 Hi everybody, I'm Donna Prosser, Chief Clinical Officer at the Patient Safety Movement Foundation. Today we are here talking with Katie Ann Blanchardt about workplace violence. Katie is the CEO and co-owner of WPV Solutions, and she's also a PhD candidate at the University of Washington. Welcome, Katie. Thank you. Thanks so much for joining us today. I wonder if you could tell us just a little bit about your background. Yeah, so I started off nursing actually in the military. I was an Army nurse for six years, and I worked in pediatrics and oncology. I medically retired out of the military in 2019, and I've been a dedicated student ever since. Wonderful, wonderful. Well, nursing is a lifelong profession, learning profession, isn't it? Sure, it's lifelong. That's right. That's right. Well, you know, when we talk about workplace violence, a lot of times the words that we hear are lateral violence or bullying or, you know, different terms like that, can you tell us a little bit about what lateral violence is and how that is distinguished from bullying? Yeah, and how I like to think about it and what's easiest for me is to think about workplace violence as being more of an umbrella term. And within this term, you kind of have a spectrum of behaviors and actions that fall underneath that. Now, lateral violence and a lot of, you know, first off, a lot of the violence is kind of labeled based on the perpetrator type and that relationship with the victim, or in what kind of context, like what the underlying cause of the violence is. And so in lateral violence, really what that means is somebody in your peer group. It's one person in that group towards another. So an employee to an employee kind of on the same organizational level. And then when you're talking about bullying, what kind of sets bullying aside is this repeated behaviors or attacks in the sense of, you know, situations where it makes you feel uncomfortable and unsafe. And so that's really those two concepts kind of broken apart. And they all kind of fall within this umbrella. And sometimes lateral violence can be bullying. So you can have more than one of these factors going on at a time. And in the spectrum of workplace violence, you have physical violence, psychological violence and verbal violence. Well, thanks for clarifying that. Now I know you had a safety experience in your role as a nurse, which led you into this work. Can you tell us what happened? Yeah. So in my case in 2016, I was working as a nursing supervisor. And at the time I had an employee who was acting very belligerent and very unprofessional was bullying me consistently. And what was happening is those actions were escalating. It started off with yelling and inappropriate behavior. And from there became physical type of tax and, you know, kind of ostracism and telling employees that he was going to take care of me and that he was going to fix the issue. And so these these open threats really kind of escalated the situation. And after nearly a year of working with this employee and being a supervisor, and a lot of other factors going into that. You know, I'd gone to my leadership, I had asked for help, I'd asked for mentorship, what kind of resources were out there. But unfortunately my organization felt at the time that it was just part of the job. And it was just part of being a young supervisor. And so those are kind of the answers that I got and I was asked to continue in my work. In 2016, in September 7, I was working after hours, and I saw this employee, we had had an altercation earlier in the day where he was upset with me and yelled at me so I was kind of letting him cool off letting myself cool off and just in my office working. He came into my doorway and cornered me in my small office and threw gasoline at me and doused me with this gasoline and then let me on fire. After I was on fire, I was screaming and went out into the hallway and luckily two of my coworkers, both doctors came to save me and put out the flames. And at that time, my attacker came after both the people that were trying to save me and again myself. And so I survived that, but it still carries through everything that I do and that kind of psychological and emotional and physical of course I'm 20% burned my total body surface area and still live with a lot of the repercussions from that attack. What a horrible situation I can only imagine. I'm so sorry that you had to deal with that but you know it certainly certainly is an extreme of what we might see in a healthcare organization, you know, I think lateral violence bullying workplace violence happens on a much, a much lower level more times than not. I wonder if you can tell us you know what are the common challenges that healthcare organizations face me in the typical sense of lateral violence and bullying. Yeah, and first I just want to that's a really great point and a lot of times it doesn't escalate to the point where my situation escalated. But what's important to know is that a lot of times there are these red flags, there are situations and risk factors that we should be identifying so that we can prevent it from getting to this level. And that's really the important part is in my situation that whole year of dealing with this escalating behavior, there could have been so many interventions and so many things done on safety nets put in place that just weren't there and so that really is what motivates me to tell my story and do this advocacy work. So when we're talking about organizations as a whole, really the, the barriers of confronting workplace violence is that the complexity of it that there's just so many pieces and such a wide variety of the spectrum of workplace violence of behaviors going on. And so, at so many different levels right and we know from working in patient safety that a lot of times this is an issue with other, you know, situations as well as just the complexity of the healthcare facility, also in the healthcare world there's a lot of power differentials and power divides between workers. And that's, that's very highlighted in the healthcare field versus some of the other industries. And so these kinds of high stress jobs, and these power differentials really help to create this environment of violence unfortunately, which we know is, you know, everything that we don't want to be. So when we're talking about the organization. Some of these barriers is that cultural humility and that conflict resolution having accountability within the workplace. And then when we're talking about employees, some of the barriers are just not knowing what workplace violence is a lot of people with a spectrum of violence even entails they think that maybe this is just part of the job and this is just the norm that a lot of times we work with people that are at their best and that dealing with some of these violent tendencies is just part of the job that we signed up for. But really what we need to do is change that culture and make everybody safe in a way that's safe for our patients and safe for employees. And what are some other recommendations that specific recommendations that healthcare organizations can can implement. That's a great question and leadership should definitely prioritize and create this culture of safety, and how that is done on is on every single organizational level. So it's really making a commitment, engaging every level and making sure that they know that this is a priority for the organization, and it's really from the mission down right so it's every, every level every person and it's living that mission, not just something on paper that we check the box. So part of that is going to be creating a program that addresses some of these issues. So within that program we're talking reporting education training conflict resolution, those kinds of different solutions that could help promote safety and help decrease the number of events that you have. So also looking at your security initiative, looking at how we can better place employees and patients and having those safety nets if we know that, you know, there's there's been issues or high risk situations. And this is also kind of feeds into looking at the risk factors, what kind of risk factors and every organization is going to have different risk factors and units are going to have different risk factors. So identifying those risk factors, and then really looking at how we can best address some of these things. So then it's also the cultivation of psychological safety and cultural humility. And when we talk about psychological safety, that's really making sure that people know that they can speak out that they can tell us what's going on that if they don't feel safe that they feel empowered to say something. So cultural humility, to me means the ability to to be okay with not knowing to ask questions to ask for help if you're unaware of somebody else's culture, or, you know, just having that understanding that we have everything, and that we have to really take it from a place that understanding and open minded, and not painting this kind of very broad stroke on cultures and people in every category of life. We talked a little bit about transformational leadership styles, but this is so important because this is really, you know, being able to go and have discussion and open up and having people feel that they can come to you. And this very much embedding of the culture of safety, and those kinds of principles of communication and the teamwork that is needed to be able to start to get at some of these issues. And lastly, I'm just going to talk a little bit about education and training. And this could go from de-escalation all the way into, you know, training what happens if there is an event and then the debriefing and supporting and resources after the event. Wow, that's fabulous information. Thank you so much, Katie for joining us today and for sharing your story. Here at the patient safety movement foundation, we know that we will never get patient safety without health worker safety. So this is such an important topic for all of us. And I know that you were very involved in creating our actionable patient safety solutions for workplace safety. So for those of you who are joining us today who have not yet seen that it's a new apps that we have on our website. So thank you so much, Katie for joining us. I hope we can have you back another time to talk more about workplace safety. I thank you so much for having me and having me be part of this discussion. I really do appreciate it. Excellent. We'll have a wonderful day, Katie.