Working to Stop Healthcare Violence with June Garen
Healthcare violence is all too real and June Garen is fighting to change that.
After decades in the OR, June Garen decided it was time for a change. She was interested in psych mental health nursing and took a job at a state mental health facility. In 2017, she was assaulted by a patient and suffered a head injury, among other physical and emotional injuries. After the violent act, she found there were no resources for her to get help and she felt “shamed and blamed” at work.
Since that time, she has worked to change that. She is spending her time talking to legislators, and is getting involved in moving bills through to protect healthcare workers and first responders while also helping others heal from such devastating trauma. She wrote a book titled “Hey, I Could Use a Little Help Here,” a story not only about her trauma but also a tribute to a less fortunate nurse that lost her life due to healthcare violence. The book is an eye opener and a call to action. The time is now and we can all shed light on this issue to improve our work environments.
Learn more about supporting the Don’t Eat Your Young Podcast with a membership — visit Don’t Eat Your Young’s membership page on Patreon!
About June
A life-long northern New Englander, June Zanes Garen has spent almost four decades on the frontlines of nursing. After experiencing a violent physical assault in her workplace, she has become an advocate for survivors of healthcare workplace violence. June is currently employed as a nurse in a local school district.
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Announcer:
Welcome to Don't Eat Your Young: A Nursing Podcast, with your host, Beth Quaas. Before we get started, we have a few quick notes. Don't Eat Your Young is a listener supported podcast. To learn more about becoming a member and the perks available to you for becoming a patron yourself, visit patreon.com/donteatyouryoung. You can learn more about the show, share your story to join Beth as a guest, or connect with our wonderful community in our Facebook group. You can find all those links and more at donteatyouryoung.com. And now, on with the show.
Beth Quaas:
Welcome back to another episode of Don't Eat Your Young. I'm your host Beth Quaas. Today, I'm grateful to have June Garen on the show. I'm also saddened by her story of being assaulted by a patient and not finding the resources that she needed to heal after the incident. Some of the content that you hear today could be hard to hear. So I caution those that may be affected by June's story. I am so excited to have June Garen here today on the podcast. Welcome June.
June Garen:
Thank you so much. Beth, I'm excited to be here.
Beth Quaas:
Great. Why don't you tell us a little bit about yourself?
June Garen:
I'm pretty incredibly average. I became a nurse after I finished a degree in social work, and back in the day, there were no entry level jobs for social work. So my mom had been a nurse and I stepped into it, much to her dismay, and I've always worked at the bedside. I spent a lot of my career working in the operating room and have always been in direct care situations. Now I'm a school nurse, so still doing direct care, but in kind of a different way.
Beth Quaas:
And you had a real change to your life in your career that you didn't anticipate. And I alluded to it in the introduction that some of this content may be hard to hear for some. So I'm very grateful that you're here to talk with us today. Tell us a little bit about that.
June Garen:
And I thank you for giving a disclaimer because I think that sometimes it's hard to hear things and it's hard to imagine the emotions around being a victim of violence and surviving it. So thank you for doing that. I really strongly support people getting the care that they need. And if something is making them feel incredibly uncomfortable or anxious, please reach out for help. Don't just sit on it or stuff it away in a closet. Actually, I would applaud you for going and getting the support you need.
June Garen:
So when my last child was getting ready to graduate from college, I decided it was time for me to figure out what I would do with the legacy years of my career. What mark would I leave? And I had worked in the operating room for decades and knew that it was time to make a change and do something different. Didn't really like the way it was so much of a production line. And it just felt as though we were always rushing and weren't really able to take care of patients the way I had wanted to and had always done in the beginning of my career there.
June Garen:
So it was time to bow out and move on. So I thought it would be great time to take my degree in social work and sort of marry it to nursing and bridge into something where I could provide services to people more one on one. I was lucky enough to be admitted to a psychiatric mental health nurse practitioner program. And while I was taking my classes online, I thought, I'm getting kind of edgy and it's time to move into this. And I kind of want to start taking care of patients in this arena. So I applied for and got a job at a locked psychiatric facility. And that's where my life went on a very different trajectory, unintentionally, because I was assaulted by a patient, ended up with significant injuries and was not able to continue in that path.
Beth Quaas:
We talked before, you didn't find the resources really that you needed. There really were no resources and your organization didn't help you enough.
June Garen:
We all have the idea that if we're hurt in the line of duty, as it were, we'll be cared for and there'll be support and there'll be services and people will try to help you get back into the saddle. And what I discovered was that actually nurses, not just me, but the bulk of us, when we get hurt in the workplace through violence, we end up getting shoved to the edge of the herd. We aren't part of the pack anymore. Your peers are discouraged from reaching out to you. It becomes a shame and blame situation where you're held accountable for a situation that you really had no control over. And it was kind of an eyeopener for me.
Beth Quaas:
We as nurses all know about the Joint Commission and Sentinel events and what is the first question that we're always asked is, "How could you have prevented this?" And that is the shame and blame that you talk about.
June Garen:
Oh, amen. Yeah, you hit that nail right on the head, Beth.
Beth Quaas:
Instead the question should be, "What could we, as an organization, done to have prevented this?" There's always blame on someone. And as I'm learning from you and listening to the stories, the victim is usually the one that gets blamed.
June Garen:
Well, you're kind of an easy mark, right? Because you're sidelined, you're not in the game anymore. So you're not participating. I had a subarachnoid hemorrhage with skull fractures and multiple other injuries. I literally was dropped off at the emergency department at the local hospital on the curb and asked if I could make my way in. There was no ambulance called. There was no paper trail that I was able to access of what actually had happened to me when I was being assaulted because much of the assault happened while I was unconscious. It's kind of a weird situation because you're being held accountable for something that you didn't even know what was happening to you.
Beth Quaas:
Were you alone in that situation? Was anyone there to help you?
June Garen:
There were other staff members, but it was kind of unclear, I think, for people because certain protocols were in place for how things would be managed. And a number of staff members were already dealing with a patient in seclusion who had been part of a psychiatric safety emergency earlier that evening. And we were trying to keep the hallway clear in case they needed to come out of the seclusion room quickly. And trying to keep patients sort of out of the mainstream while still continuing with the activities, because you have to keep a routine going. So we're trying to keep up pathway open, yet still have people travel back and forth in that pathway. And that was when one of the patients apparently didn't want to be told to wait a minute, please, and came at me. And while there were staff there, there was not enough staff to actually get him off of me and stop him.
June Garen:
So he continued. After the first punch I was unconscious. The last thing I heard was something cracking, and I realized afterwards it was my skull that I heard when he punched me. And that was the last thing I remember. And then when I regained consciousness, I was alone on the floor. The staff had how been able to walk him backwards. He was still loose, unrestrained, but he was off of me. And my first thought was I must be dead because anybody who's splayed out on the floor like this, like literally I had been picked up out of my shoes when I was hit. I had no shoes on, I couldn't find my glasses. My name tag was gone. I thought I must be dead because why would you leave somebody in this shape by themselves on the floor? Right?
June Garen:
That would be the only reason I could understand in my mind that I was there alone. I heard a patient yelling, "He's killing a nurse." And I thought, "Ooh, I should do something. I should try to help that person. I wonder who who's getting hurt." And tried to get up, and I had a huge wave of nausea. My apologies to anybody who's had a head injury that I didn't understand how nauseated you are because you are some kind of sick. And I thought, well, that isn't right. I shouldn't have nausea if I'm dead. Right? That feels like it shouldn't be. So I must still be alive. So I kind of triaged myself after that happened. And I think nobody was prepared for that amount of aggression. We didn't have the resources. There was no police officer on campus. We were trying to like bail with a cut measure as the Titanic sunk kind of thing.
Beth Quaas:
Absolutely it what a horrific story. What a terrible feeling for you, and I'm sure your colleagues as well. I'm so happy that you're here today to talk to us because of course, we know that not everyone survives these assaults. And you have healed physically, but how are you emotionally?
June Garen:
It's interesting because nothing is linear and healing from a head injury and being by myself while I was healing was probably not the setup that was optimal for preventing psychiatric sequela in me. Being isolated and being disoriented with the head injury and being sick with that sort of put me on a pathway to really struggle. Now, I've worked really hard and it's tough to say it, but I have the diagnosis on my medical record of PTSD. And it's the real deal stuff. And it's hard because it has to be managed. Every day it's managed.
Beth Quaas:
What year did that happen?
June Garen:
So it happened on June 26th, 2017. It's been four years now. But what I've learned is that some people manage PTSD really, really well, some people struggle for years. It's nothing that I can talk myself else out of. And learning to cope with your emotions is one of the hardest things because as nurses, we like to help other people, but we aren't really great about helping ourselves.
Beth Quaas:
And I know that we talked before, you found that there weren't a lot of resources or groups for you to connect with.
June Garen:
Holy cow, there was like nothing. Basically, you kind of get dumped down the chute of workers comp and their whole goal is to get you off the roster, right? And there was nothing. I thought there must be something out there for us because there's so many of us that get hurt. And there was absolutely nothing. So I started reaching out to other people, I learned that was across the board. There was nothing for anybody.
Beth Quaas:
And you've changed that.
June Garen:
I'm trying. We're swimming upstream. And part of what we have to do is we kind of have to be loud and proud and speak up and be vulnerable and share our stories. Be willing to share our stories, but also to support each other in sharing those stories and being vulnerable. There's certain lines that I remember people saying, "Well, you just got to put your big girl panties on and keep moving forward." And I'm like, "Wait a second. You don't get to tell me about my big girl panties because guess what? I've been on the floor, wondering if I was dead." So my big girl panties are pretty well on and I'm doing the work I need to do. So I think as uncomfortable as it can be, we need to take a step back, look at how we deal with not just the violence in our workplace, but how we support each other after experiencing it.
Beth Quaas:
And I applaud you for the work that you're doing and trying to get those resources out there to people.
June Garen:
Thanks.
Beth Quaas:
Oh, you're welcome. There's legislation in many states that are trying to make assault of healthcare workers a felony in some places it is going through and some it isn't. That is not going to prevent the assaults though. What are a couple things you think that organizations, what steps can they take to start preventing this?
June Garen:
I think we need to take a step back even further and think about our own practices. How are we going to change it? So we need to actually come together and demand safe workplaces. Bottom line, it has to be safe. And one of the ways that we can do that is speaking up to our elected officials because as we all know, it always comes down to two things, money and politics, right? And a lot of that is driving how we can practice and our practice environment and culture now. Healthcare is a business, it's a big business.
Beth Quaas:
Yes, it is.
June Garen:
Making it safe is going to cost money. And as we all know, the first step up of dealing with any problem is to acknowledge it. And as scientists, as well as healers, we know that the only way we're going to acknowledge it is by collecting data. Without that, we have nothing to stand on, it's all anecdotal.
June Garen:
And so we need to report, when we've been injured, we need to report. When we've been the victim of verbal aggression, we need to report it when we've been threatened. And we need to demand that those numbers be collected in one place. And that can be done through OSHA, through JCAHO, through any of those places, but it has to be legislated. So we have to hold our elected officials, responsible and accountable for mandating that we have a safe workplace. And I get it that the word mandate is a hot topic right now, but I'm going to use it here, and I'm going to sit in that one and I am going to hold onto it and say, we deserve a safe workplace to practice our professions and to heal patients. We deserve to go home safely. We deserve to not be injured. And if we are injured, we deserve care and compassion and professional kindness to move forward and continue working. And that's only going to come if we have laws to support it.
Beth Quaas:
I agree 100%. And we've both been in nursing a long time, and there's a stigma with reporting workplace injury. And there's a stigma with workman's comp. We have to get over that because like you say, until these things are reported 100% of the time and documented, we can't go to anyone and complain, for a lack of a better word.
June Garen:
No. And I think that expecting safe workplace, I'm pretty sure any other profession would expect a safe workplace. Look at what happened with factories. Back in the day, we had horrible death mills and the workers got together and started fighting for safe workplaces. And that changed the whole work environment. We can do that, but we all have to get together and we have to support each other to make it work.
Beth Quaas:
June wrote a book, which we're going to talk about here, but the numbers are staggering that people don't realize this is an everyday occurrence.
June Garen:
It's constant. And I think that as healthcare workers, a lot of times we tend to go, "Oh, well, it's just part of the deal. Right?' Patients swinging, families yelling at you. As a school nurse, I can tell you, honestly, we've come to the point now where there's enough aggression when we send kids out to be tested for COVID, there's a certain undercurrent of aggression there from a lot of folks.
Beth Quaas:
Right. I just read something about patient family members assaulting someone because they weren't allowed to come into the hospital because of the COVID mandates. We didn't make those decisions, but we are the ones policing at the door, which is not fair.
June Garen:
Yeah, you're left holding the bag. Whether you're at the ED entrance... I do so apologize for that.
Beth Quaas:
We have dogs and it's okay.
June Garen:
Thanks. But yeah, the people who are stuck at the front lines have very little say. But part of the reason we have very little say is that we've not used our voices. And that was one of the things that I learned after I was heard, was to speak up and figure out how to strategically speak up.
Beth Quaas:
How should nurses move forward?
June Garen:
I think it's hard for a lot of us because I'm in a right to work state. We don't have any nurses unions here. And for a lot of people, like in Massachusetts, they have a very powerful union and they've made huge strides to move forward with making workplaces safer. So individually, how do we speak up? Just so that you know, every single voice counts, every single piece of mail that goes to your federal representative counts. They have to account for each piece of mail that comes to their mailbox. Our voices matter. If you send a postcard to your US Senator, it gets logged in somewhere. Your voice matters. But if you don't use it, it's not going to matter. Bottom line.
Beth Quaas:
That is great advice. Where can nurses find help right now? If I were assaulted today, where could I go outside of my organization if they're not giving me the resources I need?
June Garen:
Well, that's tricky because there's not a lot there for you, period. Where I am, it's interesting because I thought that the National Alliance for Mental Illness would offer something and there was nothing. There's nothing for folks there. The groups that have actually made inroads, Beth, are the emergency first responders. And there are a couple of different places that you could go and you could find resources for help from them. And one of them is Code Green, which it talks about mental health issues for first responders. And my interactions with these guys have been amazing because I'm like, well I can't really join, I'm just a nurse. And the response has always been, "No, you take care of the people that we bring to you. You are definitely on the front line. You count, come join us."
June Garen:
Project Hope: EMS. They have a lot of work that they do around PTSD and finding support and people who've gone through the same situations, being injured physically and emotionally in the workplace. Not just supporting each other, but also saying, "Well, this is what I tried. Try this number, give this place a call. See what you can find out there." Just giving you a lifeline.
Beth Quaas:
And I have been on your website and I know you offer all of those links to people. And so anyone can find those answers on your website. Talk a little bit about your website and the book that you wrote.
June Garen:
Oh, it was quite an adventure. I got a cat and wrote a book during the pandemic. Some people got really fit, some people made bread for the first time. Yeah, I adopted a cat and wrote a book. So it's been an adventure on both fronts. I won't lie. So I sat down and I wrote the book that I wish I had had when I got hurt. I tried to put it all together. I learned about getting a cover designed, I learned about publishing, I learned about getting it edited. It was an amazing adventure. And when it came time to look at how I was going to market or share the information, I didn't want to brand myself. I'm nothing to be branded. But the concept of my book is something I wanted to brand. And so somewhere along the way, we've all used this expression, especially in the OR a lot, "Hey, I could use a little help here," as you've got a patient who's flailing or their O2 stat's dropping or you can't find the stylet when you're trying to intubate and stuff that was right there is gone.
June Garen:
"Hey, I could use a little help here," translates to "I'm going down for the third time. Hello, eyes on me now, we've got a situation that's about to erupt." But it's not arms flailing about like a windmill, it's not stamping your feet. It's just making that announcement. And it kind of appeals to most people who've worked in healthcare or emergency medical services, because we've all used that line.
Beth Quaas:
It's just like, nurses eat they're young, "Hey, I need a little help over here." And I read that you've described it in your book as well. People around don't understand the urgency, but anyone in healthcare does, "Hey, I need a little help" means "Get over here right now. I Need help."
June Garen:
Yeah. This minute, eyes on me.
Beth Quaas:
Right, right.
June Garen:
So it summed up how I felt after I got hurt because hey, I could use a little help here and I was going down for the third time. And at the end of the day, I realized it got grim enough that I got tired of living, I got tired of trying to find a way out of it and I wasn't getting any help. And I figured out that it might be easier to just die and be done with it. Because everything that I had been was gone. I didn't seem to be the problem solver anymore. Physically. I struggled with things like numbers. I had a head had injury that I couldn't understand. I was up all night thinking I heard people in my house because I was constantly scared.
June Garen:
And I just got really tired. Not that I wanted to die, but that I got tired of living. And I could use a little help at that point. And it came in the form of one of the local police officers who was called by my kids and showed up on my doorstep and said, "What's going on?" And it was a real eye-opener that I was having a wellness check. How do you get to that when you're the one who takes care of other people? And I think for a lot of us who've been hurt and significantly hurt and isolated, that story resonates well.
Beth Quaas:
This conversation is a call to anyone out there struggling right now thinking that they're the only one that they're being blamed for what happened, which appalls me, number one. Reach out to June.
June Garen:
Please. Send me an email.
Beth Quaas:
Reach out to me and I'll get you in touch with June. Reach out to someone because those things are real. Anyone with a head injury, we know has a higher rate of depression and higher rates of suicide because of that.
June Garen:
Yep.
Beth Quaas:
We don't want anyone going there. There is help out there. It might be hard to find, but now you've all heard from June and she's making it easier to find.
June Garen:
And don't blame yourself. You went in to everything with the very best of intentions, you went into heal, help, comfort, support. What happened to you shouldn't have happened to you. It's not okay. And you have value. You are something that nobody else, you are one of a kind. And what you bring to the healthcare table is so individual and so valuable and so magical, you don't deserve to be pushed out of the herd.
Beth Quaas:
I love that you said that. Everyone brings something. It's not your fault.
June Garen:
Absolutely.
Beth Quaas:
It's just unfortunate that it happens. But I think things are changing. I think your voice and everyone else's voice coming together now will change it. And it's getting more for press. The media is talking about it.
June Garen:
A lot more press. And I think, not for nothing, I think that we still have a chance to make some inroads with the federal government. There is a bill, House Bill 1195, just so that you know, I'm going to be encouraging people in a blog on my website to start writing postcards and emails to people who are sitting on the committee in the Senate where this bill has gone to just roost and is being ignored right now. And House Bill 1195 would mandate OSHA regulations be enforced to healthcare and social service workers in the workplace from violence. And it's not a panacea of perfection, as I say to people. It's not the end all on be all. But man, it is a good first step. It acknowledges the problem and it will give a good format for collecting data. And we got to have it passed. We got to have it be paid attention to.
Beth Quaas:
And there is the call to action for any listeners out there right now. Please seek it out and let your voices be heard about it.
June Garen:
Absolutely. And one line on a postcard makes all the difference. So soon on my website, I will have the information for who is on the committee, where it's sitting in the Senate and also their contact information. You can call, you can try to email. A lot of them have firewalls, so you can't email. But you can send a postcard. A postcard from your state. Imagine a postcard from Minnesota showing up on Bernie Sanders' desk.
Beth Quaas:
Right. And June has been gracious enough to offer some swag to all the Facebook participants in Don't Eat Your Young. So you'll be hearing more about that.
June Garen:
Absolutely.
Beth Quaas:
Invite a new member and you're in the drawing for her book and a mug with her logo.
June Garen:
Yeah. And it's kind of fun because you don't have to keep it yourself. You could put it in the library at work or your kids' library at school or donate it to an LNA program. So read it, pass it on, keep it moving.
Beth Quaas:
Absolutely. That's what I intend to do with mine. I want more people to hear about it and I want more people to find you. So I hope that this episode gets out there gets passed on, gets shared to anyone that needs to hear it. Not just nurses, healthcare workers, patients, families, consumers of healthcare. Anyone needs to hear this message. It's not okay. It needs to stop and we need to do something about it.
June Garen:
Amen. You said it.
Beth Quaas:
I know you want to share something with our listeners today and I would love it if you would do that.
June Garen:
This is sort of like a hybrid thing. And I thank you for letting me do this because it's probably one of my favorite chapters in the book. And it only takes a couple minutes to read, but I like to end on an upbeat note. And so I'd like to share with you all chapter 19, which is titled Hope.
June Garen:
I'm looking back at the progression through this book and now realize that there is one topic that deserves its very own space, hope. Living through the experience of violence and surviving it requires a great deal of hope. At first, I fell into the trap of thinking that following the path of least resistance required me to give up and accept the status quo. As someone once told me several months after the assault, I looked as though I was on the way to become one of those old folks who simply passed the days sitting on a park bench, feeding the ducks and simply waiting to die. That was a fairly accurate description I had given off.
June Garen:
Back in nursing school, I had a particular aggravating instructor on the pediatric and maternal infant rotations. She had a saying that was shared fast and frequently in a variety of challenging situations, "Where there's life there's hope." In my younger days, I thought that this was a totally asinine philosophy. Then came Lynne Truxillo. Lynne was a nurse who died after a patient assault, about a couple years after I was assaulted. Lynne's experience made me sit up and pay attention to an asset I had been remiss in embracing, life. I'm alive and there's hope.
June Garen:
What does hope feel like? I liken feeling hopeful to heading into a busy traffic roundabout. You know that your exit is there, but the situation requires a certain amount of faith and diligence to navigate the traffic while keeping your eyes open for the turn that will take you in your desired or direction. Even if it takes a couple of passes around the traffic circle, you just know that eventually the path will open up and you'll be purposefully traveling on it. Hope does not guarantee an easy journey. It does offer the prospect of potential. The awareness of the possibility for finding the root to a desired outcome. Hope is what allows us to get off that park bench, leave the ducks to go on about their business and regain the determination to open the door to meaningful change.
June Garen:
I've learned that even the tiniest of changes and behaviors and attitudes, if acknowledged, may affirm positive progress. If you've made it this far in your reading, you have quite possibly experienced some realignment in your thoughts and previously held beliefs. You may also have started to establish some healthy boundaries regarding formally accepted behaviors of others. If you are the survivor of a violent assault, you may be doing the challenging work of acknowledging your feelings and emotions around what happened to you and the impact it has left. Perhaps reading this book has helped you to feel supported and strong so that you may continue with your healing. Proper respect to you for this.
June Garen:
Please know that just as the flutter of the butterfly's wings on one side of the world may cause a windstorm on the other side, you are causing a shift in the universe of not only your life, but also in the lives of peers and patients. Just as the wind increases with each flutter of delicate wings, your behaviors and ideas will gain momentum and grow. I believe that, like the energetic little butterfly, you may not see the full results of your efforts in the bigger picture, but you are making an impact. Have hope.
Beth Quaas:
That is extremely powerful and I love it. I'm glad we ended that way.
June Garen:
Flutter on, friends. Flutter on.
Beth Quaas:
June, your work is so important and I really hope people start reaching out to you that need the help, because I think you are someone that understands and you're here to give that healing care.
June Garen:
Thank you, Beth. And thanks for leaning in and saying that you'll help to get people in the right direction. I think we can all take a step back and look at how we support one another and how we care for each other. And this is a brilliant first step for us. So I'm glad to partner with you. Thank you.
Beth Quaas:
I'm excited to go on. All of the links to get a hold of June will be in the show notes. Like I said, reach out to me, find me on my Facebook page, Don't Eat Your Young. You may be the recipient of some of June's swag here. We'll get that going. And I thank you again, June. Keep up the great work.
June Garen:
Thank you, Beth. And all of you, thank you for taking time to listen. Stay safe, take care of yourselves and take care of each other.
Beth Quaas:
What a powerful episode with June Garen. She's been through a lot, but we are very fortunate to have her share her story. Again, I hope this is a call to action to anyone out there listening that we need legislation against this kind of behavior and assault. Please get ahold of your legislatures. And if you need help, reach out to June, myself, we'll get you in touch with the right people. You matter, this shouldn't be happening to you and we want to help you. Have a great day.
Announcer:
Don't Eat Your Young was produced in partnership with TruStory FM. Engineering by Andy Nelson. Music by The Lighthearts. Find the show, show notes and transcripts at donteatyouryoung.com. If your podcast app allows ratings and reviews, please consider doing that for our show. But the best thing could do to support the show is to share it with a friend or colleague. Thank you for listening.
Speaker 4:
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