Zero tolerance for violence against nurses

Should the recent spate of violence towards nurses in Victoria and other states raise the alarm on national hospital safety? 

In Victoria, nurses have once again called on the government to action the recommendations set down by the 2005 Victorian Taskforce on Violence in Nursing.

“If employees were being punched, hit, pushed, kicked, bitten or threatened in any other workplace, something would be urgently done about it,” said Lisa Fitzpatrick, secretary of the Australian Nursing Federation Victoria branch. But no safety – let alone a pinch of care – seems to be available for nurses.

Fitzpatrick said these incidents of violence against nurses are unacceptable. “We’ve had a lot of talk in Victoria about nurses’ and midwives’ entitlement to a safe place to work, but the reality is very different to the politicians’ rhetoric,” she said.

Liz Cloughessy, executive director of Australian College of Emergency Nursing, said violence against nurses has increased.

“I have been an emergency nurse for forty years and I can say that there is a huge increase in the level of violence that is directed at emergency personnel – the clerical staff, the medical staff and the nursing staff,” said Cloughessy.

She said a zero tolerance policy is needed, for violence and aggression directed at healthcare personnel, including clerical staff. “We have to look at the environments that they are in and make sure that we are actually having people work in safe places.

“There also needs to be a lot of training on how to deal with violence and aggression,” she said, “learning how to not take it personally, learning how to stay calm and take that step back and say ‘that behaviour is just not OK’ rather than being reactive.”

Fitzpatrick said, “Nurses and midwives believe those with power to make hospitals safer are not taking the issue of violence urgently.”

She recognised the Victoria’s parliamentary inquiry into violence and security arrangements since December 2011 and the blueprint to stop hospital violence through 39 comprehensive recommendations.

“However, the Baillieu and now Napthine government referred all responsibility for implementing the recommendations to health services, without providing enough funding nor monitoring, oversight or evaluation,” she said.

An example is the recommendation that all Victorian hospitals implement a standardised ‘code grey’ and ‘code black’ response to alert other staff members and security to assault or aggressive patients.

Another concern that is yet to see an action is a tougher sentence for those who assault an emergency worker, as announced by Victorian attorney-general Robert Clarke more than a year ago.

Fitzpatrick added, before elections, the current Victorian government promised $21 million on protective services officers, but “instead we have $5.8 million spread thinly over four years on duress alarms and training”.

“Words and good intentions are not enough to make our hospitals safe. ANF Victoria is calling on the Napthine government to take a leadership role and properly implement, fund, systematically co-ordinate and evaluate the 39 recommendations in its parliamentary report,” she said.

More specifically, ANF Victoria is asking the government to order a standardised ‘code grey’ and ‘code black’ response, adequately fund all high-risk departments, and train nurses to prevent and manage occupational violence and bullying. She said dedicated 24/7 security personnel should man all major emergency departments, in addition to security personnel.

At the ministerial level, the advisory committee on Improving Hospital Safety and Security also needs to appoint independent occupational health and safety experts.

And lastly, nurses should be safeguarded in speaking out about an incident of workplace violence or aggression, during media interviews for instance.

ANF federal secretary Lee Thomas said nurses working in EDs, psychiatric units and in aged care facilities have been found to be the most susceptible to outbreaks of workplace violence.

“Sadly, violence is increasing in Australia’s hospitals and health services,” Thomas said.

Drug and other substance abuse, as well as grief and mental health illnesses, are some of the many reasons for this escalation of violence, she said.

“Day in, day out, nurses and assistants in nursing (AINs) are treating patients who are often agitated, frustrated, angry and aggressive. When emotions escalate into violence, it’s the nurses and the AINs who become the victims,” she said.

Many states have zero tolerance policies, she admitted, adding: “ ... they are difficult to police.”

Facing the painful truth of the issue, Thomas said, “It’s unlikely violence will ever be completely eradicated, but we all have a responsibility to stamp it out for the good of the professions and the community.”

She ensured the ANF’s support on new initiatives, such as clear escalation policies and anti-violence trainings. There are also better systems, security and equipment to look forward to, such as duress alarms to prevent and counter workplace violence.

Formal and informal counselling is also in her list. “If we want to recruit nursing professionals at a time of growing nurses shortages across the country, we sure want to keep it safe,” Thomas said.

“It is absolutely crucial that we maintain a zero tolerance approach to any form of verbal or physical violence upon nurses and then fully support them if they do then suffer any violence.”

Peter Dutton, shadow minister for health and ageing, condemns violence against hard-working health professionals.

“Those responsible should feel the full force of the law so they are accountable for their actions and to deter similar acts,” said Dutton.

He said, “Doctors, nurses and other health professionals are highly respected members of our community and should be treated as such by those they are trying to assist, irrespective of the challenging environments in which they sometimes have to work.”

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