The hospital’s enhanced violence prevention program, born out of the tragic death of nurse Lori Dupont, who was killed on the job in 2005 by her colleague and former boyfriend Dr. Marc Daniel, was still relatively new, drawing varied responses from Hotel-Dieu staff.

“When you say to people: ‘You’re compelled to take training that will prevent you from being violent,’ people feel targeted and they get their backs up,” said Dawn Ricker-Vassos. “And particularly … because of Dr. Daniel, I think physicians felt really targeted by this.”

But a year into her unique role at Hotel-Dieu, Ricker-Vassos said attitudes have changed, with doctors and hospital staff embracing workplace violence prevention training with positive feedback and even suggestions on how to make it better.

“I’ve been just astounded by the level of buy-in and participation,” Ricker-Vassos said.

The workshops — compulsory for every employee and physician seeking privileges at the hospital -— are among the sweeping changes Hotel-Dieu has made since a lengthy coroner’s inquest ended with 26 jury recommendations aimed at preventing future violent incidents in hospitals across the province.

Hotel-Dieu spokeswoman Kim Spirou said she knows of only a couple of physicians who refused to take part in the workshops and have lost privileges as a result. Both doctors had only courtesy privileges at the hospital, which usually involves dropping by from time to time to check in on patients. Spirou said Hotel-Dieu has not lost any specialists because they wouldn’t participate in violence prevention training.

Every physician must meet with Ricker-Vassos at least once and attend the workshop where key topics include conflict resolution and recognizing violence, bullying and bad behaviour in the workplace.

The hospital’s code of conduct, bylaws and rules against harassment are reviewed, and Ricker-Vassos said she makes sure everyone understands that the definition of violence in the workplace goes beyond physical contact.

“When you’re standing over someone and looming in their face, that’s workplace violence. When you’re threatening to have someone’s licence or livelihood, that’s workplace violence. And that has devastating impacts on people,” she said.

Most of the complaints that come through her office have to do with “incivility and miscommunication,” she said.

“And when it lingers, things get worse and worse.”

Ricker-Vassos said violence prevention training is just one part of her job. She spends a lot of time meeting with staff, physicians, supervisors and managers and working to resolve conflicts between people before they escalate.

“People need to be comfortable with being uncomfortable. Sitting down to address a conflict is very uncomfortable,” she said. “People would rather deliver death news, I think, than deal with these personal, contentious issues,” she said.

“It’s a matter of bringing people together and creating an ongoing plan for a resolution and then a follow-up to that plan to make sure that supervisors are working with their staff to improve relationships and communication.”

Ricker-Vassos calls her office a “one-stop shop” for staff affected by conflict and violence, whether it’s at work or at home. Many people approach her with personal issues, usually dealing with domestic violence.

At Windsor Regional Hospital, there has been a longstanding program aimed at preventing workplace violence, but there is no compulsory training for staff or physicians.

Dr. Gary Ing, the hospital’s chief of staff, said it’s not necessary because violence and conflict prevention is part of doctors’ “ongoing education” while they’re at WRH and they know that any misbehaviour will be taken into account when the status of their privileges is being reviewed.

“The physicians don’t feel obligated, but they’re willing to participate in the complaints process,” Ing said. “It has worked out for us and we’ve had a lot of success over the years.”

Ing said the hospital relies on its recently redrafted professional conduct bylaws, the physician complaint management policy and the office of mediator Aruna Koushik to deal with conflicts as soon as they are flagged.

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