Long-Term Care Workplace Violence Survey Question Title * 1. First Name Question Title * 2. Last Name Question Title * 3. Email Question Title * 4. Workplace Question Title * 5. Classification RPN PSW/HCA RN Dietary Housekeeping/Laundry Basic Aide Cook Activity Aide RAI Coordinator Custodial/Janitor Maintenance Other (please specify) Question Title * 6. Do you know who your Joint Health & Safety Committee (JHSC) Representative is at your workplace? Yes No My workplace does not have a JHSC Representative Question Title * 7. Are you currently or formerly a JHSC Representative? Yes No Question Title * 8. If you responded yes, is workplace violence a topic that can be addressed at JHSC meetings? Yes No I don’t know Not applicable, I’ve never been a JHSC representative Question Title * 9. How frequently do you experience the following types of workplace violence? Most days Most week Most months A couple times a year Almost never Never Physical aggression Physical aggression Most days Physical aggression Most week Physical aggression Most months Physical aggression A couple times a year Physical aggression Almost never Physical aggression Never Verbal abuse Verbal abuse Most days Verbal abuse Most week Verbal abuse Most months Verbal abuse A couple times a year Verbal abuse Almost never Verbal abuse Never Racism/discrimination Racism/discrimination Most days Racism/discrimination Most week Racism/discrimination Most months Racism/discrimination A couple times a year Racism/discrimination Almost never Racism/discrimination Never Sexual harassment/assault Sexual harassment/assault Most days Sexual harassment/assault Most week Sexual harassment/assault Most months Sexual harassment/assault A couple times a year Sexual harassment/assault Almost never Sexual harassment/assault Never Use of a weapon or harmful object Use of a weapon or harmful object Most days Use of a weapon or harmful object Most week Use of a weapon or harmful object Most months Use of a weapon or harmful object A couple times a year Use of a weapon or harmful object Almost never Use of a weapon or harmful object Never Question Title * 10. What are the leading sources for workplace violence? Resident behaviours and frustration Resident families Coworkers Other (please specify) Question Title * 11. Who have you experienced violence from? Management Residents Co-workers Residents’ Families Other (please specify) Question Title * 12. In the past 6 months, how often has short staffing made it harder to prevent or respond to resident aggression or workplace violence? Daily Weekly Monthly Rarely Never Not sure Question Title * 13. When workplace violence happens, is there usually enough staff available to respond safely? Always Often Sometimes Rarely Never Question Title * 14. Do you feel you are more at risk to workplace violence when working alone? Yes No Not sure Question Title * 15. Have you ever suffered an injury while at work? Yes No I don’t know Question Title * 16. If you feel comfortable, please describe the situation and injury(ies) you’ve experienced while performing your job. Question Title * 17. Have you ever missed time due to a workplace injury? Yes No I don’t know Question Title * 18. What is the most common type of workplace injury experienced at your workplace? Question Title * 19. Does your home have a policy around violence and harassment? Yes No I don’t know Question Title * 20. Does your home have a policy to prevent racism and discrimination? Yes No I don’t know Question Title * 21. Has your Employer arranged a workplace violence training for you and your coworkers? Yes No I don’t know Question Title * 22. If you responded yes, please describe what training you’ve received from your Employer, or outside organization. Question Title * 23. How prepared do you feel to de-escalate a potentially violent situation at work? Very prepared Somewhat prepared Neither prepared nor unprepared Somewhat unprepared Very unprepared Question Title * 24. Are there any flaws in the de-escalation training you’ve received that impacts your ability to remain safe at work? Question Title * 25. Which of the following are provided to you for your protection at work? Whistles Radios Personal Alarms Resident flagging Seclusion rooms Secured furniture Other (please specify) Question Title * 26. Does your LTC home have dedicated security staff? Yes No I’m not sure Question Title * 27. If they do, do the security staff intervene if there is a potentially violent incident? Never Rarely Sometimes Always N/A, my workplace does not have dedicated security staff Question Title * 28. In your opinion, rank the following causes of workplace violence? (rank) Question Title * 29. How has resident acuity changed in the LTC sector since the COVID-19 pandemic? Resident acuity has increased a lot Resident acuity has increased a little Resident acuity has remained steady Resident acuity has decreased a little Resident acuity has decreased a lot Question Title * 30. Does your LTC home have residents who are under 70 years old? Many Some None Question Title * 31. Are younger residents ever housed in the same rooms as older residents? Frequently Sometimes Rarely Never Question Title * 32. Do you feel at greater risk of violence when providing care to younger residents? Always Sometimes Rarely Never Question Title * 33. Do you have the right to refuse work due to fear of violence? Yes No I don’t know Question Title * 34. Have you ever called 911 due to a violent incident at your workplace? Yes No Question Title * 35. How would you generally describe police response? Helpful Unhelpful It depends I’ve never had to call the police Question Title * 36. How would you generally describe police response? Helpful Unhelpful It depends I’ve never had to call the police Question Title * 37. How safe do you feel working at your LTC home? Very Safe Somewhat safe Somewhat unsafe Very unsafe Question Title * 38. How comfortable do you feel reporting workplace violence and/or an unsafe work environment to your manager/supervisor? Very comfortable Somewhat comfortable Uncomfortable Afraid to report workplace violence/unsafe work Question Title * 39. How supported are you by your manager/supervisor in dealing with health and safety matters and workplace violence I feel very supported I feel somewhat supported I do not feel supported Question Title * 40. On a scale of 1 to 10, with 10 feeling very mentally healthy, how would you rate your mental well-being working at your LTC home? Not Healthy Mentally Very Mentally Healthy Not Healthy Mentally Very Mentally Healthy Question Title * 41. Do you agree with the following statement: “My manager/supervisor prioritizes the needs of residents over my own safety and wellbeing?” Strongly Agree Agree Disagree Strongly Disagree Question Title * 42. Has your manager ever blamed you for violent abuse you experienced at work? Yes No I’m not sure Question Title * 43. If you could make one change at your workplace to prevent workplace violence, what would it be? Question Title * 44. Gender: Man Woman Non-binary Prefer not to answer Other (please specify) Question Title * 45. How old are you? 18-29 30-39 40-49 50-59 60-69 70+ Prefer not to answer Question Title * 46. Which, if any, equity-deserving group(s) do you identify with? Please select all that apply. Black people Indigenous people Asian or Pacific Islander Racialized people/People of Colour LGTBQ+ people Persons with disabilities Women or gender minorities Religious minorities Other (please specify) Prefer not to answer Question Title * 47. What is your immigration status? Citizen Permanent resident On a temporary work permit Undocumented worker I would rather not say Done