Attacks on ED staff seen as ‘just part of job’
Violence and aggression towards doctors and nurses in emergency departments has been occurring at a rate far higher than previously thought.
The rate of abuse was understated in official reports because nurses and other staff said they did not have time to make formal complaints, a new study shows.
And in many cases, ED staff had come to accept abuse as “simply part of the job” and had given up reporting it.
In response, hospitals say they have beefed up security, increased training for staff, and tried to make it easier for them to log violent incidents.
Nurse researcher and lead author of the study Sandra Richardson said she had been struck, swung at, and vomited on by patients during her 30 years in the profession.
“You wouldn’t work in a bank or supermarket and know that people are going to come in and swear at you, spit at you, threaten to kill you or follow you home,” she said.
She began investigating the issue after she heard that Christchurch Hospital management had been congratulating staff for the low rates of violence. That conflicted with reports from colleagues, she said.
Her study, published in the latest
New Zealand Medical Journal, was based on responses from doctors, nurses and other staff at the hospital over a one-month period in 2014, with further surveys in following years.
During that month, 7896 patients came through ED and there were 107 incidents, 19 of them physical assaults. A woman staff member had her breast pinched, another was hit in the face, and others had pills spat in their face and water poured over them.
Most of the cases involved verbal abuse. In one case, a staff member was called a “f***ing ho and an ugly b***h” and endured nearly two hours of abuse while waiting for police.
The hospital’s health and safety records, however, showed just 29 violent incidents were formally reported over a full year. Even when all of the cases in which security was called were counted, there were still just 20 to 40 cases a month — well below the figure found in the study.
There were many reasons for this, Richardson said. The main one was that nursing staff, who copped most of the abuse, were stretched and did not have the time or energy to fill out paperwork. Of greater concern was that staff had come to accept violence and aggression as part of the job.
The number of security staff at Auckland City Hospital had been increased and made more visible, Auckland District Health Board’s emergency medicine specialist Anil Nair said.