Five percent of all workplace homicides involve employee victims of domestic violence. Would you be prepared to have domestic violence spill into your practice setting?
|Samuel DeShazer, J.D.
“Health care employers, specifically medical practices, should be proactive in developing a policy that addresses the prevention of, and the response to, threats and violence in the workplace,” advised Samuel DeShazer, J.D. “You can’t make effective policy while dealing with a crisis situation.”
Establish a policy
DeShazer, who presented during the ISMA Practice Management Workshop, noted that a workplace and/or domestic violence policy should be clear and a part of your employee handbook. For example, an employee who may have a protective order against a spouse or significant other may not inform management for fear of possible repercussions at work.
Employers must create an environment where employees who may be victims of domestic violence feel comfortable informing and helping management take steps to protect all employees. This should include providing assurances that employee privacy will be respected and that the reporting employee will not suffer adverse job consequences by informing management.
“A policy can save lives,” explained the Louisville attorney. “I’m not talking about a 40-page document. Just address some of the obvious things. Employees need to understand that management takes these issues seriously.”
Your policy’s first intent should be to protect staff. It need not be lengthy but should:
- Reflect or convey zero tolerance for aggressive, confrontational or violent behavior
- Prohibit conduct that includes harassment, intimidation or threats
- Require employees to report all incidents of threats or violence
- Provide assurances that employees will not be retaliated against for reporting
Find a sample policy here.
|Screen universally – Ask the question
Routinely ask your patients if they have been physically abused. Say, “Because violence is so common, I routinely ask about it. Have you been hit, kicked or shoved by someone?”
|Website helps patients in abusive relationships find shelter anywhere
For the first time, a new online resource can help your patients who may be victims of domestic violence find a shelter or non-residential support anywhere
in the U.S.
Patients can access approximately 3,000 organizations by going to this site and entering their zip codes. Created by the National Coalition Against Domestic Violence, the website can be accessed on any device. It also includes helpful articles, forums and chat rooms.
DeShazer noted that you can also enhance the safety of the work environment by:
- Placing bright, well-placed lighting indoors and out
- Inspecting or replacing defective or ineffective locks, security cameras or alarms
- Regularly testing locks and alarms
- Providing closed-circuit video in high-risk areas
- Installing curved mirrors at hallway intersections or remote/concealed areas
- Providing lockable bathrooms for staff members only
- Arranging furniture or fixtures to maintain escape routes
- Planning patient care rooms that have two exits
- Enclosing nurses’ stations in high-risk areas
- Offering staff security escorts to parking areas
- Developing a relationship with local law enforcement
Importance of training
Whether you are dealing with domestic violence issues involving employees or patients, DeShazer suggests you establish a crisis management team that has been trained and tasked to respond to threats or violence.
“The crisis management team, composed of managers, security and human resource personnel, should be provided with more specialized training on how to respond to threats of violence and how to cooperate with police and first responders,” he said. “All staff should receive training on the organization’s workplace violence policies and procedures, warning signs, de-escalation techniques, and reporting requirements and expectations.”
Legal duty to patients
In addition to staff, you also have a responsibility to identify patients who may be victims of domestic violence and take steps to prevent it whenever possible.
If you suspect a patient is a victim of abuse, you can typically file a report with the police only if the patient consents. However, without patient consent, you can still help by taking these steps.
- Document injuries - Good documentation in a patient’s medical record is often the only evidence of abuse. Importantly, it can help a victim obtain custody of children and secure protective orders. Effective documentation should include:
Notations in the medical record should be specific and detailed, and include names, locations and witnesses. The ISMA offers a body diagram to help you record injuries.
- Quotations from the patient
- Body charts, injury maps
- Provide referrals
Offering safety information to identified victims is crucial.
The ISMA makes available business-sized cards that provide a safety plan, as well as a list of local shelters and programs. The resource cards are small and can be hidden for further safety of the patient.
Find the screening form, body diagram, resource cards and other helpful resources on the ISMA website.