Emergency staff see violence as ‘part of the job’

Emergency department staff have been punched, kicked, scratched, spat on and sworn during 160 violent incidents in Christchurch a single month.

New research suggests staff often fail to report violence as a result, leaving health boards and management in the dark about the scale of the problem.

Dr Sandra Richardson, lead author of the latest study, said the public would be horrified if they realised the extent of the abuse.

‘‘Where else would you go to work and expect to be sworn, spat on, subjected to threats and harassment, and the risk of physical violence on an everyday basis?

‘‘It’s really hard for staff to continue to feel compassionate and caring when they’re constantly exposed to very personal and very targeted violence.’’

The study, published in the June edition of the New Zealand Medical Journal, focused on the emergency department at Christchurch Hospital. It aimed to show the discrepancy between official perceptions of violence and aggression, and those of staff.

Researchers audited staff for one month in May 2014. The audit took the form of a campaign, May – It’s Not OK, which has since been repeated, encouraging staff to report all relevant events.

Staff filled out 107 forms during the study period, covering

160 instances of violence. This was broken down into

98 counts of verbal abuse, 22 verbal threats, 21 physical threats, and 19 physical assaults.

Emergency staff reported being punched, kicked, scratched, spat on and sworn at.

No official reports, known as incident forms, were completed during the month. The year before, in 2013, 29 reports originated from the department.

Richardson, a nurse researcher at Christchurch Hospital, said some steps had been taken to improve the situation but she believed violence was still significantly under-reported.

Canterbury District Health Board executive director of nursing Mary Gordon said the board was aware of under-reporting and was working to make the department safer. It also recognised the impact of violence and aggression on staff, ‘‘whose priority is to provide treatment and care’’.

An electronic reporting system was introduced in 2015.

After feedback, a project team was working to make it easier and less time-consuming, Gordon said. Other changes included training on managing challenging behaviours, having security assistance available and management plans for repeat patients who could be disruptive.

The study did not focus on why staff were not reporting incidents but did include reasons drawn from other research.

Chief among them was a perception violence was ‘‘simply part of the job’’.