'Respect and Heal' campaign deals with workplace violence

Host Amber Smith: Upstate Medical University in Syracuse, New York invites you to be "The Informed Patient" with the podcast that features experts from Central New York's only academic medical center. I'm your host, Amber Smith.

We've seen news coverage of airline passengers flipping out on flight attendants, teachers who are assaulted in the classroom, health care workers who are attacked in the course of caring for patients. With incidents of violent, disrespectful, and disruptive behavior on the rise, Upstate leaders are responding.

Here to explain how are Frank Ferrante and Jerry Santoferrara. They're both workplace violence coordinators at Upstate.

Welcome to "The Informed Patient," Mr. Ferrante and Mr. =Santoferrara=.

Frank Ferrante: Thank you for having us.

Jerry Santoferrara: Yes, thank you.

Host Amber Smith: Let's talk about what "Respect and Heal" is. Mr. Santoferrara, can you explain how it came together?

Jerry Santoferrara: Sure. "Respect and Heal" is a collaborative effort of leaders from the hospitals and health systems across Central New York. Its aim is ensuring the safe and respectful treatment of health care workers, including support from the Onondaga (County) District Attorney Wiliam Fitzpatrick. Part of the platform actually addresses federal and state legislation that provides more penalties for those who knowingly and intentionally assault or intimidate hospital employees.

And then in the words of Dr. Corona himself, regarding the major themes, "All staff will be treated with respect. There will be zero-tolerance policy of any threat, and that any violence against frontline staff will be met with the full enforcement of the law."

Host Amber Smith: The Dr. Corona that you've mentioned is Dr. Robert Corona. He's the chief executive officer for Upstate University Hospital.

So when we say zero tolerance, what does that mean? What happens to a patient or their family member if they start getting pushy with staff?

Frank Ferrante: Well, you know, it's most important that our first intervention would always be to attempt to deescalate, but to echo what Jerry was referring to with Dr. Corona's statement is that the violence is still not going to be tolerated. That we encourage our staff to, if they feel that they're unsafe, or if they are in danger, we are fortunate, we have our UPD (University Police Department) and public safety, and you leverage their resources from there. There can be police reports filed, charges pressed -- that applies to both patients and visitors. Workplace violence is a significant issue in health care, which refers right back to "Respect and Heal," and the involvement of the DA and addressing federal and state legislation to levy more penalties.

Our staff do not come to work to get hurt. They're here to provide high level patient quality care, and it's not going to be tolerated to be assaulted.

Host Amber Smith: Do you think the fact that multiple health organizations are banding together for a "Respect and Heal" campaign -- when these are normally competitors -- do you think that that signals this is a really important issue?

Jerry Santoferrara: Yes, absolutely. The situation you described is truly not limited to Upstate. It's a nationwide crisis. The collaboration of other organizations and the support from our district attorney really does represent a monumental step toward raising awareness and implementing essential changes to really enhance the safety of staff and everyone involved within the institution.

Host Amber Smith: Do you have a feel for how many health care workers have been harmed on the job recently, or how severe the injuries have been?

Jerry Santoferrara: Upstate does closely monitor the data to identify high risk areas. So far, we've been able to suss out the emergency department and psych(iatric) units where violence is most prevalent. Notably, nurses bear the brunt of these incidents, with a wide range of severity.

To provide comprehensive support, though, we do offer resources that address physical, emotional, and cognitive needs. The resources for these include, but are not limited to, our social worker, Lauren Angelone. She's a staff support social worker, specifically for instances of these sort of violent or aggressive approaches to assist with employee management and sort of being a liaison to other services, along with our employee assistance program, which aims to bridge the gap as well for necessary care.

Host Amber Smith: Well, Mr. Ferrante, looking beyond the person who gets injured on the job, let's lay out why this is a bigger issue than the threat of individual harm. Because I'm thinking about it is got to be really difficult for a doctor or a nurse or a technician to function, I mean, just even to think straight, if they're worried about being attacked.

Frank Ferrante: It's a justifiable right, when you're considering that this is a national issue. That's why one of the things we are emphasizing is really for staff, at this point, is that situational awareness. Upstate has made it the focus to ensure that the employees are provided a safe environment by addressing issues in real time and supporting staff.

Health care providers, they can be very, it can be task oriented, and it is essential that they take their time to familiarize themselves with their surroundings and positioning. This can sometimes be overlooked or challenging given the level of patient care required. But as health care workers, you know, our primary focus is providing care, but we should also remember to take those necessary measures, when appropriate, to keep themselves safe and as safe as possible. While we must always keep in mind that the only be behavior we can ever control is our own.

Host Amber Smith: That's true. So let me ask you if you can describe your role at Upstate. You're both, I know, workplace violence coordinators, but what do you do?

Jerry Santoferrara: So as workplace violence coordinators, we're responsible for running the data to identify trends in violent activity, along with developing interventions within interdisciplinary teams to reduce the risk of violence against staff.

So basically we review each reported assault. We meet with our mitigation committee weekly, comprised of providers, nursing leaders, nurse managers, ethics, officials and many others, to optimize care of the patient to assure that their needs are met, while also reducing the risk to the staff.

We also conduct rounds throughout the institution, assessing units for environmental risks, as well as getting essential feedback from the frontline staff regarding their concerns and perspectives.

So we try to make sure that we're a visible presence and as supportive as we can possibly be.

Host Amber Smith: Is there training, or lessons to be taught, that can help a health care provider, stay safe?

Frank Ferrante: Currently the hospital does offer, there is CPI, which is Crisis Prevention Intervention. There's CISM, which is Crisis Incident Stress Management. And they're all various levels of identifying risk and how do you manage them on a variety of different levels. We are looking into whether there's other opportunities -- that's that feedback we're getting -- to see if there is additional training to be more specific to units, with the issues that they're actually encountering.

Host Amber Smith: Let me ask you -- because we know this is happening nationwide -- what is it that's making people more aggressive these days? Do you have some ideas?

Jerry Santoferrara: So as far as ideas are concerned about this, it's definitely challenging because people have speculated maybe some COVID fatigue and challenges with longer wait times, short staffing, issues that maybe aren't necessarily a direct result of COVID, but things that have sort of contributed to bogging down of some of the systems.

And so being able to understand that -- however, at the same time firmly stand by our policy here, and not tolerate disrespect and unsafe behaviors -- we can have a sort of holistic approach. And as being able to validate and understand frustrations with some individuals and how care has maybe been impacted. But we really, we're struggling as far as the violence, right? Like we are, we're not condoning that, but understanding holistically that there are more things at play and frustrations, and it's just not easy.

Host Amber Smith:

People maybe have complaints about having to wait a long time, because we're short staffed, or something along those lines. Do you find that explaining that to them helps, or not?

Jerry Santoferrara: Some people do understand, and they're very, very patient. And then others, not so much. It's a tough thing to kind of field, really. Because you do, you see people kind of feel bad for, and the patients will say, "oh, you know, I didn't want to bother the nurses. I feel bad because I see how busy people are." And so it really just depends on the person and their level of awareness and their tolerance and their patience.

Host Amber Smith: Well, it didn't used to be this way, so it gives me hope that we'll get back to what it was like before, before people started sort of freaking out. So it's encouraging to know that you are working on "Respect and Heal," and we'll see what that does. Thank you both so much for making time for this interview.

Frank Ferrante: Thank you, Amber. Really appreciate it.

Jerry Santoferrara: Yes, no problem. We appreciate it.

Host Amber Smith: My guests have been Frank Ferrante and Jerry Santoferrara. They're both workplace violence coordinators at Upstate.

"The Informed Patient" is a podcast covering health, science and medicine, brought to you by Upstate Medical University in Syracuse, New York, and produced by Jim Howe. Find our archive of previous episodes at upstate.edu/informed.

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