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00:00:01:00 - 00:00:33:17
Tom Haederle
Welcome to Advancing Health. It's a sad reality that the health care professionals in the business of healing others are among those likeliest to face violence in the workplace. In today's podcast hosted by Tina Freese Decker, president and CEO of Corewell Health and the 2025 Board chair of the ºÚÁÏÕýÄÜÁ¿ Association, she speaks with one of our nation's most prominent nursing advocates about the best ways to protect the health care teams who do so much for their patients.

00:00:33:19 - 00:01:00:03
Tina Freese Decker
Well, hello, everyone. Thank you so much for joining us today. I'm Tina Freese Decker, president and CEO of Corewell Health and board chair for the ºÚÁÏÕýÄÜÁ¿ Association. Our topic today is a serious one: workplace safety for our health care professionals. Threats of violence in any capacity are never okay. And it is so disappointing that we live in a world where this is a reality and we have to talk about it.

00:01:00:06 - 00:01:35:00
Tina Freese Decker
Workplace violence has become an urgent and pressing concern that impacts the physical and emotional well-being of our teams, the people taking care of people. Health care workers are five times more likely to experience workplace violence that other workers, from verbal aggression to outright physical attacks. Hospitals and health systems are focusing on security, training and violence prevention programs so that we can continue providing the best quality care possible in an environment that is safe for our team members, as well as safe for our patients and families.

00:01:35:03 - 00:02:01:07
Tina Freese Decker
So for our conversation today, I am so pleased to be joined by Claire Zangerle. Claire serves in the dual role of chief executive officer of AONL which is American Organization for Nursing leadership, as well as ºÚÁÏÕýÄÜÁ¿ Association senior vice president and chief nurse executive. Claire has been a lifelong advocate for nurses and nurse leaders, holding the role of chief nursing officer at Allegheny Health Network and Cleveland Clinic

00:02:01:13 - 00:02:08:10
Tina Freese Decker
before joining the AHA and AONL team. So welcome Claire. I am so happy that you are joining us today.

00:02:08:12 - 00:02:13:25
Claire Zangerle, DNP, R.N.
Thank you, Tina, and thanks for bringing this topic to the forefront. It is such an important topic.

00:02:13:27 - 00:02:23:14
Tina Freese Decker
So to set the stage, Claire, is there a story or a reason why you are so passionate about this important topic for our field? Besides the obvious?

00:02:23:21 - 00:03:09:01
Claire Zangerle, DNP, R.N.
Yeah, and the obvious is there. But I can tell you, my first job in nursing was in a trauma unit. And it seems like most violence happens in violent, caring areas, which sometimes is considered behavioral health or trauma units. They're high risk areas, they're areas of great concern. But as we know today, violence happens everywhere. But when I was a nurse in a trauma unit in Houston, I experienced some significant pushback and trauma from patients who came in and they were part of gang organizations and things like that, that they really made us fear for our own safety in the hospital.

00:03:09:09 - 00:03:37:02
Claire Zangerle, DNP, R.N.
And a lot of times, when we were caring for these patients, we also had to care for ourselves because we didn't know what was coming next. We didn't know if the violence that was happening in the streets was going to be brought into our nursing unit. And a lot of times it was. We were very fortunate to have wonderful support from our police force within the unit, but it was not something that we could predict, and that was

00:03:37:02 - 00:04:02:10
Claire Zangerle, DNP, R.N.
the scary part. And as a new nurse, it really informed what I thought was an important aspect of practice and making sure that we felt safe in the environment where we worked, no matter where we worked. Because once those patients were cared for and moved to other areas within the hospital, sometimes that violence followed them and sometimes the threat of that violence followed them.

00:04:02:12 - 00:04:11:00
Claire Zangerle, DNP, R.N.
So that's had a big impact on me, as a new nurse and has stuck with me throughout my nursing practice and into leadership.

00:04:11:03 - 00:04:37:13
Tina Freese Decker
Absolutely. That is scary. And it's stress invoking. And that isn't good for any of our health either. So very challenging. I'm sure nursing has its rewards and taking care of patients. But then the fear and then the actual violence, that's something that no one should go through. So looking back at your career and your experiences, how can our hospital field best collaborate to make our environments safer for our team members?

00:04:37:15 - 00:04:40:17
Tina Freese Decker
Are there any best practices that come to your mind?

00:04:40:19 - 00:05:21:21
Claire Zangerle, DNP, R.N.
Yeah. You know, we talk a lot because I am a nurse. I talk a lot about violence against nurses and everything, but it's the whole team. In every unit, every care setting, no matter whether it's acute care, ambulatory post-acute care, there is more than just the nurse there. It's an entire team. In thinking about how we can keep that entire team safe is, I think, a focus of a lot of the things that I've seen, a lot of the initiatives that have happened with the escalation in violence. I can tell you an experience for me, when I was the chief nurse executive at Allegheny Health Network in Pittsburgh, we recognized

00:05:21:27 - 00:05:49:07
Claire Zangerle, DNP, R.N.
the need for an increased security force. Now, a lot of hospitals had, well, you know, security companies that would come in and they would they would be the security company. But having a true certified police force is a totally different game. And that was a very important thing that Allegheny Health Network and Highmark Health, which was our parent company, did for us at Allegheny Health Network.

00:05:49:07 - 00:06:26:26
Claire Zangerle, DNP, R.N.
And here's what made a huge difference. Those police officers didn't just sit in an office watching cameras all day. They walked the beat. That's what we called it, walking the beat, essentially. They walked the nursing units. They had presence. And it almost felt like as if we were in a city. They were walking the neighborhoods, getting to know the staff, getting to demonstrate presence on units. That helped just the collateral benefit of the de-escalation of any type of issue that would happen between families that had issues

00:06:26:26 - 00:06:58:08
Claire Zangerle, DNP, R.N.
you know, because there's a lot of family dynamics that go on in some of these nursing units, especially when a loved one is ill. Just that presence of having those police officers around, that immediate feeling of safety, gave us all great collateral benefits. And we loved that. And I encourage all organizations to take that tact, because a hospital is a neighborhood, a hospital is a big city and there's different neighborhoods, which are the different units and the different care settings within that same facility.

00:06:58:10 - 00:07:28:08
Tina Freese Decker
I agree, having well-trained security and having them be part of our team is so important to really know what's going on. And so it's also there's a comfort and willingness to call them whenever you need help, even if it's something you need to stand close to your own kids, there's something happening. So having the security forces, having dogs in places, having other security elements is critical for all of our hospitals and clinics, to make sure that we're taking care of our patients.

00:07:28:10 - 00:07:35:19
Tina Freese Decker
Well, we're talking about best practices. Are there any AHA or AONL or any other resources that you want to mention for this?

00:07:35:21 - 00:08:03:06
Claire Zangerle, DNP, R.N.
AHA has a lot of resources. There are toolkits. There are guiding principles. We have the Hospitals Against Violence initiative. Raising the awareness of the resources that are there is something that both AHA and AONL do well. And I would encourage all members to take a moment to go to both of our websites and look for those resources, and it depends on what you need.

00:08:03:10 - 00:08:46:02
Claire Zangerle, DNP, R.N.
I would say that there is something on either or both of those websites that are chock full of resources. If there's something you need, it's there. And if there's something that you don't see there, I would love to hear what you need that we can explore and pull in together. AONL is focusing on incivility and bullying in the workplace with our Healthy Work Environment Committee, because that is an element of workplace violence that sometimes is overlooked, and sometimes it's about accountability and making sure that we address those uncivil behaviors, the bullying behavior, because that is the beginning of violence. Violence is on a continuum,

00:08:46:05 - 00:09:05:23
Claire Zangerle, DNP, R.N.
that's where it might start. And that's something that we're addressing. We work with the Emergency Nurses Association to come up with guiding principles in the toolkit. The ºÚÁÏÕýÄÜÁ¿ Association has toolkits on their site as well. So I would say that there are a lot of resources out there for our members.

00:09:05:25 - 00:09:21:02
Tina Freese Decker
So let's talk about team member well-being. Given our ever present challenges and delivering care, which are now coupled with those increasing acts of violence, how can we best support our team members safety and their overall well-being?

00:09:21:04 - 00:09:49:10
Claire Zangerle, DNP, R.N.
The first thing is, is that no team member should go to work scared for themselves. They should not be scared of the environment that they're going into. That is not a way to work and they do not have to tolerate that. A lot of times when we have an event and we're talking to a team member after the event, they kind of brush it off and say, well, this is just part of my job because this happens all the time.

00:09:49:13 - 00:10:15:10
Claire Zangerle, DNP, R.N.
It's not supposed to be part of your job. If something happens, report it, don't tolerate it, have zero tolerance for yourself as an employee, and leaders have zero tolerance. Zero tolerance for those coming into the hospital and committing those violent acts against our health care workers and the incivility and bullying within our own health systems and within our own employee base.

00:10:15:12 - 00:10:33:21
Claire Zangerle, DNP, R.N.
The work environment is so important. We spend so many hours a day at work that we want to feel safe going to work. We want to feel safe in the place where we work. We also want to feel safe as we're going from parking our cars or riding the shuttle bus to and from work. There's got to be adequate lighting.

00:10:33:21 - 00:10:49:28
Claire Zangerle, DNP, R.N.
We have to feel safe because we're a 24/7 operation in our acute care facilities. Some people come in the dark and they leave in the dark and they want to feel safe. So I think that has a huge impact on whether people decide to stay in the environment where they work or they leave.

00:10:50:04 - 00:10:58:23
Claire Zangerle, DNP, R.N.
And I think it's incumbent upon us as leaders and incumbent upon organizations to ensure the safety of employees.

00:10:58:25 - 00:11:21:00
Tina Freese Decker
There's so many things we can do for all the things you mentioned, like lighting is critical. Rides to cars. I know that many of our organizations have apps for mental health as well. Also, training for self-defense and how to how to navigate in different situations. My last question is just for part of AHA and AONL,

00:11:21:00 - 00:11:28:20
Tina Freese Decker
can you share a little bit about what is being done from an advocacy perspective, and how we can all join together to support those efforts?

00:11:28:23 - 00:12:02:07
Claire Zangerle, DNP, R.N.
Yes. What we do know is that other industries have federal protections against violence in their own work settings. A good example of that is airline workers, airport workers. It's a federal offense to enact violence against those workers. We don't have that in health care. That is something that we are focused on. There is legislation in the House right now that has been reintroduced because it was introduced many years ago and never moved forward.

00:12:02:12 - 00:12:29:05
Claire Zangerle, DNP, R.N.
But those that introduced it before have retired. And there are a new group of legislators that have taken up the mantle and said it should be a federal offense to commit an act of violence against a health care worker. Now, is that 100% going to stop people from doing that? No, but we know it's a mitigation tactic. We know that it's that it's something that will get offenders attention.

00:12:29:07 - 00:12:54:12
Claire Zangerle, DNP, R.N.
And right now it is around May of this year it was reintroduced and it's moving through the legislative process. AHA and AONL wholeheartedly support the passage of this act. It's called the SAVE, S-A-V-E Act. And we are excited and, focused on getting this passed so that we can have federal protections for our health care workers.

00:12:54:15 - 00:13:13:00
Tina Freese Decker
Thank you so much, Claire, for your time today, for sharing your insights and for all the work that AONL and AHA are doing to support our teams and our nursing leaders and all those in our hospitals facilities. As Claire mentioned, if there is something missing from the website, feel free to reach out to say I have another question,

00:13:13:00 - 00:13:31:19
Tina Freese Decker
I want to know where this is. We also could use all of your support on advocacy for the SAVE Act as we look at the federal perspective, also in our states. So thank you so much, Claire, for joining us. And thank you to all of you, our viewers and listeners for finding the time to tune in. We will be back next month for another Leadership Dialog conversation.

00:13:31:22 - 00:13:40:02
Tom Haederle
Thanks for listening to Advancing Health. Please subscribe and rate us five stars on Apple Podcasts, Spotify, or wherever you get your podcasts.