The two deaths came in quick succession, shocking the close-knit community of health care workers at the University of Maryland St. Joseph Medical Center.
First, in August 2013, an administrative assistant was fatally shot by her estranged husband while she was helping her 3-year-old son get into a car. Five months later, a nurse who worked with oncology patients was stabbed to death by her son after a history of domestic altercations.
"She was very optimistic and positive," said Michele McKee, director of nursing services. "The staff is still struggling with the loss. There was denial. Tears. Anger. And then, guilt. What did we miss? What could we have done?"
While hospital staff had been trained to identify patients who were experiencing domestic violence, they didn't pay the same attention to warning signs in their own peers, said Leslie Hott, St. Joseph's human resources manager.
"Our value statement says, 'loving service, compassionate care,'" Hott said. "We typically think about that for those we care for, but not each other."
That is now changing.
St. Joseph is undergoing an ambitious effort to address domestic violence among its workforce, rolling out an intensive training program to help staff members identify -- and hopefully prevent -- domestic violence, as well as a new workplace policy to support employees who are suffering.
The hospital partnered with Futures Without Violence, a nonprofit that has helped organizations across the country address how domestic violence hurts its workforce. In 2014, Futures began a pilot site project called Low Wage, High Risk to develop best practices for workplaces where employees may be vulnerable to physical and sexual violence. The nonprofit is currently collaborating with tomato crop workers in Florida and restaurant employees in New York, as well as health care workers at St. Joseph in Towson.
The hospital didn’t have a formal workplace domestic violence policy in place when its staffers were killed. Most organizations across the country don’t, even though domestic violence affects 1 in 4 women in the U.S.
There was denial. Tears. Anger. And then, guilt. What did we miss? What could we have done? Michele McKee, director of nursing services
In addition to creating serious safety issues in the workplace, the Centers for Disease Control and Prevention estimates that domestic violence costs the U.S. at least $8 billion a year in lost productivity and health care costs.
The federal government is trying to set a good example. President Barack Obama issued a memorandum in 2012 that requires all federal agencies to develop policies to support employees whose working lives are affected by domestic violence.
It is often thought to be something that occurs in private, but the pervasive effects of domestic violence can spill over into victims’ work lives. When that happens, experts say, many organizations are ill-equipped to properly support their employees -- in the worst cases, employees may even be penalized or fired.
Maya Raghu, a former lawyer with Futures Without Violence who was involved with the launch of this program, said only a handful of jurisdictions prohibit employment discrimination against survivors of domestic and sexual violence, and about 15 to 20 states provide survivors with unpaid leave.
“Having a source of income is critical to helping survivors and their families separate from the dangerous situation,” she said. “Especially if you are in a job on the lower end of the income spectrum, you may not be able to accumulate savings that you can rely on if you lose your job.”
Being a victim of violence can affect employees in overt and subtle ways. Workers may experience violence on the job, including stalking, threatening calls or physical assaults. Homicide is the second leading cause of injury death for women at work, according to the CDC, and intimate partners commit a significant percentage of those murders.
But even if the actual violence doesn’t take place at work, being in an abusive relationship can still disrupt a victim’s ability to do her job. Abusers may try to sabotage their victims’ financial independence and purposely do things to get them fired, like cut up their work clothes or steal their car keys so they miss their shifts, Raghu explained.
Victims may need to take days off to appear in court, apply for a protection order or seek medical attention. But missing work can put victims of violence in peril of losing their job -- at the exact time they desperately need a regular paycheck.
Hott said the hospital's new policy spells out the support services available to victims, so they know they won’t be penalized for seeking help, and outlines what managers should do if a staff member discloses that they are experiencing domestic violence.
"If it’s brought to our attention, we can respond appropriately," she said. "We want employees to know, we are here for you, we want it safe for you here."
St. Joseph now works with victims to change their work schedules or location, and can assign them a new phone number or parking spot if requested, Hott said. Victims can also ask for an escort between buildings and to their car, and photos of prohibited people can be distributed to security staff.
Every employee will eventually go through a training about domestic violence and learn what resources are available in the community, Hott said. Educational posters featuring employees will be plastered across the facility, and bathrooms will include pamphlets about warning signs of domestic violence and phone numbers for help.
Ideally, she said, the hospital want to make it easier for employees to come forward and not feel like they have to handle it alone.
"In health care, we want to fix, we want to repair and get you out the door and back into your life. But intimate partner violence isn’t cut and dry," she said. "That’s OK. The goal is to make it not a secret anymore."
Hott said she hopes the hospital’s policy and training program will be used as a model for other health care organizations across the country. It’s an especially important sector to target, she said, as women make up nearly 80 percent of the health care workforce.
A young crepe myrtle tree stands at the entrance of the parking lot at St. Joseph.
Each morning when employees arrive for work, they pass the flowering tree, which was planted in memory of the two employees who were fatal victims of domestic violence.
"I pull into the garage that way every morning and I look at it," McKee said. "Now that it’s spring time, we look forward to it blooming."
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