A Growing Crisis

BCNU calls for renewed action on violence in health care

Content warning: This article discusses sensitive topics, including violence against health-care workers. Reader discretion is advised.

On a routine night shift at Surrey Memorial Hospital last June, emergency room nurse Janice McCaffery was doing what she had done for years – caring for patients under high-stress conditions. As with most shifts, they were short-staffed that night, but that didn’t keep McCaffery and her colleagues from working as hard as they could to tend to over 30 people lined up in the waiting room and the dozens of patients who had already been admitted.

A nurse for over 40 years, McCaffery was in her usual work mode that night, unaware that she was about to become a victim of a violent attack that would change her life and career in an instant.

As she tended to a young male patient under the influence of a non-prescribed drug, the man lunged at her without warning, grabbed her uniform and started punching her repeatedly in the head. Her colleagues, who heard her screams, came running to help and called a code white – an alert that someone was behaving aggressively. The brutal assault left McCaffery with serious head trauma, including a brain bleed, and ever since then, she continues to experience nausea, dizziness and double vision.

“We must do more to protect the ones providing care.”

- Janice McCaffery

“It’s been absolutely devastating,” says McCaffery, who has been off work since the attack. “I’ve dedicated my life to this job, to helping people. But now I wake up every day with headaches, dizziness and the fear that it could happen again.

I’m a masters-level educated nurse who is now facing the fact that my career is over because of an unprovoked attack. My life will never be the same. We must do more to protect the ones providing care.”

McCaffery’s story is sadly just one of many. Across British Columbia, violence in health-care settings has been escalating at an alarming rate, leaving health workers traumatized, injured and increasingly fearful for their safety. According to Statistics Canada, nurses report an average of 51 injuries per month due to an act of violence. That’s nearly two nurses per day, assaulted to the point that they must take time off work to recover. The number of reported assaults has risen from 43 in the period between 2019–2023.

While BCNU has been sounding the alarm for many years through campaigns, earned media, government meetings and public advertising, violence against health-care workers continues to be a systemic crisis in need of urgent action. Recently, following a string of high-profile attacks in hospitals across the province, the issue has received widespread media attention, putting both health employers and the provincial government on notice that it’s time to confront the growing crisis.

A System Under Siege

Violence in health-care settings is not a new problem, but McCaffery and other nurses working in the system say it’s getting worse. In the last few months, there have been multiple violent incidents in hospitals across BC, adding to the sense of fear and frustration among nurses and hospital staff.

In November, a student nurse on shift at Vancouver General Hospital suffered serious knife wounds to her arm and chin when a patient who was hiding a pocketknife in their bed attacked her. The nurse is recovering from her injuries, but the terrifying incident raised serious concerns about the lack of safety measures that were in place to manage the patient, who had already threatened staff earlier that day.

That same month, a nurse at Eagle Ridge Hospital suffered severe injuries after an agitated individual in the emergency department attacked her. Police later charged the man. Two months after that, nurses and health-care staff working in the emergency department at the same hospital were left traumatized when a man threatened them with a machete, prompting the first Code Silver – an alert for a person with a weapon – in the hospital’s history.

All three incidents received widespread media coverage and have exposed the concerning reality that violence in health care is a growing trend.

“These incidents are just the tip of the iceberg,” says BCNU President Adriane Gear. “We know that nurses are threatened with or experience violence like this every day, but many attacks go unreported. Unfortunately, there is still a culture within health- care settings that sees violence as ‘part of the job.’

It’s time for that to end,” says Gear.

MAKING AN URGENT CALL

Over the years, BCNU has been actively raising the issue at all levels of government and was one of the first unions to call for Criminal Code amendments to help keep nurses safe. The union’s 2017 campaign, Violence:

Not Part of the Job alerted the public to the frequency of workplace violence against nurses, and nurses’ unions across the country picked up BCNU’s message.

Last December, BCNU’s advocacy about this issue reached the Canadian Parliament. In a presentation to members of the Standing Senate Committee on Legal and Constitutional Affairs, BCNU President Adriane Gear and Interim Executive Councillor of Occupational Health and Safety and Mental Health Denise Waurynchuk recommended that the committee accept Bill C-321, legislation that, if passed, would amend the Criminal Code to ensure stricter sentences for people who assault health-care workers.

Waurynchuk took the opportunity to reference key statistics collected in a province-wide BCNU member survey commissioned in the spring of 2024 that garnered over four thousand responses.

“The findings of our Not Okay campaign survey are eye-opening and show the extent of how violence is impacting nurses in this province,” she explained. “At least monthly, 39 percent say they are exposed to weapons. Sixty-one percent say they are exposed to illicit substances and half experience physical violence at least once a month .”

Unfortunately, the push to see Bill C-321 passed came to a halt late last year when the federal government prorogued parliament. And while the defeat came as a disappointment to many, it hasn’t deterred BCNU’s continued fight to shine a light on the issue.

“Thanks to the advocacy shown by BC nurses, there has been a significant increase in awareness about violence in health care – and we’ve seen some positive steps in the right direction,” says Waurynchuk. “Nurses’ occupational health and safety is a main priority for us as a union.”

Violence Impacting Health-Care Workers

The psychological and physical toll of workplace violence on health- care workers is immense. Many who experience violent attacks suffer from post-traumatic stress disorder (PTSD), anxiety and depression. Some leave the profession entirely, contributing to the staffing shortages plaguing BC’s health-care system. However, when workers with psychological injuries face file claims through WorkSafeBC, they often meet significant barriers preventing their access to speedy and effective care. Their experiences inspired a recent BCNU campaign called Break Down the Barriers. The campaign asked members to endorse an open letter from BCNU President Adriane Gear to newly appointed BC Labour Minister, Jennifer Whiteside, calling for a fair and equitable claim process for those suffering psychological injury.

Over 1,400 people signed the open letter, which went to Minister Whiteside’s office in late January.

“We felt it was important to bring attention to a serious injustice affecting nurses and other workers in BC who have experienced critical incidents and cumulative stressors at work,” says Gear. “We will follow up with the government, and we look forward to hearing what steps it will take to ensure the needed legislative and regulatory changes are in place to make the WorkSafeBC psychological and physical claims processes as fair as possible.” 

Danette Thomsen is BCNU’s North East regional council member. Thomsen says violence is taking a significant toll on nurses in rural and remote areas of the province who don’t have sufficient access to adequate resources or support services.

Despite requests for increased safety measures, equipment and personnel, many nurses in BC’s northern communities continue to provide patient care in isolated environments or in health-care facilities that are desperately short-staffed.

“Nurses tell me the mental strain of going back to an environment where they could be attacked is unbearable,” says Thomsen.” The fear of violence has led many nurses to take extra precautions or even contemplate career changes. The stress of not knowing if you’ll be safe at work is driving so many nurses away.”

BCNU’s Message to Employers and Government

BCNU continues to ramp up pressure on health authorities and the provincial government to explore solutions, like expanding the number of relational security officers (RSOs) to smaller, community-based health-care settings and facilities in rural communities. On Oct. 24, 2022, the provincial government announced the recruitment of 320 RSOs and 14 violence prevention leads, demonstrating the effectiveness of BCNU members’ pressure campaign.

These officers work in tandem with health-care teams, have hands-on training and are equipped to de-escalate situations when they arise. Since the move to bring RSOs to health-care facilities, many nurses have reported feeling safer at work.

However, despite this positive step forward, there are hundreds of facilities across the province that rely on hired security personnel, many of whom lack the training required to manage violent incidents or situations involving individuals needing mental health and substance use care.

“As the number of people without a family doctor or access to community mental health services grows, we are seeing emergency departments act as the first point of contact for individuals needing care for mental health and addictions,” says Gear. “The nurses and health-care staff are often the ones who are in the wrong place at the wrong time.”
For McCaffery, she knows that violence can come in all forms. In her 40-year career, she’s experienced a long list of physical attacks.

“I’ve been bitten, spat on, have had human feces thrown at me and have been groped numerous times,” she explains. “You never know what to expect.”

Short Staffing Linked to Violence

The violence plaguing BC’s health-care system is not an isolated issue – it is a symptom of broader systemic failures, including the province’s chronic staffing shortage, which is the root cause of many dysfunctional consequences.

Statistics Canada shows over 5,000 nurse vacancies in BC, depicting an inverse relationship between nurse staffing levels and workplace violence. As nurse staffing levels drop, violence against nurses rises, and so does the risk to patient safety.

In addition to managing the staffing crisis to promote safer work environments, BCNU is also pressing employers for effective local-level reporting mechanisms that address the unacceptable levels of violence in health-care workplaces and, instead, foster a culture of worker safety.

The glaring challenges around reporting were on full display in BCNU’s recent Not Okay survey, which found that despite 99 percent of respondents admitting they’d experienced reportable incidents, more than half said they had not reported anything because they lacked faith that their employer would do anything about it.

“It’s unacceptable that health employers have created a culture where nurses don’t feel as if they can come forward and report these incidents,” says Gear.

A Call for Action

McCaffery’s story, and those of the thousands of nurses across BC whose personal and professional lives have been altered due to violence, is a tragic reminder of the human cost of inaction.

As reports of violence increase, BCNU continues to apply pressure on both health employers and the government, demanding decisive action and a focus on increased security, better mental health services, improved reporting options for nurses and stricter penalties for violence against health-care workers.

“We’ve been calling for action for years, and yet nurses continue to be punched, kicked, bitten and threatened on a regular basis,” says Gear. “How many more health-care workers need to be injured before meaningful change happens?” •

UPDATE (Spring 2025)