Joint Effort
SAFETY FIRST BCNU members are leaders when it comes to promoting safe and healthy workplaces. From left: BC Women's Hospital steward Raj Johal, Okanagan-Similkameen region steward-at-large Cherish Anderson, Vancouver General Hospital full-time steward Sandra Ramos and Fischer Place, Mill Site Lodge steward Leah Takats. Photo: Peter Holst
JOHS committee: To some, it's just another of the many acronyms that nurses use within the course of their work. But for others, these four letters are the key to ensuring that their careers – and those of their co-workers – are as safe and rewarding as can be.
All workers in BC are affected by laws that govern the environments where they work. Both the province's Occupational Health and Safety (OHS) regulations and the Workers' Compensation Act contain legal requirements that must be met by all workplaces.
OHS regulations cover a large and ever-evolving variety of industries and economic sectors in BC. So it's not hard to imagine the complexity of rules, policies and procedures that need to be in place to effectively protect workers.
The health-care sector is the perfect example of an industry that's as varied as it is vast. So how can employers and workers ensure compliance with the OHS regulations governing health care? That's where joint occupational health and safety (JOHS) committees come in. A JOHS committee consists of worker and employer reps working together to create and promote safe and healthy workplaces. This committee is where the job of implementing an effective health and safety program gets done.
Any BC employer with 20 or more regularly employed workers must establish and maintain a JOHS committee that meets monthly. If a collective agreement is in place, there may be a requirement to maintain a committee with fewer than 20 workers. At least half the members must be worker representatives, and the committee must have two co-chairs, one selected by the worker representatives and the other selected by the employer representatives.
Rules that are on the books are one thing. Rules that are properly adhered to and enforced are often another matter. Fortunately, in BC, a majority of nurses and other health-care workers have the benefit of union membership – and this fact alone goes a long way to ensuring that workers' right to effect meaningful change in their workplaces is protected.
BCNU is committed to our members' safety, and the union provides significant resources to assist members and stewards who serve on JOHS committees. These members receive specialized OHS training that helps ensure that the duties and functions of JOHS committees comply with the Workers Compensation Act – the law governing occupation health and safety in BC.
Most working nurses are aware of the BCNU stewards at worksites across the province who advocate daily for their co-workers. These members are the first person a nurse can talk to whenever they're concerned about their job or working conditions, and whether their employer or manager is complying with the terms of the collective agreement.
The handling of contract grievances that often revolve around staffing issues is one of the most commonly known steward functions.
However, there are many other ways that stewards – and even members who are not stewards – can advocate to improving their colleagues' working lives. Participation on their worksite JOHS committee is one of those ways.
The role of a JOHS committee workers rep is unique, and many reps say they are drawn to the position because of the specific nature of the work involved, or discovered that the role was a good fit for them.
Cherish Anderson works at Penticton Regional Hospital. She's also the BCNU Okanagan Similkameen region steward-at-large.
She was drawn to OHS advocacy early in her career after being assaulted by a patient and receiving no support from her manager.
"We didn't have a lot of stewards in Penticton at the time, so I took a fairly active role right off the bat, and from there I got onto the JOHS committee because I felt that that is was a place where I could make a real difference," says Anderson.
Today, she wants to ensure her JOHS committee is functioning effectively and complying with WorkSafeBC regulations. She's also focused on recruiting more nurses to the committee. "I totally believe in teamwork," she states. "The more people you have on your team, the more presence you have and the greater your ability to make changes."
That teamwork, says Anderson, also means more people can see the concrete changes a JOHS committee achieves, whether it be a new policy or a piece of equipment. It also makes her work on the committee more rewarding than many other aspects of here work as a steward.
- BCNU Executive Councillor, Aida Herrera
Aida Herrera is BCNU's executive councillor responsible for health and safety. "Most JOHS committee reps say they enjoy the work they do because it can result in measurable change they can see in the workplace," she says. "Other kinds of advocacy work, such as contract grievance handling, can often take a long time to resolve."
Herrera says OHS reps who are stewards also appreciate the collaborative approach to the work they do with JOHS committee employer reps, versus the sometimes more adversarial nature of grievance handling. She argues that in a profession focused on caring for patients, it's all too easy to forget about the health of workers – and that's why occupational health and safety in the health care workplace is so important.
"The very mandate of the JOHS committee is to ensure that the employer provides a safe workplace for workers – not patients," she stresses, noting the many other organizational structures in place to serve patients.
"As a profession it's about making sure our members truly believe they have a right to a safe workplace – and that's a culture shift," she argues, saying that nurses often put themselves second. "Our patients come first – that's the nature of the profession – but that doesn't mean we deserve a second-rate work environment or tolerate risks such as exposure to violence that wouldn't be tolerated in other industries and professions."
Herrera says it should go without saying that a safe work environment equals a safe care environment for patients.
JOHS committees are a cornerstone for effective health and safety programs, and provide a forum for collaboration, consultation, and participation at the workplace. When committee worker and employer reps agree that a course of action needs to be taken, written recommendations are then made to management.
There are many examples that show how workers, using JOHS committees, have secured point-of-care solutions to make their workplaces safer and healthier.
100 Mile House's Leah Takats is a long-term care nurse who works at Fischer Place, Mill Site Lodge, a 100-bed care facility adjacent to 100 Mile District General Hospital. The JOHS committee worker rep. is also a worksite steward and the OHS rep. on the BCNU Thompson North Okanagan region executive.
A traumatic incident in 2014 while short-staffed left Takats with acute stress disorder. A co-worker had collapsed on job and the main doors to the facility would not open, trapping the patient inside the building while an ambulance waited outside. The experience galvanized Takats to take an active role in health and safety issues, and she enjoys educating coworkers about their OHS rights.
As a region executive member, Takats makes an effort to plan creative site visits that engage members. She has a coffee cart with treats and prizes for members who can provide correct answers to questions about their JOHS committee
"I do things like that because I realize there is a huge knowledge gap when it comes to OHS, and more members should appreciate how powerful their JOHS committee is – if they engage in the process."
Takats brought her attention to OHS details when her facility renovated its fire panel in 2015.
"Whenever there was an alarm, the renovated panel didn't indicate the location of the alarm in the hospital," she recalls. "The entire hospital was on the same alarm system, and this concerned me greatly. I emailed managers and maintenance and they kept telling me there was no problem."
Takats soon attended her first monthly JOHS committee meeting and made a presentation to employers to demonstrate the difficulties nurses were facing. A recommendation soon followed and the panel was redesigned with accurate labels.
Raj Johal is a steward, JOHS committee rep. and the most recent addition to the BCNU Shaughnessy Heights region executive, where she was appointed OHS rep.
Johal has been nursing for over 25 years, the majority of it at BC Women's Hospital obstetrical unit, providing care for new mothers struggling with substance use and managing infant withdrawal. It's specialized work that comes with its own unique challenges and rewards.
She says safety condition have become more challenging over the years, first because of a unit expansion 15 years ago that's now made it more difficult for staff to communicate and check in with each other, and more recently because of the homeless crisis.
"Before, during the pregnancy, we would stabilize women, send them home, and then they would come back and have a baby. Now, once they get admitted, they end up staying on our unit for the entire pregnancy, and then even afterwards," she reports.
Johal and her coworkers have faced several serious incidents over the years. Johal once found an axe under a patient's bed, an experience that she says galvanized her to become more active in her union. Another time, the partner of one mother began threatening staff with a sword. The care team had to barricade themselves in the nursing station until police arrived.
- Forensic Psychiatric Hospital JOHS committee worker rep. Tracia Batson-Dottin
Johal's advocacy and leadership has resulted in significant improvement to safety and working conditions in her program. One recent incident involved a patient who smoked a substance in one of the unit's toilets, creating a plume that made Johal and the other nurses exposed to it too ill to work.
Johal first reported the incident to the Provincial Workplace Health Contact Center, but it was not until she called WorkSafeBC to create a permanent record of her exposure that she and the other nurses discovered their worksite had no external exposure plan.
WorkSafeBC then issued compliance orders, and the experience led Johal to join her worksite JOSH committee to be in a position to better oversee and monitor her employer's safety protocols.
"Now, we've got special gloves we don when we go into the room of a patient who uses substances, and the external exposure plan is in a binder sitting at the desk," she reports. "When something happens, we can pull it out and see what needs to be done."
Tracia Batson-Dottin works as the infection control practitioner at Forensic Psychiatric Hospital (FPH) in Colony Farm, Coquitlam. In addition to being a JOSH committee member, she is a steward and serves as the mental health rep. on BCNU's Simon Fraser region executive committee. She is also chair of the Mosaic of Colour caucus, one of the four equity seeking groups within BCNU.
Kitimat steward Connie Kearley wants members to understand the importance of properly reporting and documenting worksite health and safety issues.
Photo: Lindsay Campbell
As a JOHS committee worker rep., Batson-Dottin plays an instrumental role in advancing anti-racism work. Approximately, three years ago, FPH established its Diversity and Inclusion committee on the recommendation of the JOHS committee.
The recommendation was made following the employer's Guarding Minds survey, which found that the staff's trust in the organization was lacking. The committee agreed that there needed to be immediate attention to how discrimination, systemic racism, harassment and bullying within the organization was managed and addressed.
The main focus of the Diversity and Inclusion committee, which Batson-Dottin co-chairs as the employee rep., is to educate all staff in cultural sensitivity with the hope of providing a culturally safe working environment. The committee has organized numerous educational events and initiatives to foster cultural safety and celebrate diversity within the hospital, and has won a grant from the Provincial Health Services Authority for this initiative.
"We've organized celebrations for Black History Month, Chinese New Year and various events surrounding National Indigenous Peoples Day," says Batson-Dottin. "We've also organized Diwali and Pride celebrations at the hospital, and the activities involved both for staff and patients.
"The Diversity and Inclusion committee reports to the FPH JOSH committee to provide updates on the work being done," she explains. "We focus on education because this is what's needed to change behaviors and the way we interact with each other."
She adds that FPH leadership has embraced the Diversity and Inclusion committee's work and has diligently supported its efforts to provide a culturally safe working environment for staff and patients.
Batson-Dottin's focus on psychological health and safety comes from the recognition that workers of colour and marginalized workers face a higher risk of psychological harm due experiences of personal and systemic racism, discrimination and other forms of exclusion.
She says it's now time for the employer to conduct another staff survey to evaluate the progress of the measures currently in place, and re-assess the psychological safety levels within the hospital.
"We need a re-evaluation to see how far we've come, and what else we need to put in place to address the issues identified in the first survey," she states, "because these are some serious issues, especially when we consider the staff's lack of trust in the employer."
Batson-Dottin reports that the FPH Diversity and Inclusion committee is currently reviewing the employer's respectful workplace policy in the hope of making recommendations in the areas of accountability, time specific process, and the use of joint investigations similar to those used by the employer and union following violent physical incidents.
She also says the employer's existing respectful workplace policy is inadequate and, and many members have said it isn't working.
Forensic Psychiatric Hospital steward Tracia Batson-Dottin is using provincial health regulations to advance anti-racism efforts at her worksite.
Photo: Ron Morley
In response, a JOHS sub-committee led by Batson-Dottin, with the support BCNU OHS department staff, has now drafted a site-specific anti-racism procedure which is currently being reviewed by all interested parties and awaiting approval.
Batson-Dottin wants all members to know that verbal violence and abuse is not part of their job. "Report it every time you encounter it," she says. "Take care of your mental health because as nurses we always think of others first but we need to start putting ourselves first sometimes."
Consistently raising health and safety concerns with managers and, importantly, reporting those concerns to a union rep or the Provincial Workplace Health Contact Center is critical for establishing a record. These important, initial steps that individual workers can take will better support a JOHS committees' efforts to monitor and address long-term safety issues at their worksites.
However, all of the JOHS committee reps interviewed agree that the underreporting of health and safety hazards and incidents is an ongoing challenge. Takats argues that more education is needed to develop a culture of safety where the very notion of health and safety is better understood, and where the risk of mental injury is given the same weight as physical harm by workers themselves.
She says developing a practice where a worker always reports to the Provincial Workplace Health Contact Center when they have an injury, whether psychological or physical, and understanding the definition of violence are two of the most important ways nurses can change their worksite's safety culture. And she's committed to making this happen.
"I talk to so many people at my site who don't understand Section 4.2.7 of the OHS Regulation, which defines violence, and what violence is in the eyes of WorkSafeBC," Takats reports. "I know that section off by heart, and I say it so many times. I think I say it in my sleep," she laughs. "It's not just physical interaction. It's verbal aggression with a physical threat that you believe a patient intends to carry out. That is violence, and it needs to be reported."
Takats confesses that, earlier in her career, her conventional understanding of violence led her, like so many nurses, to accept the verbal violence she endured, and to ignore her normal autonomic response to this kind of trauma.
"I became numb over the years before realizing that 'hey, this is not cool,'" she remarks, and suggests that nurses still have a long way to go when it comes to consistently reporting workplace incidents.
"And soon as an incident happens, you take yourself off the floor and call the Provincial Workplace Health Contact Center – for your own protection. It's so important."
Kitimat's Connie Kearley works part-time in home care nursing and is a casual in the ER at Kitimat General Hospital, where she began working in 2013. She is also a steward and serves as the mental health rep on BCNU's North West region executive committee.
Kearley believes many nurses don't report verbal violence because they perceive the incidents as minor, and not warranting their employer's attention. She wants her colleagues to ask themselves how many times an incident needs to happen before they don't want to come in to work the next day.
- Leah Takats
"At what point does the mental health impact of this repeated behavior or experience have you wanting to change jobs or take up a different line of work?" she asks. "At what point is it going to result in a sick call because you're not feeling mentally capable of dealing with it again?"
Proper reporting, she says, lets her track the frequency and type of violent incidents. "Then I can start looking for a trigger, and ask, 'what is happening here? What has changed and what do we need to implement to prevent this from happening?'"
Anderson has worked with her worksite JOHS committee to help educate Penticton Regional Hospital workers on the importance of using the correct incident reporting system.
All workplace incidents and near-misses need to be reported to the Provincial Workplace Health Contact Center. However, Anderson says her JOHS committee discovered that many workers were filling out PSLS (Patient Safety Learning System) reports after serious near misses when they should have been calling the contact centre.
"The PSLS is for the benefit of patients. The information goes to managers and they are not required to share it," explains Anderson. "That's why it's important to call the Workplace Health Contact Center, as it must share the reports it receives with the JOHS committee."
All of the members interviewed say they couldn't have achieved what they have without the support of BCNU's OHS department, which offers a helpful one-day course for JOHS committee members and assists them with research and problem-solving. It also offers a two-day advanced course on how to identify hazards, conduct inspections and investigations, and write recommendations.
Batson-Dottin notes that BCNU health and safety officers are always available to assist and advise JOHS committee reps. "You learn a lot about your safety, you help advocate for your colleagues' safety, whether it be physical or psychological, and you're effecting change within your facility and organization," she says, when asked why other members should consider joining their worksite JOHS committee. "If we want to change how things are done presently, then we need to come forward, and we need to be able to put in the work, not only for us, but for the generations that are following behind us. We need to do this for them. As Roger Nash Baldwin said, 'Silence never won rights. They are not handed down from above; they are forced by pressures from below.'"
Kearley agrees. "Get involved, use your voice, ask questions, and take the education that's offered. And when you're comfortable and get the opportunity, take a JOHS committee worker co-chair roll if you can," she says, reminding members that they are never alone. "Lean on your BCNU regional OHS rep and your BCNU health and safety officer on BCNU staff. They have been instrumental in supporting me in my work."
Herrera says supporting JOHS committees is one of the union's highest priorities. "We want to make sure we have BCNU representation on all of the JOHS committees at worksites where our members are working – because there are some gaps," she says. "It's about doing that analysis and determining where we can provide the training and mentorship to make sure JOHS committees are staffed with BCNU members and also doing an effective job." •
UPDATE (Fall 2022)
Are you feeling inspired by what you've read? Curious about how you could help make your workplace healthier and safer? Talk to your worksite steward or BCNU regional council member, and start your OHS journey today.
For further information about Joint Occupational Health and Safety (JOHS) committees such as functions, investigations, inspections, 21-day recommendation letters, and education, please contact healthandsafety@bcnu.org
WHAT IS A
JOHS COMMITTEE?
A Joint Occupational Health and Safety (JOHS) committee consists of worker and employer reps working together to create and promote safe and healthy workplaces.
JOHS committees meet at least monthly. The number of worker reps on each committee must be equal to or greater than the number of employer reps.
WHY ARE
JOHS COMMITTEES IMPORTANT?
JOHS committees are a cornerstone for effective health and safety programs, providing a forum for collaboration, consultation, and participation at the workplace.
JOHS committees guarantee you the right to participate in health and safety issues at your worksite. It's through these committees that you and your co-workers can offer frontline solutions to make our workplaces safer and healthier.
HOW IS
BCNU INVOLVED?
To be effective, JOHS committee members need education and training on a wide range of issues. BCNU's OHS department offers a helpful one-day course for JOHS committee members, and assists them with research and problem-solving.
For further information about JOHS committees, such as functions, investigations, inspections, 21-day recommendation letters and education, please contact
healthandsafety@bcnu.org.