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Naleena Gounder, client care coordinator

Naleena Gounder care coordinator

HSA REPORT, MARCH 2014

BY LAURA BUSHEIKIN

Making a positive change in your workplace starts with one simple step: talk to someone.

That's how Naleena Gounder sees it. Gounder is a care coordinator at the Assertive Community Treatment Program (ACT) based at Vancouver General Hospital.

"If you have concerns, don't just sit on them. Don't assume you can't have a voice. We all have a voice," she says. Gounder recently used her voice to create a program to improve safety at her workplace.

ACT serves the needs of people with multiple issues of substance abuse and mental health. These are some of the most vulnerable people in society, says Gounder. In order to reach clients successfully, the ACT team has to go out and meet them on their own turf.

"The program is specifically designed for individuals who would not normally benefit from typical treatment. They are not necessarily organized enough to keep track of appointments. Many clients also have legal issues, a lot of them are homeless, and most don't have family members to support them," she says.

The nature of this program poses particular health and safety risks for ACT staff.

"Substance use can make people unpredictable. It can be difficult to know how people will act after using substances, especially coupled with medication incompliance. Paranoia may be heightened. We don't always know how people will be affected."

While understanding the importance of identifying the risks involved in her work, Gounder says she wants to be careful not to contribute to the stigma that so often attaches to Vancouver's downtown eastside population.

"People with mental illness are more likely to be the victim of violence than to be the perpetrator," she points out. "Nothing physical has ever happened to me." At the same time, she knows she faces risks every day.

"We go in our own vehicles to the downtown eastside; we are often going into single room occupancy hotels. Maybe it's cheque day and things can be pretty unpredictable. You might not be concerned about your safety with a client you know, but there can be other things going on around you.

"Often in those single room occupancy hotels, each floor is quite isolated. So there might be staff on hand, but on the other side of the building. If something happens I can only count on myself. And they have those long narrow hallways – it's not that easy to run away," she says.

Gounder sees that she and her team members would benefit from additional training in how to assess danger, how to prevent a situation from escalating, and how to handle themselves if things start to feel unsafe. And when there is an incident of any kind, there needs to be a clear procedure for reporting, documentation, debriefing and follow-up.

These sorts of issues were not being dealt with in a systematic way at her workplace. Although staff talked about safety at her workplace, occupational health and safety (OHS) procedures and policies were not consistently applied, and there was no Joint Occupational Health and Safety (JOSH) Committee.

Getting the ball rolling on putting these things in place was "actually pretty easy," she says. "I started by asking around to other members of my union and the nurses' union. There were some people who were interested and so I contacted David Durning, from HSA's OHS team. He has been really helpful."

Forming a JOSH Committee has been a learning experience for Gounder. "I've never started a team from the ground up, although I was on the JOSH at Burnaby Centre for Mental Health and Addictions," she says.

Once the JOSH committee is up and running, it will create and implement policies and procedures, provide education for the team, and provide a forum to discuss OHS issues. Gounder will see the result of speaking up – of using her voice to improve her workplace.

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