That year, OSHA took its first workplace sexual violence case. A Pennsylvania pediatric nurse reported that she had been sexually assaulted by the father of the child she cared for. OSHA believed that the in-home health care company, Epic Health Services, could have protected its workers from sexual assault if it had offered a system to report and address the attacks. Epic had received complaints from other nurses about physical and sexual assaults from the same man, but it had not taken action to protect employees from his attacks.
The company was fined $98,000, and it received citations for “willful violation” of workplace violence and for failure to report injuries properly to OSHA. “Epic Health Services failed to protect its employees from life-threatening hazards of workplace violence and failed to provide an effective workplace violence prevention program,” Richard Mendelson, the OSHA regional administrator in Philadelphia, said in a statement. “No worker should ever have to sacrifice their physical well-being to earn a paycheck.”
Since health care and social service workers consistently face the highest rates of job-based violence in the private sector, OSHA also took a significant and laudable step by initiating the development of workplace violence standards for the health care industry in 2016. The process will be lengthy, but if it succeeds in establishing these standards, OSHA can clarify what employers are required to do to prevent violence at work and articulate the kinds of protections workers should expect.
The effort may sound like little more than an exercise in bureaucracy, but the move would create new assurances that workers would be protected from harm. For unions and worker advocacy groups like Worksafe, a California-based worker health and safety advocacy organization, the hope is that the future adoption of standards in one industry will eventually lead to standards for all workers—including farmworkers, janitors, and domestic workers.
It is safe to assume that the creation of the country’s first set of national workplace violence standards is a nonstarter under President Donald Trump, who favors reducing regulations on businesses. Under his presidency, OSHA will likely focus less on policing violations and more on helping companies follow existing rules. Congress, with the president’s backing, has also scaled back worker safety regulations implemented during the Obama administration.
Efforts to prevent sexual violence in the workplace are more likely to happen state by state. New York State already has workplace violence standards that apply to public employees.5 Washington State has implemented regulations for people working in health care facilities, psychiatric hospitals, and late-night retail outlets, such as convenience stores.6 And in 2016, following more than two years of advocacy, California created new rules for health care employers that are considered some of the toughest in the nation.7
The push for a workplace violence standard in California began in 2010, when two San Francisco Bay Area health care workers were killed on the job within a week. First, a Napa State Hospital employee named Donna Gross was strangled to death by a psychiatric patient. Days later, Cynthia Palomata, a nurse working at a jail in the San Francisco Bay Area, was hit on the head with a lamp so brutally by an inmate that she fell into a coma. She was removed from life support three days later.
These incidents galvanized the state’s health care workers and brought wider public attention to an ongoing problem. To eliminate some of the risks of the job, the unions representing nurses—the California Nurses Association/National Nurses Organizing Committee and the Service Employees International Union—both began pushing for legislation that would require some hospitals to create workplace violence prevention plans. After one failed legislative attempt, the bill passed in the fall of 2014.
Months before that bill passed, the unions sought another route to improving job safety for health care workers. Each union petitioned the state’s department of labor for a workplace violence standard to demand that employers become more proactive about reducing violence in their industry. “We recognize that you cannot eliminate all violence in the workplace but you can make an honest attempt to eliminate it as much as possible,” says Katherine Hughes, a registered nurse and the executive director of the Service Employees International Union Nurse Alliance of California.
Given the overlap between the petitions and the state law that the union had fought for, the state’s Occupational Health and Safety Standards Board began exploring a workplace violence standard for health care workers that could incorporate the requirements of the law. But first, the standards board had to overcome internal skepticism about the issue. At the first hearing, Hughes remembers a board member telling the crowd that workplace violence in nursing “isn’t a big problem” and that it’s better tackled by law enforcement after the fact.
The board became more committed to the issue after health care workers began to offer testimony at public hearings about workplace violence. Two women in Southern California had been stabbed in separate hospitals in the same weekend. One nurse had been kicked in the head by a patient and had suffered a concussion. A female nurse was raped in a medicine closet. “After hearing these stories and realizing what a problem it was on a human level, they realized they could do something about it,” Hughes says of the board.
The board also had questions about how employers could be expected to prevent what might seem like random acts of violence, which led to discussions about the foreseeable nature of the violence that health care workers face. “Most violent incidents come with some of kind of warning,” Hughes says. “They don’t go from zero to sixty in a breath.”
The scenarios and infrastructure that facilitate violence is where intervention can begin, Hughes says. Work areas can be redesigned. Workers can be taught de-escalation techniques and given self-defense training.
In the spring of 2017, some of the workplace violence standards for California health care workers began to go into effect. Going forward, California businesses and organizations that employ certain kinds of health care workers are required to conduct violence risk assessments and then create prevention plans. These plans require the input of workers, under the logic that they are the ones most aware of the potential hazards of their jobs.
Under this new system, health care workers are also able to make complaints if they feel that a hospital or health care facility is not following its prevention plan. Employers are prohibited from retaliating against anyone who raises an issue, and they are required to evaluate the prevention plan each year in conjunction with front-line workers.
Plans to expand these protections to all California workers are already in the works, with a state committee analyzing the feasibility of creating a workplace violence standard for a wide range of jobs and industries. As this process moves forward, advocates like Nicole Márquez of Worksafe are working to ensure that the experiences of low-wage immigrant workers will be specifically considered. In particular, Márquez says, her organization will point to the needs of women working in the janitorial, hotel housekeeping, and agricultural industries, whose workers are particularly vulnerable. Of the organization’s goals, Márquez says simply, “Violence should not be part of the job.”
Employers, however, continue to have concerns about the standard. In some industries, like construction, employers say that workplace violence is not a problem. Others have expressed concern that the California requirements are overbroad and will subject them to undue liability. In an online editorial, two lawyers from BakerHostetler, a firm that represents employers, described California’s workplace violence standards for health care workers as “broad, unclear obligations on health care employers who now must design a program to protect employees from seemingly unpredictable acts of violence perpetrated by virtually anyone on the premises.”
On one point, however, both advocates and opponents of the new standards are in agreement: it won’t be long before other states—and maybe one day, the federal government—take a similar approach to workplace violence prevention. “California has set an extreme tone in establishing such a far-reachi
ng workplace safety standard, and federal and other state OSHAs will look to these standards when addressing this issue,” the BakerHostetler lawyers wrote in their editorial.
For nurse advocate Bonnie Castillo, the director of health and safety for the California Nurses Association/National Nurses United, widespread adoption of the workplace violence standards is exactly the point. “We know that these protections are necessary across America,” Castillo said in a statement, “and that’s why it’s so important that California can now serve as a model for the nation.”
7
¡Sí Se Pudo! Yes We Did!
The circumstances that led to Georgina Hernández being raped while cleaning a Los Angeles hotel began decades before she took a job as a janitor.
Hernández had been born and raised in a small village in Puebla, a state in south-central Mexico, and she was the oldest of nine siblings. When she was ten, their father abandoned the family, and she was left to take care of her siblings while her mother worked. His departure robbed Hernández of an education, and it thrust the family deeper into poverty, but it was also a relief, because he had been physically abusive of them.
Whatever work her mother cobbled together never seemed to be enough, so Hernández helped her mother finance the family’s survival. Their neighbors noticed Hernández’s resourcefulness and industry with her younger siblings, and though she was a child herself, they hired her to take care of their kids or clean their houses.
Poverty was compounded by violence. When Hernández was a teenager, a family friend raped her, and she became pregnant. Terminating the pregnancy wasn’t an option, so to continue supporting her siblings and provide for the new baby, she took a job at a factory.
Hernández was a diligent and fast worker, and she caught the attention of a man who would become the father of her next five children. He was older, and she liked the way he talked to her in the beginning. “When I met him, I thought he was a good person because he told me I was a very good young lady, that I got ahead, that I was helping my family,” Hernández says.
The relationship became a way to escape her mother’s house, which always seemed heavy with hunger and uncontrolled emotions. She moved in with him when her baby was about a year old, and within a couple of years, she was pregnant with twin boys. She had always fantasized about having her own home and raising a big family, and it felt like the start of her dream coming true.
Within a few years, she was pregnant again with another boy. Then over the course of another half-dozen years, she had two more children, first a girl and then a boy. Even with so many young children to tend to, Hernández continued to do what she had become expert in: working and earning money. She took ironing and sewing jobs, working at night when the kids were sleeping.
She also volunteered for a political party, and in exchange, it gave her the cement, sand, and gravel to build an addition to the house. Her long-held dream was slowly becoming a reality. “My dream was to have my own home, to have a home for my children,” she says, “I made that dream come true. I had a very pretty home. My house was what I’d never had before. And I had my children, and I felt very happy. But I worked too hard.”
Another problem was her children’s father, who traveled between the United States and Mexico for work, and who was growing resentful of the number of kids he had to support. She dreaded his return home. Behind his charm and flattery was an unsteady temper. When he got angry, he berated Hernández, telling her that she was ignorant and a disgrace. Or he took out his rage on her physically, just as her father had on her and her mother. Hernández learned to absorb the violence. She tried to tolerate it through sheer resolve because, with six kids, she didn’t see a clear way out, and she was tethered to the house and the dream it represented.
“There were times I couldn’t stand it, and I’d tell myself, ‘If I leave, I’m going to leave all this, which has cost me so much,’” she says. “But there came a day that I couldn’t . . . I couldn’t do it anymore, couldn’t bear so much. And I decided to leave him.”
That is when he told her he had put the deed of the house—the one that she had put so much into building and improving—in his parents’ name only. “There was nothing left to fight for,” she says.
After fifteen years together, she left. The only place to go was her mother’s house, which was already crowded with a handful of her brothers and sisters. Now with Hernández and her kids, there would be seven more, all of them in one room.
Hernández did her best to plod forward, though there came a moment when the daily fight overcame her tenacity, and her resourcefulness and grit didn’t provide a way forward. She had lost her house. All of the work that she did never added up to enough food to feed her kids or send them to school. “I’d look at my children and look at how poor I was,” she says. “I didn’t know what to feed them. That was when I thought to myself, I no longer have anything in my life, my life is worthless.”
She left her mother’s house and began to walk one afternoon, dazed and devastated. She ended up at the intersection of a busy road. Without looking, she stepped into the traffic and began to walk. A few steps later, she was hit by a truck.
“It wasn’t an accident,” she says. “I had intended to kill myself.”
Hernández ended up in the hospital for three weeks. During her recovery, she overheard the nurses speculating that she had been in an accident because she was an alcoholic. As broken as she was, it made her indignant. “How is it that this is what people think of me, that this is who I am?” she thought. “They say that because they don’t know what I’ve been through.”
Hernández settled on a Hail Mary: she would support her children by going to the United States to find work. Her cousin and brother were already planning to go. They had a coyote lined up to guide them through the desert and across the Mexico-California border. She would have to find $5,000 to travel with them.
Her mother hated the idea, and her oldest children were vocal in their opposition. Hernández did not truly want to go either—her youngest child was only six months old at the time—but her children had known only a pattern of poverty and hunger, and her inability to provide for them was even more devastating than the idea of leaving them behind.
Three weeks after leaving the hospital, she was in the desert with more than a dozen people, including her cousin and her fourteen-year-old brother. They walked at night, and the two sweatshirts Hernández wore did not ward off the cold. Her legs were weak from the hospitalization and she still wore a cervical collar around her neck. There was only a short distance left to go when someone yelled out, “¡La migra!” With the medical collar on, Hernández couldn’t turn her head, so she ran straight ahead. Out of the corner of her eye, she watched as immigration agents took her brother and put him into the back of a truck. She thought about giving herself up, too, but then she thought of her children. “I said, God, I have a purpose and I don’t want to go back,” Hernández says.
She hid under a tree, and though the border patrol swept the area, they never passed their lights down low, where she was crouching. Once they had passed, she calmed herself by drinking a little water and washing her face from a small trickle of water that she found on the ground. She kept still, certain that the group would come looking for her. No one did. She had to keep walking. If I’m not dead yet, I’m not going to die, she said to herself. I’m going to cross. “And that was how I was lost for a whole night in the desert by myself,” she says.
In time, she heard a noise in the brush. The coyote had given them a code if they came across other people but were not sure if they were friendly or not. One person would say “one, two” and the correct response was “one, two.”
“Uno, dos,” Hernández said, tentatively.
“Uno, dos,” came the reply from the bushes.
They both emerged from the brush, and in a stroke of serendipity, the other person was her cousin. Hernández tearfully told him that her brother had been dragged off by la migr
a. Her cousin tried to console her, and she came to accept that he was right when he said that they had to just keep on moving. Physically, though, she didn’t think she do it. Her cousin asked the coyote to give her a pill to numb the pain.
By the end of the journey, Hernández’s feet were torn up and blistered. Her calves were swollen. To get to the van that would take them to Los Angeles, they had to jump from a tall fence and Hernández was afraid she’d break her legs. But she made it. Of the fifteen people who had started with them, there were now only four in the van headed north to the city.
They were taken to a safe house for the night until her sister, who had made the trek to Los Angeles years before, came to pick her up. Hernández slept a few hours, and the next day, her feet and legs still aching, she went to look for work in Los Angeles’s garment district. Her sister tried to encourage her to rest for a few days because Hernández was clearly dehydrated and sickly. Hernández told her sister she had no choice. “I left my children without money,” she said.
The first garment factory turned her away because she didn’t have her own sewing plates, spindle, or scissors. At factory after factory, it was the same. There was no work if she didn’t bring her own materials. It was a catch-22: Hernández didn’t have any money to buy the equipment, but she couldn’t get a job without it. After visiting nearly a half-dozen factories, she caught a break when she met a man outside of a factory that produced clothes for a fancy name brand. He said he would lend her some sewing plates for the day. If she got the job, he would expect payment.
Inside, Hernández was given a test. The supervisor gave her a sample blouse and told her to have one finished by the middle of the day. Hernández nearly scoffed. She completed it in three hours. They hired her on the spot and asked her to stay and finish out the day.
She worked at the garment factory for a year. It was a good job that paid decently because Hernández sewed quickly. She remembers one particularly good week when she earned $700 after making hundreds of pairs of pants. But the supervisor made the job hard to take. She could almost put up with the his insults and yelling—that they looked like elephants, that they ate too much, that they used too much toilet paper in the bathroom. What she hated most about the job was that her supervisor scared her. Rumors circulated that he had a Jacuzzi in his office, where he would demand sex from female workers whom he called in to meet with him.
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