Hospital staff need protection; is pepper gel the right prescription?

Opinion

Hey there, time traveller!
This article was published 15/04/2024 (542 days ago), so information in it may no longer be current.

In the rush to protect front-line hospital staff, has the NDP government put its pepper gel before the cart?

Last week, responding to criticism the province had been lax in addressing security concerns at Health Sciences Centre, Health Minister Uzoma Asagwara directed that new security officers — who started work Monday — be armed with pepper gel.

The minister’s directive came after arbitrator Kris Gibson, responding to a grievance by the Manitoba Nurses Union about safety concerns, found employees face “an unacceptable level of risk” outside HSC buildings and within parking garages. Gibson gave Shared Health, the province’s main health authority, 30 days to develop a safety plan to address the concerns.

The minister issued the directive last week, in the wake of a Free Press report about the HSC’s new complement of “institutional safety officers” — specially trained security personnel with the authority to restrain and detain unruly patients and visitors — were not equipped with the same tools as the same classification of security officers working in University of Manitoba Bannatyne Avenue medical sciences buildings, which make up part of the larger HSC campus.

Those officers, who are employed by the university, carry batons and pepper gel spray. The MNU, which represents nurses in HSC’s adult emergency department — where the number of violent incidents has been increasing — was dismayed to learn the just-trained security personnel that started Monday would be equipped with handcuffs, period.

Shared Health had made that decision on the basis that some patients would be uncomfortable seeking care in an environment where security officers were visibly armed.

Asagwara, a registered pyschiatric nurse, agreed with the union’s concerns and issued the pepper gel directive the day after the arbitrator’s decision.

On one hand, it’s refreshing to see a minister responding to a concern with urgency, particularly when it’s connected to a story that has, as its underlying narrative, years of inaction.

But on the other, there is reason to be concerned that Asagwara has not fully considered the implications of their decision.

The minister is clearly aware that health-care staff face a constant threat of violence. Between skyrocketing mental-health and addictions problems and a hospital system that is overflowing and gridlocked, patients and their families are frustrated. And that frustration is being directed at staff.

The MNU’s grievance and the arbitrator’s final report clearly show that in Manitoba, Shared Health failed to act in a timely manner to address safety concerns in and around parking facilities at the campus. At a time when the province is desperately trying to recruit 1,000 new health-care workers, a failure of that kind seems hilariously counter-intuitive.

However, while the minister has correctly assessed the threats facing staff, it’s not clear Asagwara has correctly assessed the impact of arming hospital security with something as dangerous as pepper gel spray.

Proponents will point out that pepper gel is one of the most-reliable, non-lethal tools that can be employed by security personnel. They will further note that pepper gels and foams are more accurate than the more common pepper spray when deployed, and less harmful to both the person using them and others who may be in close proximity to the target.

The plume from traditional aerosol pepper spray is extremely difficult to contain and, when used indoors, it can invade ventilation systems and take hours to fully decontaminate a room where it has been deployed.

However, there is no consensus that pepper gel is a good idea in a hospital setting, where patients and staff are in close proximity to each other.

At hearings on the MNU grievance, there was testimony from Marc Saindon, director of security services at HSC. A former police officer, Saindon said that while aerosol weapons could be safely used outside, the deployment inside a hospital would create significant contamination problems.

Based on the fact that no other testimony or evidence was brought forward at the grievance in support of using pepper gels inside a hospital, Gibson declined to issue an order that they be used by HSC security.

You may ask, what evidence does the minister have that the arbitrator did not?

Most of the research and reporting on pepper gels indicates that while it causes less collateral contamination than traditional sprays, it does not eliminate the problem. And with a spray range of seven or more metres, it’s not hard to imagine innocent bystanders being affected if a security guard’s aim is off by a smidge.

Finally, it is somewhat disconcerting that there seems to have been precious little consideration about whether the introduction of better-armed security will act as a deterrent to violent behaviour, or trigger more of it.

It may be instructive to remember that this community and many others are struggling with the best way to intervene in mental-health and addictions crises without the use of uniformed police because it is well established that uniforms and weapons tend to provoke as many violent incidents as they quell.

Something must be done to protect staff from the rising tide of violence. But someone is going to have to produce compelling evidence that batons and pepper gel actually make the hospital safer.

The minister is, no doubt, aware that “do no harm” is one of the most important overarching principles in health care. Until we get more evidence, it’s going to be hard to see how pepper gel fits into that principle.

dan.lett@winnipegfreepress.com