– I have experienced being beaten and scratched, but still have not written a non-conformity, says Linnea. She has been employed by several health institutions in Rogaland, and has been professionally active in the health and care sector for five years. Out of consideration for her workplaces, news does not use Linnea’s surname. Although she admits that she has not been a role model in the past, she now hopes that more employees will take responsibility for their own work. Part of everyday life Examples of deviations in the health and social sector can be less serious, such as lights that do not work as they should. But it can also mean that you are hit, scratched, spat on, harassed or threatened, for example by users, patients or customers. Figures from 2016 and 2019 show that it is in the health and social services that there is the greatest risk of being exposed to such incidents. Linnea says that there has been a greater focus on deviations in her workplaces recently, but that many also think that it is part of the job. – I think you forget to write deviations because it becomes a matter of habit. If there are violent patients or users, you might get used to them doing that, and stop thinking about it so much, she says. In addition, she points out that the patients or users often do not understand the situations they are in. – Then they can act out in that way. We know that the intention is not to harm us, and we often get sympathy for them, instead of thinking that one should sit down and write the deviation. Gunn Robstad Andersen is a senior adviser at the Norwegian Labor Inspection Authority. Photo: Norwegian Labor Inspection Authority At the same time, the Norwegian Labor Inspection Authority is experiencing significant under-reporting of deviations in the health sector. – We are learning that there is an under-registration of violence and threats in the health and social care sector, and that this happens in most businesses even where they have a system for reporting deviations, says senior advisor at the Norwegian Labor Inspection Authority, Gunn Robstad Andersen. Figures taken from Statistics Norway. Several reasons Andersen in the Norwegian Labor Inspection Authority says the inspectors have learned that some businesses in the health and social care sector under-register deviations because: Violence and threats are considered “part of the job”. It “happens all the time” In some workplaces, employees are so frequently exposed to violence and threats that it is not practically possible to register the incidents. Employees experience that the deviations are not followed up by the management. The employer or employee is unsure which cases are “serious enough”. Linnea also points out that health and care personnel often do not want to sit on overtime to write deviations. – You are told to write a deviation, but then you are in a hurry during an evening shift. When you get tired and burnt out after big events at work, you just want to go home. Then you don’t write deviations, she says. In 2021, the Norwegian Labor Inspection Authority was notified of a total of 57 accidents as a result of injuries caused by violence and five threats of violence within health and social services. – There are probably also dark figures related to the number of notifications we receive about violence and threats in the sector, says Robstad Andersen. She points out that not all deviations must be reported to the Norwegian Labor Inspection Authority. They must be notified if an employee is seriously injured as a result of, for example, violence at work. A “vicious circle” Marius Bergeslien Malmo is the company’s chief safety officer at Stavanger University Hospital. He believes that non-conformity reporting is one of the most important things health workers do in addition to their work for patients. – The deviation system is one of many quality systems we use to adjust what we do, he says. Deviations are part of the documentation that forms the basis for the risk assessment in a business. The aim is to reduce the number of deviations and to reduce possible costs as a result of the deviations. It is also a key factor when assessing staffing needs at workplaces. – I have worked in several places where it has been understaffed, and it ends up with sick leave and deviations that have not been written. Then we won’t bring in extra people, because we have no arguments when nothing is written, says Linnea. Linnea admits that she is not a model. Several times she has failed to write deviations in cases of violence. Photo: Erik Waage / news Getting deviations when deviations are not written The chief union representative of the Norwegian Nurses Association in Health Stavanger, Mette Øfstegaard, says it varies how good employees are at reporting deviations. – Some people are good at reporting. Others report once without getting a response, and they find that nothing happens. It is a pity. We ask people to report, says Øfstegaard. She points out that passing on notices of deviations is a central part of her role as shop steward. – If we are to complain about something as shop stewards, and there is no deviation written on it, it is questioned whether it really happened, she says. In connection with this matter, news has been in contact with several municipalities, all of which say they have a focus on issuing deviations. As one of the department heads in one institution writes: “We have received a non-conformity that no non-conformity is written. I have also called for deviations that we have seen, and which have not been written.” All municipalities express that they encourage staff to have a low threshold when it comes to reporting deviations. Has been discussed for years Head of health and welfare in KS, Anne Gamme, does not know of any figures that support the Norwegian Labor Inspection Authority’s view of under-reporting. – But what we do know is that there have been many discussions over several years about how deviations should be managed, both when it comes to deviations on HSE and other deviations. She adds that KS feels that there is a great interest in creating a culture to prevent deviations, and to ensure systematic work with quality improvement of HSE and patient safety. – HSE deviations must be reported when there is a breach of HSE legislation. There may be doubts about when there is a breach and when it is not, or whether a case should be categorized as an unwanted event or deviation. In any case, the most important thing is that the message is taken care of. Hi! Do you have thoughts about the case you have read, or input on other things we should check out? Feel free to send me an email!
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Healthcare workers are beaten and clawed at work without reporting – news Rogaland – Local news, TV and radio
