A very supportive opinion piece in today’s Daily Telegraph by former detective Tim Priest.
Three things I would like to say before you read it.
- From my own experience working in the ED with aggressive and abusive patients, the police (as a whole) have been nothing but efficient and effective dealing with situations that they have become involved in.
Frustrated? Oh yes, I have seen them get frustrated. They often have to remain in our department for hours with high risk patients waiting for our resources to become available to manage their custodians. But when we need them, they have our six. - Although it is probably more prevalent, this sort of thing is not just limited to the Emergency Department. The wards cop more than their fair share of violence and assault. With mental health and, believe it or not, paediatrics and maternity being frequent hot spots.
- I so totally agree with Mr Priest: ZERO tolerance for this sort of behavior. Zero. Nil. Nix. Nada. Niet. Zip. Zilch.
Yet at times I have been guilty as anyone of letting this stuff slide under the ‘its our job to absorb this stuff‘ rug. [Later you might like to come back and take a read of this story].
Thank you Mr Priest for your salient words which I will repeat here for my friends:
THERE was a time, not so long ago, when hospitals were considered sacred ground and those who worked there, the doctors and nurses, were treated with the respect they deserved.
But not in 2012. Hospital emergency rooms have become mini-battlegrounds with violent and abusive behaviour directed at hospital staff occurring almost daily.
Those who work in emergency wards are already under immense pressure to satisfy near impossible patient treatment times dictated to them by opportunistic politicians and out of touch bureaucrats.
Now there is the burden of dealing with a growing number of abusive and intimidating patients, many affected by drugs or alcohol, who virtually hold an emergency ward to ransom until they are treated and released.
This “priority” treatment for the loud and aggressive is at the expense of the ordinary person who suffers in silence and just waits their turn.
A recent University of Wollongong survey of 91 emergency nurses at two NSW south coast hospitals gave a shocking insight into the level of abuse directed towards nursing staff. Thirty-nine nurses reported almost daily abuse while 23 nurses reported being assaulted at least once a month. Can you believe this?
I have no doubt these experiences are replicated in each and every emergency room across the country.
Recently, the Royal Adelaide Hospital had to close after a suspicious package was intercepted by police within the hospital.
The heightened state of alarm was a result of another shooting victim connected with motorcycle gang violence being admitted to that hospital.
There are similar problems reported in Queensland and the Northern Territory and just a few days ago, two doctors were assaulted at a northern Sydney hospital.
These incidents should alarm all of us, whether we are in good health or not.
There will come a time in all of our lives when we need the help of these special people and you would expect that the care they give is not with one eye on you and the other on a violent and abusive patient nearby.
A senior nurse told me of an incident at another public hospital emergency ward where a drug-affected patient was going off in full view of staff, sick patients and their relatives.
The language was extreme as was his threats of violence towards anyone who caught his gaze.
Despite the fact two uniformed police officers stood nearby him, he continued to abuse both staff and patients.
According to the nurse, the police did little more than “pretend” to get angry with the offender while reminding this senior nurse that tolerating abuse from patients was part of her “job description”.
Since when did nurses have to cop abuse from people with no manners, no self-discipline and only themselves to blame for their predicament?
That same hospital was also the scene of a harrowing tale of how much our community has declined.
An elderly man brought in his terminally ill wife for the final time and while she was being given medication to ease her pain, yet another “patient” decided to put on a scene and screams abuse at nursing staff and threaten violence towards the security guards summoned to restrain him.
The incident does not end quickly and the elderly couple can do nothing else other than try and block out the screams and the noise coming from a nearby cubicle.
The elderly man lamented to a nurse that both he and his wife were good citizens, had raised their children well, had worked all their lives and never burdened anybody, yet his wife would leave this world to the sounds of someone who was the complete opposite.
The question for all of us is why?
Why do we allow this to happen inside an environment where people are ill, many seriously ill and often they are young children.
Shouldn’t there be at least one place where violence, abuse and anti-social behaviour is not tolerated and action against those that offend is swift and meaningful?
Every emergency department around the country displays “zero tolerance” signs warning that bad behaviour will not be tolerated.
The fact is a hospital has to treat you no matter what and the morons know that. They also know “zero tolerance” is rarely, if ever, practised.
If a hospital ejected a violent and abusive patient without treatment, the likely outcome would be the hospital turned upside down by a stampede of ambulance-chasing lawyers.
The answer is simple.
Emergency department managers must call police to every violent incident and the police must arrest and charge those responsible.
That’s what zero tolerance means. Every crime matters, especially those in our hospitals.
Very little is going to happen until someone is badly hurt. We have patients screaming at nurses all day everyday. The Police are of little help, we have had the same Police bring the same patient to our ED three times in one shift, on the third time they were met by the ED consultant at the door and told that the patient had the cleared by ECATT already and the patient was not to be brought back to the ED for 24h.
Police don’t want to get involved as it means paperwork for them, maybe if it was simpler paperwork they would be more likely to charge people. The other issue are the drunks. Our Police don’t want drunk people in their cells due to safety, so they bring them to us to sober up. This is one bed which is occupied for the whole night by someone who has nothing wrong with them, just drunk!
Hospital administration know what is going on, but they don’t care, as long as the hospital is making money. The recent EBA for Victorian nurses shows what hospital administration think of their nurses. Hospitals were fighting AGAINST their nurses. The ANF is supposed to be a powerful Union, where are they on this topic?
I whole-heartedly agree, but let’s not forget the horizontal violence that’s rife between those in the nursing profession. We’re told by our employers it’s unacceptable and will not be tolerated, but try proving it and having justice done! Unless you’re a drooling psychotic mess restrained by a strait jacket, no-one wants to know and even if they did, the process of investigation is so protracted, exhausting, stressful and geared towards protecting the perpetrator/s that’s it’s hardly worth the effort involved. In many instances it’s a case of the Manager and his/her sycophants engaging in the terrorizing, so how do you go TO the problem ABOUT the problem! Out comes the broom….sweep, sweep, sweep,… under the carpet it goes, so your most effective, uncomplicated option is simply to move on before the emotional battering transforms into lifelong, suppurating psychological woundsl! Combine that with abuse/violence from patients and families, and nursing is without doubt the dream profession….NOT! I still love what I do. I knew from aged 3 that I wanted to be a nurse and I’m a damned good one too, but I didn’t sign up to be a receptacle for frustration, discontent and anger from all quarters. Whilst there is no disputing the hazards of caring for the public, let’s not turn a blind eye to what goes on in our own backyards. It’s no wonder nurses burn out and are leaving the profession in droves. I mean let’s face it, there just isn’t enough money forthcoming to compensate for being a moving target! It’s a jungle out there and nurses are the cannon fodder, not only from their charges but their colleagues as well. Absolutely the public should be held accountable for any bad behaviour, but nurses need to reconsider the nasty, vicious, unsupportive, critical and persecutory manner in which they frequently treat each other AND BE TAKEN TO TASK! It’s the ultimate hypocrisy to condemn the public for being aggressive, violent, verbally abusive and unappreciative when there’s warfare being waged amongst the ranks.
I’ve worked in three ED’s as a ward clerk, one as a PCA/AIN and about to commence in my fifth as an RN. I have experienced violence in many forms, from verbal abuse to all out physical, life-threatening assault. I wholeheartedly agree with Mr Priest in that every form of violence should be dealt with by the police and the offender charged. Thankfully, all of my managers and team leaders so far are of the same opinion.
No hospitals are no longer classed as sacred places. These patients/ visitors that attend either the Emergancy Dept or the wards have no respect whatsoever towards any medical staff or those sick that surround them. In my many years of nursing (Paeds ) I have found myself in situations where I have thought I was going to be phyically attacked. Many years ago I was thrown across a room and landed against a window. A table broke the full impactof me going through the window. We were on the 5th floor. I was off sick the next day, with no follow up. The patient was mentally stable and was not seen by police or hospital management, and he was not charged. Yes I say charged …..with assault as the case should have been.
I ask myself nowadays with a hugely increased incidence of assaults and threats towards medical staff why dont staff press charges? Unless a patient/ visitor has a history of mental unstability, staff should be able to press charges. This is not pushed as it brings discredit to the hospital involved. Never mind those that have been assaulted.
These patients are in what used to be classed as a safe place to recieve treatment to enable them to go about their daily lives fit and well. Medical staff are the ones that are increasingly being abused.
When is the time going to come that medical staff are protected from this?
Hospita lmanagement have a duty of care not just to patients but the staff who work for them!
I fully agree, it seems that domestic violence is now allowed in ERs and elsewhere, instead of its just the wife being precious, now nurses/docs/staff are being precious if they dont accept the abuse.
It also needs to go right to the top where the managers hide behind the secretaries desk and office.
When I worked in the operating theatres, suddenly clothes in the change room started disappearing, including shoes belonging to members of my family, so we lost over $200 worth.. the Department boss refused to call the police in, stating it would upset everyone, well for 6mths staff were upset daily with their gear missing, [not enough lockers for staff numbers]
Finally they caught the staff member doing the uplifting…………what were the repercussions, Invited to hand in their resignation and leave immediately. No charges were laid.
Excuse was she was a solo parent and couldnt pay her bills. Well so was I and many other co workers, we couldnt afford replacing the gear either.
I bet within 2mths of violence in the ER being ‘hit’ with a night in the concrete cells and a hefty fine, violence would end. In most cases its done by those accompanying the patient, who is normally a level 5 triage, so can wait for care until the next morning after the court has dealt with them.
Here! Here!, I second that, etc. My rural Canadian hospital doesn’t even have security, we have to call our local police.
My colleagues and I have been dealing with an aggressive patient for an extended period of time. One senior RN told us that he’s just frustrated and that as nurses it’s our job to “put up with it” and that if we don’t like it we should find new jobs!
How can we practice zero tolerance when our own colleagues refuse to support us? The only way we will ever solve this problem is if we are allowed to throw them out on the streets without being afraid of the consequences, or if we have security staff in every ward and unit.