Aggression is widespread – and on the increase

Survey exposes alarming levels of violence against nurses.

Eighty per cent of nurses and midwives experienced at least one episode of verbal and/or physical violence in the six months before answering a survey of NSWNMA members. Forty-seven per cent of nurses and midwives reported an episode of violence in the week prior to completing the survey. A total of 3416 members took part in the survey, which was sent to all members.

The survey asked about violence from patients and family/friends/visitors of patients. Of those who responded to her survey, 77 per cent were RNs and 87 per cent were women. Almost one quarter (24 per cent) had suffered physical violence with 76 per cent receiving verbal/non-physical abuse.

Among members who reported physical abuse, 35 per cent of cases involved use of a “traditional or opportunistic” weapon. Inappropriate physical or sexual contact occurred in 41 per cent of cases and sexual assault occurred in two per cent. Among members who reported verbal abuse, 14 per cent involved use of social media and taking of photos and 25 per cent involved “sexually inappropriate” behaviour.

More violence in public sector

Emergency department, drug and alcohol and mental health services were the clinical areas most likely to be subjected to violence. Public sector workers were more likely to experience violence (82 per cent compared to 69 per cent for the private sector) and there was slightly more physical violence in regional areas compared to metropolitan. The number of reported violent episodes ranged from 1 to 100 with the majority (80 per cent) reporting between one to 20 episodes. Older and more experienced nurses were less likely to be subjected to violence and men were more likely to experience it.

The survey indicates the workplace is becoming more violent. Of those who responded to the survey, 76 per cent believed the frequency of violent episodes was increasing. Members were asked about signs and symptoms exhibited by people who inflicted violence. Members said mental health issues were apparent in 78 per cent of cases. Substance abuse (57 per cent) and alcohol intoxication (46 per cent) were also common.  

Psychological injuries are consequences of violence

The survey also examined the impact violence is having. Twenty-eight per cent of respondents reported that they had suffered a physical or psychological injury/illness as a consequence of violence. In this group, psychological injury was the most common (71 per cent). Almost 52 per cent of those who reported violence said it had an impact on their professional practice.

Impacts included lack of empathy towards patients, decline in quality of care, avoidance of patients, feeling of professional incompetence and self-doubt. Members were asked about employer responses to violence and any risk-prevention strategies in place. Only 12 per cent thought their organisation’s policies and procedures related to prevention and management of violence were effective.

Almost half (48 per cent) of survey participants were not satisfied with their employer’s immediate response to the most significant episode of violence in the preceding six months. In this group, just over 10 per cent said the employer blamed them for the violence. Sixty-seven per cent said they were not provided 
with adequate information, support and follow-up after the episode.

The survey indicates that incidents of violence are greatly under-reported. Only 33.45 per cent of staff subject to physical abuse said they reported all episodes. When asked why they did not report these episodes, almost 41 per cent said they were “an accepted/expected part of the job”. A higher percentage – 56 per cent – said they did not make a report because they did not expect anything to change in the long term as a result.

This research was conducted with Prof Jacqui Pich and UTS Health. 

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