Recent Attacks on Nurses Underscore Need For Cal/OSHA Workplace Violence Prevention Standard

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Two separate and horrific incidents of workplace violence took place on Easter Sunday at Olive View-UCLA Medical Center and Harbor-UCLA Medical Center in the Los Angeles area. These incidents speak directly to the need for a comprehensive Cal/OSHA workplace violence prevention standard that covers all healthcare workers in California.

The first attack happened when a man allegedly bypassed the weapons screening area at Olive View-UCLA Medical Center in Sylmar and allegedly stabbed a nurse twenty-two times in her upper body with a knife. She is in critical condition.

Later in the morning, another man walked into Harbor-UCLA Medical Center in Torrance, grabbed a nurse, and stabbed her in the ear with a pencil. The nurse was treated at the hospital for non-life threatening injuries.

The California Safe Care Standard Campaign is a campaign to get a Cal/OSHA standard on workplace violence prevention to cover all healthcare workers in the state of California –not just acute care nurses, not just public health nurses — everyone. The campaign has been active in educating, mobilizing, and organizing healthcare workers and allies, and in doing so, it hears firsthand of the violence that healthcare workers experience on the job on a daily basis. The violence — physical, sexual, emotional, and verbal — is pandemic, but not all of it “makes” the news. It is not until attacks occur such as the two that happened on Easter that the mainstream media reports about the problem.

While not all workplace violence is preventable, there is clarity about the fact that with engineering and administrative controls in place to address the most common and predictable instances, a comprehensive regulation — which would be enforced by Cal/OSHA — would significantly help to eliminate the hazard.

Regulation v. Legislation

The easiest way to explain the difference between regulation and legislation is that one is very broad and vague (legislation), and the other is very specific and enforced, usually, by a government agency (regulation).

There are merits to each. State legislation is law that is created by statutes that originate from legislative bills which are introduced by either the Senate or the House (in California, the Assembly). Legislative language is usually broad and very abstract and frequently tries to describe the end result of what the legislation should achieve. Where it falls short is that it does not specifically say how this result will be achieved, just that it wants to “get it done.” The process to “getting it done” is, in fact, the regulatory process.

The irony in California is that there is workplace violence prevention legislation that, for some unknown reason, is codified in licensing code. This means that Cal/OSHA — the agency charged with protecting workers in the state from occupational injuries and illness hazards (such as workplace violence) — can’t directly enforce this legislation. There is currently new workplace violence prevention legislation moving through the legislature, but it is not comprehensive, well thought out, or even very scientific in its approach to dealing with the hazard of violence.

Regulations are promulgated by state agencies, such as Cal/OSHA, which are codified in the California Code of Regulations and carry the force of law to the extent that they do not conflict with any statutes or constitutions of either the state or the federal government. Regulations are standards adopted as rules to implement, interpret, and make specific the law enforced or administered by an agency, in this case, Cal/OSHA.

Since California Labor Code Section 142.2 permits people or organizations to propose new or revised standards concerning occupational safety and health, and requires the Cal/OSHA Standards Board to consider these proposals, SEIU Local 121RN and the SEIU Nurse Alliance of California petitioned the Board with the California Safe Care Standard, now referred to and filed with the state as Petition No. 538.


For those not familiar with the use of the word “scope” as it applies to labor contracts, legislation, or regulations, it simply means who is or isn’t covered. When the California Safe Care Standard Campaign submitted Petition No. 538, it cited two incidents from October 2010: a psychiatric technician who was strangled by a patient at Napa State Hospital and a Registered Nurse working at the Contra Costa County jail in Martinez who died as a result of an inmate assault.

Scope is important because while the newly proposed legislation on workplace violence prevention for healthcare workers would definitely cover the two workers who were recently stabbed, it would not have covered the Napa State or Contra Costa nurses. Legislation or regulations that cover one class of healthcare workers but not another (or healthcare workers at some facilities but not others) is simply inadequate.

The mainstream media seems to understand legislation more so than regulation, and that’s okay. Workers — healthcare workers and working people of all trades — know and understand that limited legislation can’t bring about the preventive measures that are needed better than regulations that are specific, comprehensive, and enforceable.

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