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9. Dealing With Injured or Assaulted Caregivers

Caregiver Reports

When a caregiver reports being assaulted and/or injured in the course of his or her work, the employer should assess the injury, provide first aid treatment if required, and facilitate any short- or long-term medical treatment that is necessary.

First Aid and Subsequent Medical Care

Provision for first aid should be made.

In addition:

• provision needs to be made for employees to be able to summon help quickly
• plans/arrangements may be necessary with local medical care facilities for urgent consultations in cases of injuries.
• A treatment plan or provider network should be established in advance, not only to deal withy any physical injuries but also to provide a treatment plan for any psychological or mental health issues that might arise from a workplace incident.

Rehabilitation

Best practice rehabilitation policies, procedures and responsibilities include:

• early intervention
• a strong management commitment to rehabilitation including the provision of safe modified duties during the recovery phase.
• appropriate (insurance and work fitness) certification by the treating doctors
• consideration of training and vocational needs
• the early development of rehabilitation plans in face-to-face interviews with the injured employee
• a supportive and consultative workplace culture for injured employees, including the provision and support for modified work and reduced hours of work in the short term
• the feedback into hazard management of issues arising out of the rehabilitation process
• return to work in a safe environment.

Supporting People who have been Injured or Assaulted

Employers have a duty of care towards employees to ensure that they are not harmed in any way by work activity. If violent incidents occur the effects should be minimised.

Long-term affects may include reduced morale, impaired performance, absenteeism, increased sick leave and the psychological trauma suffered by the people involved in the incident. The employer should have:

• documented procedures for prevention and early intervention strategies, as soon as an assault or the potential for an assault is identified
• procedures in place to be followed for an effective immediate response that controls and diffuses the situation
• access to a debriefing session if required (providers need to be aware of the deleterious effect on the individual of "traumatic incident debriefing" regimes - http://www.nice.org.uk/ [external link - pdf file]
• a rehabilitation assessment that considers:
  • time frames for interventions
  • the responsibilities of those involved
  • the methods for assessing needs
• A process to ensure that referrals are made to the relevant service providers for the appropriate treatment.

Dealing with Injured or Assaulted Employees

• When a caregiver reports being assaulted and/or injured in the course of his or her work, provide first aid treatment if required, and facilitate any short or long-term medical treatment that is necessary
• Make provision for employees to be able to summon help quickly
• Allocate a safe place to retreat to
• Control media access to those involved
• Provide communication with families and arrange transport home
• Make arrangements, if necessary, with local medical care facilities for urgent consultations in cases of injuries
• Be aware of different people's reaction to a stressful situation. These may include: feelings of anger, frustration, anxiety, guilt, embarrassment and of being "out of control". They may respond inappropriately and have physical symptoms such as vomiting. Longer term, they may suffer with sleeplessness, "reliving the event", and a fear of returning to work. These reactions should be recognised and managed quickly after the episode to reduce the risk of psychological harm
• Have best practice rehabilitation and support policies and procedures in place for employees who have been assaulted or injured
• Liaise with the insurer or ACC regarding medical treatment and any other entitlements, for example, earnings-related compensation or rehabilitation support
• Consider referral to employee assistance programmes to provide psychological first aid support.

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