Workplace Violence Personal Safety for Rural Health Professionals “Safety is about going home at the end of the day and being with your loved ones,” And let me say this in the strongest possible terms, Safety is a basic human right. We all accept that the right to vote, freedom of speech, own property, choose who we marry, how we worship are basic human rights. So is the right to safety. The declaration of independence specifies life, liberty and the pursuit of happiness as inalienable rights. The three right do not exist when and where people aren’t safe. Although some of us will choose to sacrifice our own personal safety to protect the rights of others. Nobody has the right to make you unsafe., nobody. “We are each responsible for our own safety.” Who’s here from Security, Risk Management, HR, Emergency Prepardness

Learning Objectives Scope & Impact of Workplace Violence Typology of Workplace Violence & Risk Factors Recognizing/Avoiding Dangerous People & Situations Responding to Threats & Assaults . Type I- Person has no relationship to the business or its employees; person is usually robbery, sexual assault or crime usually involved Accounts for approximately 85% of workplace homicides. Risk factors are Working alone Handling money, Working the nights, poor lighting, High crime areas Type II- Client/Patient or family member and becomes violent while receiving care or services Risk factors are alone or with few other present, inadequate security measures, working with persons with dementia, subtance abusers, severe mental illness, or history of violence. TYPE III- Current or former employee, Risk factors, Inadaquate employee screening, high stress work conditions, WPV policies lacking, weak or not enforced. TYPE IV_ Current/previous relationship with an employee. Domestic violence spill over. Lack of access controls, lack of fast help communications and response.

Workplace Violence

Definition Workplace violence is any physical assault, threatening behavior, or verbal abuse occurring in the work setting A workplace may be any location either permanent or temporary where an employee performs any work-related duty This includes, but is not limited to, the buildings and the surrounding perimeters, including the parking lots, field locations, clients’ homes and traveling to and from work assignments

Workplace Violence Includes: Beatings Stabbings Suicides Shootings Rapes Psychological traumas Threats or obscene phone calls Intimidation Harassment of any nature Being followed, sworn or shouted at

Continuum of Violence Insulting Bullying Intimidating Threatening Warning signs of violent behavior may be classified into three levels. Not everyone exhibiting warning signs will become violent. However, no warning sign should be completely ignored. Any one or combination of warning signs, at any level, may indicate a potentially violent situation. Level 1: Intimidation Level 2: Escalating Level 3: Further Escalation Level 4 Extreme Escalation In Level 1, the person exhibits intimidating behaviors that are: Discourteous/disrespectful,Uncooperative, and/or Verbally abusive. Level 2 Argues with staff, family, patients and others, Refuse to obey agency policies or procedures. Sabotage equipment or steal property for revenge. Verbalize wishes to hurt people Stalk, harass, or show undue focus on another person. Make direct or indirect threats (in person, in writing, by phone). Views himself or herself as a victim. Level 3 usually results in some form of emergency response. In such cases, the person displays intense anger resulting in: Suicidal threats. Physical fights or assaults others Damage or destruction of property. Concealment or use of a weapon to harm others. Display of extreme rage or physically aggressive acts, throwing or striking objects, shaking fists, verbally cursing at others, pounding on desks, punching walls, or angrily jumping up and down. Insulting Bullying Intimidating Threatening Vandalizing Stalking Slapping Shoving Pinching Hitting Kicking Biting Weapon Use

Statistics on Workplace Violence Homicide is the second leading cause of death in the workplace 1# among women and supervisors Assaults and threats of violence number exceed 2 million a year

Economic Impact of Workplace Violence Cost 500,000 employees 1,175,100 lost work days each year Lost wages: $55 million annually Lost productivity, legal expenses, property damage, diminished public image, increased security: $ billions $

CRIMINAL INTENT Violence Type I The perpetrator has no legitimate relationship to your business or its employee(s). Violence is incidental to another crime, such as assault, robbery, theft, or burglary. Most workplace homicides (85 percent) are Type I violence. RISK FACTORS: Handling cash, valuables or drugs Working alone or isolation Inadequate security & access controls High risk neighborhoods & locations Poorly lit parking areas Inadequate training Be clear no fool proof method for predicting violence by strangers. Mental illness, intoxication? Gut instinct, guesses Dark, isolated Capability to harm, physicallity weapons, multiple potential assailents?

PATIENT/CUSTOMER/CLIENT (and their families and associates) Violence Type II PATIENT/CUSTOMER/CLIENT (and their families and associates) Accounts for a majority of nonfatal workplace violence incidents. Victims are often patient care providers. Healthcare occupations are 18% of workforce BUT 48% of WPV victims RISK FACTORS: Working alone or isolation Prevalence of guns and other weapons. Dementia, substance abuse/use & mental illness Budget cuts for mental health services. Inadequate training Be clear no fool proof method for predicting violence by strangers. Mental illness, intoxication? Gut instinct, guesses Dark, isolated Capability to harm, physicallity weapons, multiple potential assailents?

Worker On Worker Violence Type III Employee(or former), vendor or contractor who attacks or threatens employees or former employees. Worker-on-worker fatalities account for approximately 7 percent of all workplace homicides. RISK FACTORS: Inadequate pre-employment screening. Lack of effective WPV Polices. Employee terminations. Inadequate training Be clear no fool proof method for predicting violence by strangers. Mental illness, intoxication? Gut instinct, guesses Dark, isolated Capability to harm, physicallity weapons, multiple potential assailents?

Personal Violence Violence Type III Perpetrator has no relationship with the business but does with the intended victim. This category includes victims of domestic violence who are assaulted or threatened while at work. Accounts for about 5 percent of all workplace homicides. RISK FACTORS: Lack of E.A.P. program. Uncontrolled public access to work space. Lack of effective WPV Polices. Inadequate training Be clear no fool proof method for predicting violence by strangers. Mental illness, intoxication? Gut instinct, guesses Dark, isolated Capability to harm, physicallity weapons, multiple potential assailents?

A Simple Model The Fire Triangle Heat Air For many years the fire traiangle has been used to teach how Heat, Air and Fuel are all required for combustion to occur. Take away one and there is no fire or a fire will go out. Fuel

Violence! The Violence Triangle Intent Ability Opportunity Now the Violance Triangle of ability, intent and opportunity provides a simple easy model avoiding violence and managing to reduce harm should it occur. Opportunity

Awareness Critical for use: Before Entering/Changing Locations When Traveling When Encountering Unknown Persons Before Hiring He'll feel you out with sucker questions like "Hey Miss! Can you help me?" or "Excuse me, Ma'am, do you know what time it is?" or "Do you know where the Sears store is?" Or he'll pay you 'compliments' like "Nice ass!" "Great legs!" Testing may last ten weeks or ten seconds. He may whisper or holler. He may walk beside you or stop and face you. His come-ons and questions may even sound plausible! Don't be taken in --- your creepy feeling tells you what's really going on: You are being tested. You are in danger. The imminent next act will be the assault itself. You yourself need to do something.

Awareness Tools & Resources” Sex Offender Registry Crime Maps Criminal Justice Look Ups Background Checks Intuition Who is he? And what’s he doing here? He'll feel you out with sucker questions like "Hey Miss! Can you help me?" or "Excuse me, Ma'am, do you know what time it is?" or "Do you know where the Sears store is?" Or he'll pay you 'compliments' like "Nice ass!" "Great legs!" Testing may last ten weeks or ten seconds. He may whisper or holler. He may walk beside you or stop and face you. His come-ons and questions may even sound plausible! Don't be taken in --- your creepy feeling tells you what's really going on: You are being tested. You are in danger. The imminent next act will be the assault itself. You yourself need to do something.

Actions If Attacked or Threatened Experts Agree… The most effective precaution is… Having a plan ahead of time. He'll feel you out with sucker questions like "Hey Miss! Can you help me?" or "Excuse me, Ma'am, do you know what time it is?" or "Do you know where the Sears store is?" Or he'll pay you 'compliments' like "Nice ass!" "Great legs!" Testing may last ten weeks or ten seconds. He may whisper or holler. He may walk beside you or stop and face you. His come-ons and questions may even sound plausible! Don't be taken in --- your creepy feeling tells you what's really going on: You are being tested. You are in danger. The imminent next act will be the assault itself. You yourself need to do something.

You’ll NEVER lose a fight Action #1 Running Away You’ll NEVER lose a fight you run away from! He'll feel you out with sucker questions like "Hey Miss! Can you help me?" or "Excuse me, Ma'am, do you know what time it is?" or "Do you know where the Sears store is?" Or he'll pay you 'compliments' like "Nice ass!" "Great legs!" Testing may last ten weeks or ten seconds. He may whisper or holler. He may walk beside you or stop and face you. His come-ons and questions may even sound plausible! Don't be taken in --- your creepy feeling tells you what's really going on: You are being tested. You are in danger. The imminent next act will be the assault itself. You yourself need to do something.

Action #2 Getting Help Call 911 Coded Distress Signal Security System Elevators On the “Street” He'll feel you out with sucker questions like "Hey Miss! Can you help me?" or "Excuse me, Ma'am, do you know what time it is?" or "Do you know where the Sears store is?" Or he'll pay you 'compliments' like "Nice ass!" "Great legs!" Testing may last ten weeks or ten seconds. He may whisper or holler. He may walk beside you or stop and face you. His come-ons and questions may even sound plausible! Don't be taken in --- your creepy feeling tells you what's really going on: You are being tested. You are in danger. The imminent next act will be the assault itself. You yourself need to do something.

Psychological Barriers Action #3 Barriers Indoor Barriers Outdoor Barriers Psychological Barriers He'll feel you out with sucker questions like "Hey Miss! Can you help me?" or "Excuse me, Ma'am, do you know what time it is?" or "Do you know where the Sears store is?" Or he'll pay you 'compliments' like "Nice ass!" "Great legs!" Testing may last ten weeks or ten seconds. He may whisper or holler. He may walk beside you or stop and face you. His come-ons and questions may even sound plausible! Don't be taken in --- your creepy feeling tells you what's really going on: You are being tested. You are in danger. The imminent next act will be the assault itself. You yourself need to do something.

Action #4 Verbal Self Defense Verbal Judo* Redirection Focused Empathy 1. Ask 2. Set Context 3. Offer Options 4. Confirm 5. Next Step Redirection Focused Empathy He'll feel you out with sucker questions like "Hey Miss! Can you help me?" or "Excuse me, Ma'am, do you know what time it is?" or "Do you know where the Sears store is?" Or he'll pay you 'compliments' like "Nice ass!" "Great legs!" Testing may last ten weeks or ten seconds. He may whisper or holler. He may walk beside you or stop and face you. His come-ons and questions may even sound plausible! Don't be taken in --- your creepy feeling tells you what's really going on: You are being tested. You are in danger. The imminent next act will be the assault itself. You yourself need to do something. * “Verbal Judo, The Gentle Art of Persuasion”, George J Thompson & Jerry B. Jenkins, HarperCollins 1994

4. MUST NOT CAUSE PAIN OR HARM TO PATIENTS!!! Action #5 Self Defense Rules for Self Defense 1. Last Resort 2. Always Full Power 3. Has Only One Purpose 4. MUST NOT CAUSE PAIN OR HARM TO PATIENTS!!! He'll feel you out with sucker questions like "Hey Miss! Can you help me?" or "Excuse me, Ma'am, do you know what time it is?" or "Do you know where the Sears store is?" Or he'll pay you 'compliments' like "Nice ass!" "Great legs!" Testing may last ten weeks or ten seconds. He may whisper or holler. He may walk beside you or stop and face you. His come-ons and questions may even sound plausible! Don't be taken in --- your creepy feeling tells you what's really going on: You are being tested. You are in danger. The imminent next act will be the assault itself. You yourself need to do something.

Action #6 Self Defense Tools Firearms Stun Guns Blunt & Edged Weapons Improvised Self Defense Spray He'll feel you out with sucker questions like "Hey Miss! Can you help me?" or "Excuse me, Ma'am, do you know what time it is?" or "Do you know where the Sears store is?" Or he'll pay you 'compliments' like "Nice ass!" "Great legs!" Testing may last ten weeks or ten seconds. He may whisper or holler. He may walk beside you or stop and face you. His come-ons and questions may even sound plausible! Don't be taken in --- your creepy feeling tells you what's really going on: You are being tested. You are in danger. The imminent next act will be the assault itself. You yourself need to do something.

Questions, Comments, Concerns? Joe Rosner WWW.BestDefenseUSA.com Joe.Rosner@USA.net 888 439-1411

Closing Thought The most important thing we do today, tomorrow and everyday is to go home safely.

CV of Joe Rosner US Army Drug & Alcohol Spec./Unit Police Private Investigator/Bodyguard Evanston Park Police Officer Multiple Black Belts Founder/Director of Best Defense USA Author of-- Street Smarts & Self Defense for Children The Real Estate Safety Book Taking Care!: Personal Safety for Home Health Workers Workplace violence can be any act of physical violence, threats of physical violence, harassment, intimidation, or other threatening, disruptive behavior that occurs at the work site. Workplace violence can affect or involve patients, patient families, visitors, vendors, contractors, neighbors and co-workers.

Additional Resources www.BestDefenseUSA.com www.gavindebecker.com/ www. www.shrm.org http://www.osha.gov He'll feel you out with sucker questions like "Hey Miss! Can you help me?" or "Excuse me, Ma'am, do you know what time it is?" or "Do you know where the Sears store is?" Or he'll pay you 'compliments' like "Nice ass!" "Great legs!" Testing may last ten weeks or ten seconds. He may whisper or holler. He may walk beside you or stop and face you. His come-ons and questions may even sound plausible! Don't be taken in --- your creepy feeling tells you what's really going on: You are being tested. You are in danger. The imminent next act will be the assault itself. You yourself need to do something.