Beyond Bill C-3: What else is needed to protect doctors against intimidation?

A proposal to expand Canada’s Criminal Code to include actions that intimidate healthcare workers and patients or that block access to healthcare facilities is, by most accounts, a step in the right direction. But Bill C3–which was introduced on November 26 in the House of Commons in Ottawa–is not the only step that must be taken to protect the country’s healthcare workers, who have experienced more bullying and attacks since the pandemic began, workplace safety experts and the head of the Canadian Medical Association told The Medical Post. “The legislation has to be tied to workplace safety policies,” said Henrietta Van hulle, vice president, client outreach at the Public Services Health and Safety Association, which provides training, consulting and resources to reduce risks in Ontario workplaces. “Hospitals and clinics need to look at their occupational health and safety policies and think about what new measures and procedures should be put in place to support this legislation.” Having a clear definition of what constitutes intimidation, and making sure healthcare workers and security staff understand this definition, will be critical, she added. “And healthcare facilities have to make sure their security guards are appropriately trained so there’s a very clear mandate on when they can restrain or when they can use force,” said Van hulle. “If this becomes criminalized, then it’s not just an internal security issue so staff will need to know if and when they should call the police.” At healthcare facilities that have a higher likelihood of having workers and patients subjected to intimidation—such as high-profile hospitals and abortion clinics—management should consider doing risk assessments to find ways to tighten safety protocols. For example, a staff member or security guard could be assigned to monitor shift changes, said Van hulle. Or maybe workers are required to take their personal wearable alarms home with them so they could put these on before they even enter the facility. Read: In one bill, Liberals push sick leave and crack down on healthcare worker harassment Kerry Brock, president and chief revenue officer Guard RFID Solutions Inc.—a Delta, B.C. provider of security technology solutions such as wearable radio-frequency ID tags—said it’s also important to identify high-risk spots in hospitals and clinics, especially in facilities that can’t provide comprehensive security coverage because of budget constraints. Intensive care units and behavioural health departments tend to see higher incidences of violence or threatening behaviour against healthcare workers, said Brock. “We’ve seen more of this with COVID, where family members who are really upset about what’s happening with their loved one get violent or aggressive,” she said. While it will be great to have a law criminalizing intimidation against healthcare workers, hospitals and clinics need to focus on preventing this behaviour from happening. “Training and public awareness are key,” said Brock. “You need to have signage and other messaging that lets people know there’s zero tolerance for people who try to intimidate healthcare workers or anyone in a healthcare facility. And your workplace policy needs to explain what intimidation looks like, because hospitals are such high-stress, emotional environments that it can be hard to tell the difference between someone who’s just really, really upset or demanding and someone who’s threatening.” Read: Ontario doctor considering zero-tolerance policy says his staff are going home in tears because of verbal abuse from patients Dr. Katharine Smart, president of the Canadian Medical Association, said with Bill C-3 in the pipeline many hospitals and clinics are starting to revisit their safety policies. A big question to ask is whether or not healthcare workers have tolerated too much intimidation and violence, even before the pandemic. “What’s been very challenging for us is the balance of recognizing we’re caring for people who are unwell and who are in many cases marginalized, so we’ve tolerated abuse from patients in an effort to meet their needs,” said Dr. Smart. “We hope (Bill C3) makes healthcare professionals feel more empowered to report abusive and intimidating behaviour, knowing their concerns will be taken seriously as opposed to minimizing them.” A “reset” in workplace culture is imperative, she added. “It starts with us as peers not normalizing these behaviours,” said Dr. Smart. “If we see a colleague being intimidated or harassed, we need to acknowledge what’s going on and to reinforce the message that it’s not okay.” Perhaps even more importantly, clinics and hospitals need to make it clear they will back their staff. “We hear a lot, especially from nurses, that they feel they won’t be supported by their employer and they feel alienated because of that,” said Dr. Smart. “But when it’s clear that intimidating and threatening staff is universally unacceptable, and when there’s a law that backs that up, then it will stop.” Read: Change the terms and conditions: CMA meets social media giants pushing for healthcare workers' online safety

Beyond Bill C-3: What else is needed to protect doctors against intimidation?

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