Field Safety: Lets be careful out there

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Field Safety Lets be careful out there!

• Harman and Davis (1997) observe that one of the
  major obstacles to social workers safety in
  general is our strong commitment to helping
  people. This desire may lead us to minimize
  danger, overlook existing danger signs, be lax in
  anticipating danger, and not recognize that some
  clients cannot be helped and that some clients do
  not want our help.
• Presented by John Reeves, M.S., M.S.W.
• Field Practicum Director
• reevesj_at_byuh.edu
• 808.675.3836

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Definition of Workplace Violence

• Any act against an employee that creates a
  hostile work environment and negatively affects
  the employee, either physically or
  psychologically. These acts include all types of
  physical or verbal assaults, threats, coercion,
  intimidation and all forms of harassment.
• Workplace Violence Research Institute

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National Institute for Occupational Safety and
Health (NIOSH)

• violent acts (including physical assaults and
  threats of assaults) directed toward persons at
  work or on duty. This includes terrorism.

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Incidence rates for nonfatal assaults violent
acts by industry, 2000Incidence rate per 10,000
full-time workers
Source U.S. Department of Labor, Bureau of
Labor Statistics. (2001). Survey of Occupational
Injuries and Illnesses, 2000.
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Social Workers Often Victims of Violence

• OSHAs 2004 Guidelines for Preventing Workplace
  Violence for Health Care Social Service Workers
  reported 48 of all nonfatal injuries from
  occupational assaults violent acts occurred in
  the fields of health care social services.
• NASW found that among members (800) of the Child
  Welfare Specialty Practice Section, 19 had been
  victims of violence 63 had been threatened at
  some point in their careers.
• The American Federation of State, County
  Municipal Employees found that 70 of front-line
  child welfare workers had been victims of
  violence or threats while on the job.

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Legislative Response

• The Boni Frederick Memorial Bill (HB 362) was
  signed into law April 2005. Frederick, a social
  services aide with the Kentucky Cabinet for
  Health Family Services, was killed October 2006
  while conducting a supervised home visit between
  a state foster child and its mother.
• The Teri Zenner Social Workers Safety Act, H.R.
  2165 was introduced by U.S. Rep. Dennis Moore,
  D-Kan. May, 2007. Zenner, a social worker case
  manager was stabbed to death during a home visit
  with a client in 2004. NASW has endorsed this
  legislation.

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Causes for Increasing Violence Towards Social
Workers

• Client frustration with human service systems
• Budget cuts in services and provisions
• Increased levels of crime, drug use, and violence
  in society
• Antiauthority or antigovernment attitudes
• Disparity of income in the population
• Shift from institutional care to communitybased
  care
• Availability of guns

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Common Forms of Client Violence

• Verbal Threats
• Property Damage
• Attempted assaults
• Actual assaults

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Risky Practice Settings

• Criminal Justice Services
• 24-hour Residential Agencies (time at risk)
• Alcohol and Drug Services
• Child and Youth Services
• Mental Health Services
• Homeless Shelters
• Developmental Disability Mental Retardation
  Services
• School Social Work
• Family Services
• Medical Health Care Services
• Services to the Aged
• Clients Primary Physical Environment

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Risk Factors

• Prevalence of handguns other weapons
• Police criminal justice system using hospitals
  for criminal holds
• Release of acute chronic mentally ill patients
  from hospitals without follow-up care
• Hospitals, clinics, and pharmacies becoming
  robbery targets
• Client frustration over an inability to obtain
  needed services promptly
• Increase presence of gang members, AD abusers,
  trauma patients or distraught family members

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Risk Factors (continued)

• Low staffing levels
• Isolated work
• Solo work
• Lack of staff training in recognizing and
  managing hostile assaultive behavior
• Poorly lit parking areas
• Domestic violence spilling into the workplace

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Predictive Factors

• History of Violent Behavior
• Substance Use
• History of Child Abuse
• Presence of certain Medical conditions (brain
  injury)
• Age (15- 25 years), male, urban area,
  socioeconomic status
• Certain Mental Disorders, non-med compliant
• Access to Weapons
• Peer Pressure
• Level of Social Support
• Criminal Record
• Military Combat Experience

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Client Signals when Assessing Risk Modified from
Weinger, S.(2001), page 16.
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Client Signals continued Modified from Weinger,
S.(2001), page 16.
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De-escalation Techniques (Blank, 2005)

• Appear calm, centered, self-assured using a low
  monotonous tone of voice.
• Do not become defensive.
• Be respectful when setting limits or calling for
  help.
• Do not turn you back on the person. Keep eye
  contact level but do not stare. Allow physical
  space between you client. Keep your hands out
  of your pockets.
• Do not get loud or try to speak over a screaming
  person. Speak when they take a breath or pause.
• Empathize with the feelings, but not with the
  behavior. Do not argue or try to convince.
• Trust your instincts. If it is not working,
  STOP! Tell the person to leave, call for help,
  or leave yourself.

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Office Safety

• Become familiar with agency safety security
  practices, procedures, protocols, and policies.
  Learn your agencys procedures for dealing with
  violent situations.
• Arrange office to allow for quick exit and
  prevent entrapment.
• Do not have an excessive amount of items on your
  desk such as vases, paperweights, staplers,
  scissors, pens, letter openers. These items can
  become possible weapons.
• Create a pleasant office environment.
• Know how to activate alarm systems and other
  security devices. Know who you should contact
  when you need emergency help.
• Interview rooms should have two exits and be in
  view.
• Never work in the office alone.

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Office Safety continued

• When entering and leaving your agency, scan the
  environment for suspicious circumstances. When
  leaving the building, consider walking out with
  other staff.
• Consult with your Field Instructor and other
  staff regarding what measures they take to ensure
  personal safety.
• Be familiar with emergency exit procedures.
  (fire, power outage, natural disaster)
• Secure purses out of sight.
• Inform your Field Instructor of any safety
  concerns you may have regarding assignments or
  working with certain clients.
• Trust your instincts. Do not take risks that will
  jeopardize your personal safety.
• Be aware that clothing accessories can be used in
  harmful ways these include necklaces, dangling
  earrings, scarfs, and neckties.

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Home Visits

• Before you leave the office, make sure your Field
  Instructor/Staff know where you are going, what
  time you expect to return, your cell phone
  number, and the name of your client, their
  address, and phone number.
• Before your visit, make sure the vehicle is in
  good working order, the gas tank is full, keep
  the doors locked, and wear your seat belt. Lock
  all valuables in the trunk leaving nothing in
  view inside the car. Park in a place which will
  allow for quick escape.
• Before you go know your client (you may want to
  use the buddy system) know how to get there
  know the community. Schedule visits early in the
  day. Once at the location, make a visual
  assessment from the street to the yard to the
  front door.
• Be respectful. Remember that you are a guest.
  The client may perceive your visit as intrusive
  and threatening.

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Home Visits continued

• Dress appropriately leave jewelry, credit cards,
  and your check book at the office. Carry only a
  necessary amount of money with you. Walk
  confidently, be alert and aware of your
  environment.
• Always identify yourself and do not enter the
  dwelling until you are invited in. Choose a seat
  that is close to a door. Visually scan the room
  and note who else may be in the house. Do not
  conduct the interview in the kitchen.
• Know when to terminate the visit. If you believe
  your client or others in the home are under the
  influence of alcohol, drugs, or engaging in
  illegal behavior, leave immediately.
• Avoid arguments. Try to deescalate emotionally
  charged conversations. Remember, If your gut
  feelings tell you that things are getting out of
  control, leave immediately.
• Posted signs. Beware of Dog or No Trespassing.
  Alert client to your visit and ask the client to
  secure the dog and inform others that you are
  allowed to visit.

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Community Safety

• Know your community. Consult with your Field
  Instructor, staff or from those who work or live
  there.
• Limit number of items in your possession
• Fit in. Dont stand out as different.
• Be confident. Walk with a purpose. Try not to
  appear fearful.
• Pay attention to your surroundings.
• Carry a cell phone.
• Know where you are going. Get a map. If lost, ask
  for directions at a convenience store or a gas
  station.
• Ensure car is in working order, has enough gas,
  lock it, leave no items in view, park it close to
  where you are going, and in a position for a
  quick exit.

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Response to Personal Safety Incidents

• Immediately inform your Field Instructor and the
  Field Practicum Director
• Follow agencys policy regarding reporting safety
  incidents
• Complete incident report form (see sample form)
• Process incident with a trusted colleague
• Seek counseling
• Contact law enforcement
• Obtain medical attention

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Sample Incident Report Form

• Student name and contact information
• Field Instructor name and contact information
• Date, time, and location of incident
• Detailed description of incident
• Extent of Injuries, if any
• List witnesses and contact information
• Law enforcement involvement
• Name of hospital treated at and contact
  information
• Resolution of Incident

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References Resources For Safety Preparation

• Blank, B.T. (2005). Safety first Paying heed to
  and preventing professional risks. The New Social
  Worker, summer issue.
• Everett-Davis, M (2005). Guidelines for personal
  safety risk management A manual for social work
  practicum students. IHC Books. Woodbridge VA.
• Garthwait, C.L.(2007). Chapter 6 Personal
  Safety. The social work practicum A guide and
  workbook for students. Boston Allyn and Bacon.
• Griffin, W.V. (1995). Social worker and agency
  safety. In R.L. Edwards (Ed.-in-chief),
  Encyclopedia of social work (19th ed., Vol. 3,
  pp. 2293-2305). Washington, DC NASW Press.
• Irwin, D. (1997). Safety training for human
  services professionals. Protecting Children 13.1.
• NASW Standards for Social Work Practice in Child
  Welfare http//www.socialworkers.org/practice/stan
  dards/NASWChildWelfareStandards0905.pdf.

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References Resources continued

• Newhill, C. E. (2003). Client violence in social
  work practice Prevention, intervention, and
  research. New York Guilford.
• Occupational Safety Health Administration.
  (2004). Guidelines for preventing workplace
  violence for health care and social service
  workers. Retrieved from www.osha.gov/Publications/
  osha3148.pdf.
• Sheafor, B.S., Horejsi, C.R. (2006). Techniques
  and guidelines for social work practice (7th
  ed.). Boston, MA Allyn Bacon.
• Versen, G. (1995). Be careful, its a jungle out
  there A look at risks in field placement. The
  New Social Worker. 2(1) 7-8.
• Weinger, S. (2001). Security risk Preventing
  client violence against social workers.
  Washington, DC NASW Press.