Action on violence needed now

The high prevalence of violence to nurses and midwives is well-documented but underreported.

Nurses have called for there to be no further investigations into preventing violence in Victorian hospitals, with the government needing to take immediate action.

However, this action should not include armed guards.

In a submission to a parliamentary inquiry into violence and security arrangements in the state's hospitals, the ANF Victorian branch said there was already in existence an "abundance of agreed guidelines, standards and research" which were not being complied with.

"The government can act on this issue now. In 2005 the Violence in Nursing Taskforce made 29 recommendations to minimise and control violence, but they haven't been fully implemented," the submission said.

"These recommendations are still relevant. There doesn't need to be further inquiries or taskforces to investigate this issue. Instead the government should implement these identified controls, and then evaluate there performance."

Among the controls recommended were the proper surveillance for waiting and reception areas, escape doors, the minimisation of hiding spots, after hours access by swipe card only and alarms linked to security guards and police.

Current arrangements were not working, as shown by the continuing number of violent incidents, the submission said.

The high prevalence of violence to nurses and midwives is well-documented and well-researched, but it is widely accepted that it is underreported.

ANF branch secretary Lisa Fitzpatrick said it was well known that there was a reluctance to report incidents of violence and aggression in Victorian hospitals, therefore looking at incident and injury, including workers compensation claims data, would not fully demonstrate the severity of the problem.

In a 2010 study by La Trobe University, that involved 1500 nurses and midwives, 36 per cent reported experiencing some kinds of occupational violence. The most common types were verbal abuse, at 90 per cent, physical abuse (44 per cent) and threat of harm (27 per cent).

The main perpetrators were identified as male patients. More than half of the nurses surveyed rated their organisation's management of situations as only 'fair' or 'poor'.

Violence not only had an impact on the individual nurse, but on colleagues and patients.

In the same La Trobe study, over a quarter of respondents said occupational violence affected their productivity, with 8 per cent reporting it increased work related errors.

If the safety of staff alone wasn't enough to push the government into immediate action, the effect on workforce retention in a sector that was already being stretched to its limit should.

Almost a third indicated they were thinking of leaving their current employment and almost a quarter thought of leaving nursing altogether, the study said.

"It shouldn't be a surprise that is staff don't feel safe in their workplace they will leave. With current staffing shortages, we can't afford to be losing experienced staff," Kathy Chrisfield, OHS unit coordinator, ANF (Vic Branch) said.

"And it impacts on attracting staff. If they hear stories about incidents of violence, they are going to look somewhere else.

The solution, however, is not the government's election pledge - which it is now reconsidering - to put armed guards, Protective Services Officers (PSO's), in hospital emergency departments.

"Introducing weapons into hospitals is not a solution, rather it adds a new risk," Christfield said.
There has been concern raised about a PSO's level of training, with Victoria Police Chief Commissioner Simon Overland saying the eight week training wouldn't be enough for those deployed to railway stations.

If this is the case, the ANF and Australian Medical Association is in agreement that they should not be put in charge of the safety of nurses, doctors and patients.

Resources could be better spent on more staff and the right skills mix, the ANF submission said.
"Sufficient staffing levels and appropriate staff skills mix significantly contribute to the prevention of violence and aggression in health services. Failure to provide this is a further contributing factor to the level of violence through increased waiting times in emergency departments," it said.

Hospital security is also a current issue in NSW, following a nurse being stabbed with a butter knife by a patient at Blacktown Hospital last month. It was the second time a nurse at the hospital had been attacked in the last 12 months.

Up to 50 nurses, doctors and security guards from the hospital stopped work following the incident, calling for extra security.

Then at the recent NSW Nurses Association's annual conference, a resolution for mandated security staffing in hospitals was passed unanimously.

The resolution, moved by the union's Blacktown Hospital branch, calls for mandated minimum security staff numbers in all emergency departments and hospitals.

It also calls for the reconvening the Violence Taskforce and a complete state-wide review of Emergency Department security jointly with NSWNA to determine gaps in compliance with the Protecting People and Property Manual, Zero Tolerance Policy and the Australian Standard on Hospital Security.

NSWNA general secretary, Brett Holmes, said security and safety in hospitals was an important part of delivering safe patient care and it can no longer be compromised by budget decisions made by managers, who are often not facing the risks themselves.

"There needs to be minimum security-staffing levels, which each facility must comply with. We also need to tighten up a number of other practices including the provision of training, the use of cutlery, record keeping and police assistance. Patients and staff have a right to be and feel safe in our hospitals and community health facilities," Holmes said in a statement.

Do you have an idea for a story?
Email [email protected]