:02

That's a great question. The obvious answer is that patients and their families are dealing with the unbelievable, right? The unimaginable. And the stress level is through the roof and, you know, nurses, because I see everything through a nursing lens, of course. We are the ones that are there primarily at the bedside disproportionately more than any of the other health care workers. And so we bear the brunt of that. Certainly COVID did not help I think there remains now still a lot of animosity from, from certain parts of the public that I think, We were out to get them, that we were forcing a vaccine on them, that it's our fault that they couldn't come and be with their loved one, end of life, all these things. We have really been villainized since the pandemic and that unfortunately persists.

Chris: 9:54

Yeah, you know, I always joke with some of my colleagues and say, you know, wasn't it a good week when we were heroes and the healthcare workers, right? It was a great week, right? You know, we got, we got free pizza. It was good, man. It was like, it was good, but I mean, you know,

Erica: 10:08

it was lovely.

Chris: 10:10

Exactly. Right. You know, and you're exactly right. You know, that, that is kind of when I felt that my own personal, uh, experiences with healthcare violence and, and patient interactions, you know, unfortunately, especially the pandemic was very politicized and, you know, a lot of sentiments came out of that. And even to this day, you know, I, we, we get told by some patients, I had a patient interaction the other day that said, you know, how much are you getting paid every time you diagnose me with COVID or with flu, right. And it's like, Uh, you know, I don't know how you can get through to that, so yeah.

Erica: 10:40

There's a certain level of ignorance you're never going to overcome.

Chris: 10:43

One of the things that, so a lot of these questions were brought up by colleagues of mine and I asked them to send in questions because, you know, they're, like I said, we're all huge fans of yours and, and they wanted to ask, directly to the source. Just for some of our listeners here, what are some of the most common types of violence that nurses experience and healthcare workers experience in the workplace?

Erica: 11:02

Yeah, um, it's everything from verbal, you know, that is actually a very overlooked form of violence. Verbal threats, threats going so far as. I'm gonna look you up on the board of nursing website. I'm gonna find your address I'm gonna follow you home and that has happened and then it's it's things like spitting slapping sexual grabbing Inappropriately hot coffee that's happened a lot the burning hot coffee and they throw it In a healthcare worker's face, you know, strangulation, assault, absolutely, no one wants to hear it, but homicide and rape does, in fact, happen in healthcare settings against healthcare workers. And then one that is really overlooked is bodily fluids. That are weaponized against healthcare and, and in my opinion, that absolutely needs to be added to legislation as a form of a weapon. When someone is, is dangling their, their urinal, whatever it may be, any type of bodily fluid in front of you, and they may or may not have some sort of a, you know, bloodborne disease that we could contract. And they are actively, like, threatening to throw it on us, and do, and do, you know, that's a weapon. But yeah, homicide, rape, one of the worst cases I ever covered had to do with a nurse being raped in the hospital.

Chris: 12:33

These are the things that it really hits home when I have these conversations with people who don't work in healthcare like we do, and don't see it as often as we do. But if you remove the hospital from these situations, right? Like if you were out at McDonald's or out at a restaurant or out at the mall and someone did these things to you, somebody threw a bodily fluid on you. You know, that would in some cases if they had a communicable disease that's bioterrorism, right? Like these are things that that would be covered under the law but like you said Oh, these these are things that kind of are under the shroud of secrecy and dismissals in the in the hospital setting

Erica: 13:09

yeah, I mean think about just flying on a plane if you were to do just a Fraction of any of this or even the threat of doing any of

Chris: 13:19

this

Erica: 13:20

Immediately, you would be kicked off the plane, you would be arrested. Right?

Chris: 13:24

Mhm.

Erica: 13:24

Literally in every other setting, profession, anything. There are more protections than in healthcare. You go to the library and you go through a metal detector often into a show without Disneyland, the happiest place on earth has metal detectors, right? But we don't

Chris: 13:44

Mickey ain't playing. Mickey ain't playing.

Erica: 13:45

Good. And he shouldn't.

Chris: 13:48

You know, one of the things that we talk about all the time, because I have practiced long enough now that I've seen the entirety of some nurses careers. And unfortunately, in some cases, you know, it's from the start to the end of that career because of, some of the things that we talked about here, some of the stressors outside of the administrative or even the burnout from the psychological aspect of carrying these burdens of all the things that you're seeing. But also. Because of this workplace violence, how has the rise of violence in the workplace in health care impacted nurse retention and burnout in your estimation?

Erica: 14:21

Yeah, well, let's let's start with the term burnout because we're not burned out necessarily We are exploited especially as nurses burnout implies that it's our fault That that we have some sort of you know responsibility in that right? Nurses leaving the profession, for example, when you talk about retention, that's just us finally having healthy boundaries.

Chris: 14:48

And it's taken

Erica: 14:49

us generations to get to this point. What other profession would you criticize for having healthy boundaries? None. None. You know. Moral injury, okay? No one talks about that, or they don't talk about it enough. But the fact is that when you suffer from moral injury long enough, it, it greatly diminishes your ability to be compassionate, right? Towards our patients, you know towards each other last time. I checked I believe the stat was 1 in 18 new nurses Contemplate suicide their first year.

Chris: 15:24

Oh my gosh,

Erica: 15:24

and a big part of that is workplace violence It's not all about but a big part of it is and I don't know if you Recall or if you had a chance to read a letter to my abuser written by an ED nurse A couple years ago, Tristan Kate Smith, who sadly took her own life and left behind a very well written letter from a nurse's perspective. And one of the big components of it was workplace violence and how hospitals simply won't do anything to protect us.

Chris: 15:56

Yeah. And it's sad. Like you said, it's an entire generation that is affected. And even if you get out of the nursing profession. A lot of folks don't understand that this is something that you're going to carry with you for a lifetime. This is PTSD, right? We'll call it what it is, right? And you know, if this was a, if this was an interpersonal relationship, this would be an abusive relationship in some, in some instances, some of the situations that you're being placed in.

Erica: 16:21

Lots of correlations there. We have kids together. I have to do it for the patients.

Chris: 16:27

Mm hmm. He didn't

Erica: 16:28

mean it. The hospital cares about me. One, once I get a plan in place, then I'll leave. Well, I need this job. You know, it's really the same thing when you think about it.

Chris: 16:42

It's interesting. We had a doctor on the very beginning of the second season, Dr. Jane Morgan. She's a cardiologist out of Atlanta. And she spoke to some of that similar thought process in physicians, specifically in African American physicians as well. When she talked about, you know, You're staying in it, but maybe you're staying in it too long, right? Because what are the patients going to do without me? What was the community going to do without me here? And then you stay in a bad situation too long until the point where you get, you know, an incident like this that occurs. And again, it just has downstream effects with your work life, with your interpersonal life. And then in going forward too, right?

Erica: 17:17

Very true.

Chris: 17:19

So one of the things that I recently spoke to a colleague about who I witnessed an incident that occurred with them. was reporting, right? As we know, it's been publicized recently. There's a lot of federal statutes and they're state by state statutes on the books now for healthcare worker violence and some of the punishments that are associated with patients who will perpetrate this. What are some of the barriers and are there any barriers as you and I both know there are but for our listeners Are there any barriers for reporting incidences of violence and how can those be addressed?

Erica: 17:52

Definitely. I will say the biggest barrier from a nursing perspective is retaliation. You are almost guaranteed You know, there's some outliers There are some good employers but by and large you are almost guaranteed to if you do report things to be the victim of Victim blaming and or retaliation from your job. They actively, like, aggressively discourage us from filing police reports, oftentimes. Incident reports, and you know, it's, it's so common that it's almost a cliche at this point. But when nurses are assaulted, the one thing that they are asked time and again is what could you have done differently? That's the epitome of victim blaming, right? So I challenge not just nurses, but all healthcare workers. When you are asked that, flip the script, flip the table on them and say, What could you have done differently to protect your staff? What could you have done differently to provide the safe working conditions that you're required to do?

Chris: 18:58

Damn. And same way, right? Like we, we had on a group of sane nurses that came on and talked about some of the resources that were available in Milwaukee. And one of the things that they talked about was when they initially speak to a patient who has had this assault or has had this trauma. They create the feel of this is not your fault, right? Like you did nothing to deserve this. How can we move forward to help get you out? Right. And so it's so, you know, the contrast of that, like you said, you know, I have heard that personally in instances where I've been assaulted in the past and you know, you're right on. And by saying, you know, that, that whole ideology is flipped.

Erica: 19:35

Yeah, yeah, it really is pervasive, the retaliation. So often, if you, for example, are injured, you need to take time off. Well then, they find that, they use that as an excuse to ultimately terminate you. You've missed too much work. Yeah, I've missed work because I was injured at work, where you refused to do anything to protect employees, you know. Or they just start writing. Healthcare workers up, making their, their work environment so miserable that they eventually quit, the retaliation is out of control.

Chris: 20:08

And, you know, one of the questions that was brought up by a good friend of mine who is a nurse here was, you know, how, how can you hold, how can healthcare workers hold their administrators accountable? You spoke to that, you know, kind of flip it on there, but What are other ways to hold them accountable when they fail to support, you know, filing charges against individuals who harm us or taking it to that next level?

Erica: 20:28

You have always got to be working on your paper trail. You have just the same way that we document to CYA. Right. We have to be doing the same thing to document as in a paper trail so that we can prove that these things happen, right? Because the reality is that reporting unsafe working conditions or safety concerns is considered a protected act. So any retaliation for that. is absolutely illegal, you can immediately report that to the NLRB and to OSHA. But can you prove it?

Chris: 21:04

And

Erica: 21:04

most of the time, they can't. They don't have a paper trail. They had all these verbal interactions. They didn't fill out an incident report. They didn't file a police report. They didn't send summary emails. They can tell you all about it, and we know they're telling the truth. But legally, they can't prove it. So you need to always be creating a paper trail, and I always tell everyone, keep copies of it at home. Don't keep it in your work email, because if and when they Terminate you, you're locked out of that email before you even know that they're going to. So make sure you have copies at home printed of everything. Get witness statements from anyone that witnessed anything. Send the summary emails. I just wanted to follow up on our conversation this morning in your office where I relayed these following concerns and you responded with. Now is there. An inherent risk that the manager whomever is going to recognize that as oh shit. They're trying to create a paper trail That they they know what's up. Sure, but What what's the alternative to do nothing?

Chris: 22:09

Right,

Erica: 22:10

you know,

Chris: 22:10

right, right, you know It's so interesting to me too that in some cases that's seen as like a negative, right? Like so like you said if someone that you spoke to who's a superior It's now looking at you a certain way because you're keeping a paper truck. I mean, if you get assaulted on the street, a police officer is going to file a report. They got a stack of paperwork this this heavy. Right. So I don't understand like that disconnect. Like I said, I've been through it. My I've had friends of mine that have been through it as well. But it is that disconnect between administrators and those individuals who are in charge of taking it to the next step. But you got to protect, like you say, you got to cover your ass, CYA, right? You got to, you got to protect yourself and you have to be your own advocate in those situations.

Erica: 22:52

Absolutely.

Chris: 22:53

How can nurses protect themselves from retaliation, from that retaliation, when they're speaking out against those unsafe work environments?

Erica: 23:00

It really does come down to the paper trail. Again, you have to be able to prove it, you know, and people think that retaliation only is like termination. Like I was assaulted and then no, if you look it up, the retaliation takes numerous forms and this is spelled out in federal legislation, you know, so it can be. A change in schedule. Sudden, suddenly you're switched to night shift. Suddenly you're no longer given your charge nurse positions with the differential. Suddenly you are being scrutinized for your time in attendance when you never were before, you know, it can take all manner. Of different forms, but you have to be able to prove it, you know, do a timeline, like a, if you think you're being retaliated against, do a bare bones timeline, this date, I was assaulted, this date, I reported it, this date, two weeks later, called to HR, this date, one week following, put on performance improvement plan, this date, one month later, terminated, like show the trajectory with the bare bones outline, you know,

Chris: 24:11

Mm hmm. In instances that you have seen be successful, if you've seen some nurses speak out and have been successful at it, what, what legal avenues were taken? Is it strictly through the hospital, through like the HR department, through wherever? How would you recommend nurses go about it?

Erica: 24:28

Lawyer up. And, you know, people hear that and they tune out and they say, I can't do that. I can't afford that. Well, you know what? I've done it. And I was a single mom most of my kid's life. I couldn't afford it either, but I did it anyway. Because sometimes there's a greater good involved.

Chris: 24:43

Yeah. Yeah.

Erica: 24:45

Go see the employment attorneys. Most of them will have free consultations. Go see two or three of them. And tell them what happened and then say, Do I have a case? And if so, is this a case you would be willing to take? And get get the feedback from them

Chris: 25:01

in my experience, you know Those lawyers will tell you the same thing that erica's telling you right now. Make sure you have that paper trail Yeah, right and a lot of those lawyers are going to request that paper trail as well So they can have that documentation they can go back and then they can advocate for you on your behalf Because you know on top of all those things like you said erica like you you were a single mom You you're working full time at that point in time, right? And so you have all these things that are going on Why not get someone else involved who can take it the next step and to advocate for you in that, right? So one of the things I paid a clip before before this this episode about Some of the new federal and state laws that currently exist to protect nurses from from workplace violence What are some of the ones that you've seen work and not work in recent years?

Erica: 25:46

Well, I want to start with, we all need to support a pending legislation. It's, uh, Workplace Violence Prevention for Healthcare and Social Service Workers Act. It's a mouthful. Um, but this is, you know, gets reintroduced every, every congressional session, unfortunately, and they, Typically don't even vote on it and it dies and then it has to get reintroduced with the next, um, session, but we need to get federal legislation passed because right now we have all the states working in a silo, right? And I think about 29 have laws saying that it's a felony to assault a healthcare worker. However, The vast majority of them have carve outs with exceptions for anything that they could possibly construe as like an intellectual disability or mental health, you know, anything. And they do. They do. And so, even the ones that have it, don't. Effectively have it, you know, Ohio recently passed some, some legislation for workplace safety. A lot of the states claim that they have laws, but what it comes down to is they'll have like a guidance or a statement, you know, or, or something minuscule that says, okay, well, the employer is required to report these incidents to OSHA within these timeframes. Okay, great. But what's that doing to help me now? You know what I mean? So we in my opinion, it needs to be a felony There are some people that disagree with that and they say, you know, we need to focus on prevention I think we need to do both Knowing that it's a felony Nationwide is would absolutely be a deterrent to a lot of this, you know Just like they're not going to do that to a cop because they know it's going to come down so hard on them Right. It needs to be the same for frontline health care workers So we, we need to focus on federal legislation, not just state by state. It needs to stop having so many exceptions because let, let's be real. We're not trying to put 90 year old meemaw with Lewy body dementia in prison. Be so for real. I, you know, we can look at these things objectively. Okay. But we also know that a lot of the quote unquote psych patients or whatever other category you want to put them in these patients. know exactly what they're doing. And just because you have a mental health diagnosis does not automatically negate you from knowing right and wrong. I mean, I have personally looked in the eyes of someone before they assault a healthcare worker and they intentionally did it and they knew what they were doing regardless of their diagnosis.

Chris: 28:33

Mm hmm. And like you said, you know, if it happened to a police officer, that mental health ringer doesn't come into play. I can tell you, you know, and there's Eric in the same situation. I can tell you when I've done medical clearances for patients, a good number of those patients that come into the department who are under police custody. Have some form of mental health disorder. I have seen them personally, I can tell you from their charts, you know, and, and, and it, it, it should not have that exception in those cases because it's not going to deter it in the future. It's gonna continue to happen.

Erica: 29:03

Yeah. And we need, we need district attorneys that are willing to prosecute these cases, you know, because that's one of the big excuses that healthcare workers have for not reporting it, is they've all heard stories of another healthcare worker that has reported it and then. they drop the charges. Well, that's a fight we need to fight, but you still need to do your part. We cannot control what a DA decides to do. But we can report it, we can create the tracking mechanism to show that this, you know, Community Hospital A has had a disproportionate amount of acts of violence against its employees in the last year, whatever, you know, it makes it trackable, we can quantify it, right? We can only control what we can control, so. File those police reports. It is your right, regardless of what they tell you. And regardless of what a district attorney's office may or may not do. And another big excuse that we have is sometimes they require you to put your home address on a police report. And then the fear is that this violent person is going to come after you. And that there has been cases of that. List your work address, the hospital address, the employer's address. It's not that hard, you

Chris: 30:21

know And you know, I would take it a step forward and say like any medical documentation like for your licensing, etc Etc. If they allow you to list your hospital location Definitely do that.

Erica: 30:34

There are some state boards of nursing that require that your address be listed publicly. Which is insane, right? Absolutely insane. And then you couple that with the quote unquote Cures Act, where they claim that we're required to have our last name on our badge, which we're really not, but they try to enforce that. And so it's so easy. You have the full name. You go to the Board of Nursing website, you find their home address. Like, it's the easiest thing in the world. Those states, if you live in one of those states, please get a P. O. box. Please get a P. O. box. Do not have your home address listed anywhere.

Chris: 31:08

Absolutely. So let, let's turn it on the hospitals now, right? So let's say if there are laws on the books right now to protect us, are there any specific laws that require now the hospitals to implement violence per violence prevention programs for nurses?

Erica: 31:24

Not really. The federal legislation that I mentioned earlier would mandate across the nation that health care employers have and implement workplace violence prevention plans, and they would be accountable to federal OSHA for that. So again, right now it's kind of state by state. Some states do a little more than others, but in general, it's weak.

Chris: 31:50

And I don't know, you probably got the same module, Erica. We've gotten them probably every year since my residency. Right. Uh, you know, how to deescalate a situation, you know, what, what parameters to take, what steps to take with somebody to assault. Do you mean, you mean those aren't effective enough, Erica, that you're telling us?

Erica: 32:06

Yeah. Yeah. You know, and when the most egregious thing is after there is an incident and someone's injured, then they will assign extra health stream modules or whatever. Like, like it's almost a punishment. Those are not doing, first of all, we're clicking through it because we don't have time to do it. So no one's reading it. We gotta

Chris: 32:24

be patient.

Erica: 32:24

Like, let's be real, you know, but that is almost another form of victim blaming because then they can come back to you and say, well, did you use your CPI training? Did you use your de escalation techniques that we provided to you as an organization? It's a way to put the blame on the health care worker.

Chris: 32:44

Yeah. Yeah. You know, one of the things that, that is a question that came up from one of my nurse friends from, from like residency and she's been a nurse for about 15 years now and you know, she had a situation that she went through where she was attacked and went through the avenues and felt as though she was being, again, you know, victim blamed in the situation and that even for speaking up, that her job was on the line in that case, right? I've heard of other nurses as well over the years being pushed out of jobs or having their careers threatened for speaking out. What advice do you have for nurses who experience work based retaliation?

Erica: 33:21

Paper trail again. I hate to be repetitive, but I mean it is so important. You have to always be thinking in that way and also, you know, I can't say enough. Courage is so important, right? Nurses. I have a tendency to be very apathetic and they hate when I say that, but it's true. We have been born and bred through generations of nursing to be that way. You have to have the courage to do the right thing and not just have all the excuses because if I can do it, you can do it too. You know, you can do the hard things. You can do the scary things. Yes. It comes with inherent risk. Yes. You could experience retaliation. But that should not stop you from doing the scary thing that has a risk because we know it's the right thing to do. And the thing is, nothing's going to change, right? Like disruption is what catalyzes change.

Chris: 34:16

So

Erica: 34:16

if you are not willing to be the disruptor, to put the things in writing, to report the things, to hold employers accountable, Then you can expect no change and you have yourself to blame.

Chris: 34:32

Yeah, and you know, I I will I will Push back a little bit on that too because this is a question that came directly from another friend of mine That said you you know nurse erica has been such a fearless advocate in this space Could you ask her how does she manage to stay employed while speaking out

Erica: 34:47

I've been i've been terminated For being vocal. I absolutely have, more than once. It has happened to me before I ever started on social media when I was a bedside nurse. That happened to me for simply doing the right thing. For following hospital policy, for being vocal about it, for reporting things. I've been terminated. I fought back and I won. It was not an easy fight or a quick fight. But you can do the hard things, as I said. But it has also happened to me since I have started with this platform for the past like six years and where I have been terminated from a job because of how outspoken I am. And uh, you know, it's kind of one of my goals is to normalize that because retaliation is so prevalent, especially in nursing. And there's a lot of shame attached to that. So you almost never hear a nurse say they reported me to the board of nursing or they terminated me even when they know they did nothing wrong. Because there's so much shame attached to it. We need to normalize that. We need to get that out in the open and start talking about it. I did nothing wrong. I was retaliated against. I was terminated. Say it like, say it, you know? But yeah, um, I, it does not escape my attention that I have effectively painted myself into a corner. Where I'm not rehirable as a nurse at this point. I am still working, knock on wood. God forbid something happens with my current job. Because who in their right mind is gonna hire Nurse Erika? You know what I mean? So my I'll hire

Chris: 36:23

you Erika if I had a hospital. They don't allow us to own hospitals anymore.

Erica: 36:29

But you know what I'm saying? Like my advocacy has absolutely cost me professionally. I never knew that it was gonna go this far. This, my platform, this was never a plan of mine. Um, you know, had I known that me being vocal on this level would mean I could never be a bedside nurse again, I probably wouldn't have done it. Like that really kind of breaks my heart, you know, as much as I don't want to go back to bedside, the fact that I can't. Breaks my heart, you know, um, so I've actually paid the price professionally for this.

Chris: 37:02

Which is just unfortunate, right? Especially, like you said, just for doing the right thing, for advocating for safety in the workplace. No one should have to go to work and, and think to themselves, is this going to be the last time I'm going to see my family? Is this going to be the last time I'm going to be able to do this work? Am I going to get injured to the point where I'm unable to do my job day to day? My dad was a firefighter growing up. Um, and you know, before every shift he would like hug us and kiss us and, you know, because again, you know, it comes with that, you know, you don't know if you're going to come home and, I've found myself in recent years doing the same thing with my kids, right? And it's just unfortunate that that's kind of where we are. In a situation that, this is supposed to be an environment that is a safe place. People come to our hospitals when they are in violent situations or being assaulted out in the community for care, for safety. And here we are, we can't even guarantee it in some instances in our own environments. Have you seen? Any Hospitals get it right. Have you seen any states get it right? Have you seen any successful policies or practices that protect nurses and other health care staff?

Erica: 38:09

You know, I think wisconsin from what I understand is doing something Right, they have made it a felony to assault a health care worker they face. I believe it's up to six years In prison. Even shorter. Shout out

Chris: 38:20

Tammy Baldwin, our senator.

Erica: 38:22

My understanding is that to even threaten a health care worker comes with. Up to six years in prison. So shout out Wisconsin, you know, I hear from nurses a lot that claim their hospital, their employer is doing the right thing. And then I always say, great. Tell me what they're doing. Well, they put in a metal detector. They put in a metal detector. Oh yeah. And they go through that

Chris: 38:50

door. Yeah.

Erica: 38:51

Right. Because the average hospital has something like seven. You know public entrances. So what good is that one in the ED doing? It's not, you know Don't come and tell me that your employer is doing the right thing unless you can tell me that there is a metal detector That is manned 24 7 at every single public entrance, right? Don't tell me your employer is doing the right thing unless you can tell me that you have armed security At your facility that are allowed to touch patients because believe it or not There's a lot of places that have ridiculous policies preventing public safety or security from even physically touching the patient. They're useless

Chris: 39:34

Absolutely

Erica: 39:35

useless, you know Don't tell me your employer is doing the right thing unless you are actively encouraged To file police reports and you are supported and you have security Outside of the ed because let's be real in the last couple years The big horrible incidents weren't even in the ed. They've been primarily in labor and delivery units for god's sake like no one is safe You know, so i'm sure there are some outliers That are doing it right. I honestly could not give you a name though.

Chris: 40:08

Yeah, that's fair. And that's fair. And you know, like you said, it boggles the mind that some of these environments, especially, like you said, when we have such lax, in some states, parameters around patients and in them coming to the hospital and being able to essentially do whatever they want in some cases, right? If you go to You know, let's say a lock facility. If you go to a prison, right, where it is expected that, you know, there's going to be a fully maximum security effort. If you go to the police station, there's going to be a metal detector. If you go to a lot of these places, even if you go, I went to Costco the other day, there was a metal detector at Costco, right? So it's like, what, why aren't we carrying through? And some of it has to do with like the press Ganey. And we can go an hour and a half about that conversation. And about for our listeners is more so kind of the evaluations that you do when you go to the hospital, how'd you like your experience of the, the, the, the. But at the same time, you know, not only the health care providers are going to be affected by these violent attacks, you know, I prevented patients in the past from being assaulted by other patients, right? And so this affects all of us in that environment. So why not make it safer for all of us?

Erica: 41:09

I'm glad you brought up prison, you know, it's interesting that Across the board, correctional nurses will say that they felt safer in prison than they did in any other nursing job and setting. Imagine you are dealing with murderers, rapists, all day, every day, they're all around you, and you felt safer in prison because there were armed guards that you knew would protect you, weren't, you know, discouraged from protecting you, right? That, I think, speaks volumes.

Chris: 41:44

And to that point, you know, every nurse that I know that has had, some of the most vicious assaults that I've seen, the majority of them went to, you know, the, the prison setting, the majority of them went to, you know, those locations because of that protection aspect. And after working through it, um, you know, to the point where they felt as though they were strong enough mentally to go back to those, those situations, you know, it's kind of where they're landed. One of the questions that, uh, came in, as we know, from the pandemic. Um, there was an upsurge in travel nursing. A lot of contracts were taken by folks who were like, you know, I'm going to go to a rural location and practice. For nurses who travel or work at different hospitals, how can they still be proactive in advocating for better protections?

Erica: 42:26

You know, research the place before you go, first of all, right? See, see if it's, you know, a place that maybe has a nursing union or do they have metal detectors? It's so easy to find out information these days because there there's travel nurse groups on Facebook all over the place. You can just type the question in it. Has anyone worked at this? Specific place, you know, tell me they'll tell you and they'll tell you the good the bad and the ugly They will tell you you know, um, but also Travel nurses are such a great resource to full time staff because a lot of places There are staff that have only ever worked there, or they have only ever worked in that city or state, and they suffer under the delusion that that's just the way it is everywhere. Or they don't have a basis of comparison. You know, they don't know what they don't know. So, when a travel nurse comes in, and they can say from their vast experience and traveling around the country, this is not. Okay, like this would whatever they're doing here would not fly anywhere else that i've worked that's valuable You know impart that wisdom to the non travelers

Chris: 43:38

Yeah, yeah And you know, like you said when you're traveling you're bringing new ideas to different environments and you know I I work at I think at this point about 14 different hospitals now with our group And so we bounce from place to place and a lot of the positives that we have coming out of it Is from that. Okay. Well, at this location, this is what we do. You know, maybe we can improve it, right? The pediatric hospitals, this is what we do. Maybe we can save a kid, you know, an ED to ED transfer, just directly admit them. Right. So a lot of that comes out of it. Why not this? All right. Why not the protections that we can have for our staff and our faculty beyond personal advocacy? You mentioned a little bit here. What else can healthcare workers do to push for real political change on this issue? You mentioned that bill there. How can some of our workers support those efforts or other efforts in going forward?

Erica: 44:25

Yeah, well, supporting that bill is not as simple as calling your representative once. I think people suffer under that delusion. Well, I sent an email. Great. Okay. That got put in the trash, you know, you need to keep doing it. Like put a reminder in your calendar once a week. Hit hit send send that email at like call out tag your representatives on social media They're all on the different social medias at them and say representative smith Why have you not signed on to support bill number dot dot dot, you know Call them out. You can make appointments and go meet with your representatives Go there. Tell them the really horrific stories. We all have one

Chris: 45:12

You know

Erica: 45:13

put it in layman's terms tell them how bad it is make it real paint the picture for them, you know Send the email send them the snail mail You can text them even make the appointments at them on social media and get everyone You know to do the same thing and here's what I always tell people You end it with if you fail to support this legislation, myself and my friends and family will not support you in any and all future election camp because that's what they care about. Let's be real, you know, so you do that. But also we need the public to get involved. You know, the public, despite. Like, all of my work remains vastly unaware that workplace violence is even a thing for health care workers. You know, I had someone, uh, doing some work on my house a couple weeks ago, and he said, What do you do? And I said, well, you know, I do a little advocacy and talk about violence against nurses and health. And he's like, is that, did that happen? Yes!

Chris: 46:16

It happens, and it's

Erica: 46:17

so frustrating, but you know, the media doesn't report on it. The only time you hear anything in the media is if there's like a really horrific attack. Like the two we had recently in Florida and Pennsylvania, UPMC. Those you kind of heard a little bit about because they were so big and so awful that they couldn't not report on it, you know? But they never talk about the bigger picture. They present it as this is an isolated incident. It's not isolated. over 80 percent of nurses report experiencing workplace violence in the past year. 73 percent of all non fatal workplace violence is in healthcare.

Chris: 46:59

Every

Erica: 47:01

year nurses will report increased workplace violence from the year before. Right? Like the national average is something like 57 incidents of violence against healthcare workers per day. And those are only the ones that report it. It's probably quadruple that, you know? And we also know that the public are victims of this too. It's not just the health care workers, right? There are tons of examples of patients and or their families and visitors becoming the victims of the violent attack in the hospital just for being there. You're not safe when you go in a hospital and no one wants me to say that or hear that. You are not safe in a hospital. You are not safe in a nursing home. That is the reality. And until the public gets involved, because Legislators really see, especially nurses, as like whiny, you know, they're, oh, their nurses are complaining again. We need the public to get involved and put the same pressure on our representatives to do the right thing on our local hospitals and facilities to have basic security measures in place.

Chris: 48:11

Yeah. And you're absolutely right, right? Like the, the, these folks who are representatives, you, you know, Erica and I both, we, we do a lot of advocacy work and I can tell you how tangible these folks are. Even at the highest levels, you'd be surprised if you are adamant, if you are making noise, if you and your community, cause it's not just going to be one person that's going to do this in order to get across the finish line. We all need to work together, both healthcare and folks in the community. to make sure that we're pushing forward and putting that pressure on our elected officials who are then subsequently going to put the pressure on hospital systems to get their acts together and make sure that it's safe for not only us, but for our patients as well. So tell us about your organization and your, and I saw that you had an Etsy shop too. I'm going to order some stuff. I'm an Etsy fan. Tell me about your efforts in that respect.

Erica: 48:57

So, three years ago, in the wake of the double homicide of a nurse and a social worker at Methodist Dallas Hospital, in the immediate aftermath of that, myself and a good friend of mine, Matthew, another nurse, created this red and black awareness ribbon. Red and black being the colors that denote homicide. And so, it was just this little thing we created. Hey, healthcare workers, go out, go to your fabric store, whatever, your craft store, get some red and black ribbon, Pin it on. This serves a purpose, a couple of purposes. One, it's like a silent protest, right? Imagine you are the C suite and you're walking through the halls and you notice every single one of the employees is wearing some sort of red and black ribbon. That makes a statement, you know, um, that we're not going to tolerate this. We demand that you provide the basic security measures that you're obligated to provide. But also it creates an opportunity for conversations, right? So maybe you're a patient or a family member and you notice everyone's wearing these red and black ribbons. Eventually you're going to ask, what is that? What does that mean? Why is everybody wearing that? Oh, well, actually it is to promote awareness of violence against healthcare workers. Violence against health care workers. That's a thing. Oh, yeah. Yeah, it's actually like a national emergency at this point

Chris: 50:13

Mm

Erica: 50:14

hmm. And so it sparks conversations and we get to educate people about it. And so people started making ribbons We purchased thousands of them. We sent them to Methodist, Dallas where that double homicide took place and we started talking about it and then people, you know, nurses started saying and healthcare workers like, it's coming apart. I'm trying to wipe it down with the purple sandy wipes and it's coming apart. Can you make a, like an enamel pin? So I made an enamel pin and I opened up Etsy shop. I knew nothing about doing any of this, but I did it. So you can go to my Etsy shop. It's the nurse, Erica, Erica with a C, and you can get an enamel pin. And then they said, well, can you make a badge real? I don't want to wear a pin. So I made one with a badge wreath.

Chris: 50:56

Nice nice

Erica: 50:57

and then they said can you make a sticker so I can put it on my water bottle or whatever? So I made a sticker and there's t shirts come in and bumper stickers come in and all these things But it's really just been a labor of love I am continually shocked at this has gone like worldwide. This red and black ribbon a couple of weeks ago, one of my followers sent me a picture. She had the red and black ribbon tattooed on her arm. I'm still in shock. I, I, like, I can't wrap my head around that, you know? And if you go on social media, you'll notice a lot of people have it as their profile picture. Like it's really taken on. A life of its own, you know, and it really started as an actionable event. Like we've got to stop just complaining in the break room or at the nurses station, we need an actionable event. So contact your representatives, educate the public, put a ribbon on, do something. To keep this conversation going.

Chris: 52:02

Yeah, no, absolutely. And thank you for all your efforts in that respect. And I tell you from, from this interview here, there are going to be a lot of folks who are going to be looking for those enamel pins. So definitely, uh, just, just give me a warning ahead of time.

Erica: 52:15

It's okay. That's okay. I've been excited because there's been unions that have reached out to me saying, Hey, can, can you send us like 500, like a thousand?

Chris: 52:23

Mm hmm.

Erica: 52:23

Yes. Yes, please pass this out to your union members. That is actually amazing. Yeah,

Chris: 52:31

so How can people follow you? How can people follow your efforts? Uh, you know, I know there's gonna be a lot of folks that are gonna want to follow up with this We'll post some information on the website too. But how can they get it? How can they get in contact with you?

Erica: 52:42

Yeah, I co host a successful nursing podcast. It's called Nurses Uncorked. Uh, and we talk a lot about violence on that podcast. We put a new episode out every week. I've been doing it for a couple years. It's a, it's a passion project. You know, you know how much work it is. It really is. Um, but it's, it's a great medium to have the long form conversations that you're not limited like you are on social media. But, um, you can find me on virtually every social media. platform at the nurse Erica, Erica with a C. My largest platform is, is TikTok. I think I have about 600, 000 followers. I post on there daily and then on Instagram and Facebook and YouTube. Those are the four primary ones. You can also find me on like X and some of the others, but I don't post. Nearly as often and my website the nurse or what is my website nurseerica. com.

Chris: 53:35

Also, Erica I'm gonna wrap it up here But you know for all those that are listening and let's say, you know, you have a new intern nurse You know, you have a nurse first year out however many years out What is the one piece of advice that you would give to that nurse who is scared to report workplace violence because of fear of retaliation? Losing her job or being switched to another shift. What is your advice to that person?

Erica: 53:59

Yeah, um, first of all, please go in with the knowledge that going to work should never be a matter of life and death, right? That that is simply unacceptable and you should never tolerate it. Recognize when you are being gaslit or retaliated against. You know, I mentioned earlier courage, but I, I have to say, if I'm being honest, I'm really kind of at a point after years and years of saying everything and all the advocacy and traveling around the country and giving speeches, I can't teach you courage. That is a choice. It is a choice. It's a hard choice, but it's a choice. And you can do the scary things, as I mentioned. And understand, like I said, disruption is what catalyzes change. So you have to be willing to turn off all of the people that are going to be whispering in your ear, saying, there's no point in reporting it. They're going to fire you if you do this, you know. Stop listening to that garbage and just stay true to what you know that going to work should not be a matter of life and death, and that it is your right to report it, and then you need to proactively always be creating that paper trail to protect yourself.

Chris: 55:12

Absolutely. Well, Erica, thank you so much for making the time today. For everyone out there, we will post all the information for Nurse Erica, or Etsy Shop, all the information about the bill that we're supporting here too, and thank you for all you do. Hopefully we'll be in contact in the future.

Erica: 55:27

Thank you so much for having me.

55:32

So I want to thank Nurse Erica for joining us today and for bringing that perspective to our listeners. Again, this is not an issue that is solely going to affect our healthcare providers. This is gonna affect everyone in our communities. As such, we all need to continue to speak out against healthcare worker violence. We need to continue to hold our elected officials accountable when it comes to the laws that are on the books for protecting healthcare providers. And to be frank, we need to hold hospital systems accountable as well. This is something that we're seeing. This is something that we are seeing exponentially now. It's going up in its incidents and. Couple that with nursing shortages and physician shortages and healthcare provider shortages just in general, and you have a recipe for disaster, you have a recipe in which you're gonna have worse healthcare, you're gonna have a whole generation of folks who are going to be traumatized mentally and physically due to the inaction of a lot of governing bodies. We're gonna have some information out about Nurse Erica's page to show your support and things to do to help protect healthcare providers. This is an exclusive to this podcast, but currently we are in the works with the Milwaukee Base Artery Link. Uh, a lot of you may know them from their t-shirts and their swag and everything that they do great here in the city of Milwaukee, but there will be a limited edition shirt that we will post to the website geared towards showing your support for healthcare worker rights as well as to stand against healthcare worker violence. So we will post that. Uh, be on a lookout for that and grab your shirt. Uh, we are going to wear this in solidarity. We are going to force the hand of folks in charge to make sure that we ourselves are kept safe. Our patients are kept safe and our hospitals are environment for healing and not for harm. So that being said I want to thank you all for coming out Looking forward to seeing you the next time and