Kelsey Reed, nurse practitioner and director of patient care at Phoebe Putney Health System shares how her personal experience speaking out about violence against healthcare workers earned her a spot on a Georgia Senate Committee responsible for looking into the problem. Kelsey also shares Phoebe Health's strategies to protect their workforce and ways employees are supporting one another.
Title: Preventing Violence Against Healthcare Workers
Guests: Kelsey Reed, Nurse Practitioner and Director of Patient Care at Phoebe Putney Health System
Host: Christine Parent, Associate Vice President, MEDITECH
Kelsey: "Most people would not accept being physically or verbally abused on the job but as healthcare workers we often just take it. I hear and I see daily, people say, it's just part of the job but it can no longer be that way."
Christine: Welcome to another episode of MEDITECH podcast, we’re the leader in healthcare technology empowering you to be a more informed healthcare consumer and provider. Hear the latest from our friends and colleagues on topics we think you should know about.
Today I'm joined by Kelsey Reed, Nurse Practitioner and Director of Patient Care at Phoebe Putney Health System, a not-for-profit network located in Albany, Georgia, and sole provider of this rural corner of the state. Recently, Kelsey served on a Georgia Senate Committee responsible for looking into the problem of violence against healthcare workers in the state. A long-time advocate for worker safety, Kelsey's role on this committee is tightly aligned with Phoebe's mission to put safety first for patients and healthcare workers alike.
Welcome, Kelsey! I'm excited to have you join me today.
Kelsey: Thank you so much. Thanks for having me. I look forward to it.
Christine: Lately, I've heard a lot of stories in the media regarding violence against healthcare workers which is unfortunate considering all that you've experienced throughout the pandemic. You've been a long strong advocate for your fellow nurses and speaking out against this violence. What is the number one takeaway you want everyone to leave with today?
Kelsey: First, I want people to know that they are absolutely not alone. Violence against healthcare workers is an issue that all of us in healthcare have to mitigate daily. From our nurses to our techs, to those in our registration department, and even those working in our dietary department but it's also an issue that we've been dealing with for many years and it's truly a long-standing problem that's just not new to us, but I think a lot of people feel that violence against healthcare workers is a result of the pandemic. I personally believe it has just exacerbated the issue. We all know that COVID has taken a toll on everyone's mental health and we see every day how that has affected our patients. Everyone is just on edge and patients are becoming outraged due to changes that we have in our visitation policy or due to emergency room wait times and our staff are the ones that often have to suffer due to that outrage from our patients. The pandemic has simply brought this issue to the surface and it's caused a lot of us to start talking about it and we need to keep talking about it so that we can be more solutions focused and we can look for answers on how we can combat this together as a workforce.
Christine: I agree with you. This pandemic it's been a long road and it has amplified, as you mentioned, the conversation. Now let's talk a bit about your role on the Senate Study Committee on Violence Against Health Workers. What do you and your fellow committee members hope to gain from your collaborative involvement?
Kelsey: I think one thing that the committee has shown us is that we're not alone in our challenges and in our struggles, and we have been able to hear testimonies from nurses all across the state and there's a lot of camaraderie. A lot of shared experiences and advice that we can take back to our own organizations and I'm sure we'll be able to continue to collaborate long after this committee has disbanded. Most importantly, we want to establish a set of shared guidelines to get to the root of the problem and how organizations can address it. Calling this a result of the pandemic I think is just too simplistic. There are a lot of mental health challenges that we need to address in both our emergency setting but in our hospital setting as a whole and is asking the question, how do we get these mental health patients that care and the proper support and medications that they need to help prevent this aggressive and violent behavior? What policies and safeguards can we put in place as a healthcare organization to identify these patients and protect our healthcare workers, and that really needs to be what we focus on. Most people would not accept being physically or verbally abused on the job but as healthcare workers, we often just take it. I hear and I see daily, people say, it's just part of the job, but it can no longer be that way and I think many are too afraid to file a report as the patient would have that personal information of the individual. We absolutely need to work together to do more to protect our healthcare workers.
Christine: Kelsey, the Senate Study Committee on Violence Against Healthcare Workers, is that still ongoing, or did that complete, and what has been the outcome?
Kelsey: We are working on finalizing right now our final recommendations that will be shared with the public and the goal of that is to standardize our response as a state to make sure that we are all gathering together to learn from each other on what has worked well for one organization that could potentially work well for another as well. We will be sharing those recommendations with the public, hopefully, early 2022.
Christine: You describe mental health as one of the primary contributors to this violence. Let's expand upon this a little bit. What effect is this violence having on the healthcare work you know, personally?
Kelsey: I will say the PTSD is very real. I have experienced it myself which is one of the reasons that I got involved. I've had patients make death threats against me and you start to take this worry and these threats home with you every day and worry about how it not only affects you but your family as well, and I know that some of our healthcare workers have left the field over this violence. It's a real concern. When the incident is over, you know most people can just move on but we have to live with it as healthcare workers. We have to continue to cope with it and that often poses a great challenge. I will say as an organization, Phoebe is truly great to us as employees. We have an Employee Assistance Program that actually offers six free visits a year and those visits are with a counselor. They also offer many different support groups with peers as well and then also we have a daily safety huddle at Phoebe. Then oftentimes, violent or aggressive patients are brought up on that safety huddle and we have senior leaders that reach out to know how they can support our teams. They're asking what can they do to help and I think that really goes a long way with our staff. It makes our staff feel valued and appreciated. It's nice to know that we have that constant support.
Christine: Many healthcare workers that are probably listening to this podcast now that are wondering, what are some of the initiatives that Phoebe has put into place as part of your support program that they may be able to learn from?
Kelsey: We get security involved very early. When we have aggressive and violent patients, we immediately alert the security team and we ask them to increase rounding these patients so that they're constantly involved and they have that presence on the unit and that really makes a difference for our staff to know that they have that support. We're also working on creating a Behavioral Health Emergency Response Team. We would initiate a cohort when we have aggressive and violent patients. This team would have support from not only security but from nursing leadership and then also the Spiritual Care Team to help with the de-escalation of those violent and aggressive patients. We've been looking at what other organizations are doing and many other organizations are using the same type of team and they've proven to be very successful.
I also think it's important that we ensure communication with providers so if a patient is showing violent behavior then we need to look at what are our options. Can we make some medication changes and do we need to evaluate what we can do as a support team to help our patients? Then, we also have a patient safety huddle every day just like I discussed earlier. We discuss these incidents in real-time as they present themselves and then we're looking at Best Practices across cohorts. We know that we can learn from measures that other organizations are taking to help mitigate the issue. We'll continue to look at those. We're also working on offering more de-escalation training for all staff. I think this is a really critical component. I’m typically, in most settings. This is just offered for our Emergency Room Staff but when the patient leaves the ER, they go up to the floor and our floor staff and our unit staff continue to support, to care for these patients. We need de-escalation training in all settings.
Christine: Are some of these initiatives considered part of your workplace strategy plan or are they part of patient safety in general?
Kelsey: I think it's really both. We recommend the first step for employees is to fill out that incident report and I think that certainly helps with tracking purposes.
Christine: Kelsey, what are your recommendations for other nurse leaders or clinical leaders on beginning a program like Phoebe's for their health system? Where or how would you suggest they start?
Kelsey: First, is that reporting is encouraging employees to fill out incident reports. This helps with tracking so that we can continue to watch the trends. Also, like I stated earlier, it's super important to get security involved early and we need to be working very closely with our security teams and then offering that de-escalation training for staff. We need to teach our teams exactly how to work through these situations with aggressive and violent patients and they need to know how to do it and offer those simulation experiences before it actually occurs. I think, most importantly though too, it's also just listening to staff, giving them a voice. They have great ideas. Let's let them know that we hear them and we value their feedback and their ideas and then reminding staff of what support services that we have available within the organization and how they can utilize those support services.
Christine: Well, I'm very happy you joined us today Kelsey. This is such an important topic and I'm very thankful for the work you've done with Georgia and all of the committees that you sit on to really advance and have this conversation. I want to give you the opportunity, because of the topic that we're discussing, to provide any closing remarks you want to leave our audience with today.
Kelsey: Most importantly is to not give up. We need to continue to talk about this issue, continue to look for ways that we can support each other and hold hands as a profession, and then to remain solutions-focused because we have to overcome this challenge. Most importantly, to check on each other, to check on our colleagues, and to keep a constant check on our staff. We have to support one another so that we can give the best possible care to our patients.
Christine: Kelsey, in our podcast, we always end on a very fun note just to learn a little bit more about people in their personal lives. You and I were chatting before we started the podcast and I know you mentioned you have a young child at home that has a passport with only one stamp and you and your family enjoy traveling. Tell me what your next adventure may look like and what are you looking forward to?
Kelsey: Yes, so this year, I'm looking forward to being able to take my daughter to Spain and when I was in college many years ago, I studied in Spain for a semester and just fell in love with the country. I fell in love with the culture and the food, and the people, and so I want my daughter to experience that too. Hopefully, we can safely go to Spain by the end of the year. That is certainly my goal, I want her to continue to collect some passport stamps.
Christine: I love it, thank you very much, Kelsey, and good luck with everything that you're doing, and thank you for being on our program today.
Kelsey: Thank you so much for the opportunity.
Christine: Thanks for tuning in, stay informed and subscribe to MEDITECH podcast and be sure to check out our resource page for links from this episode. We'll talk to you next time.