The everyday violence of health

The power of NSWNMA members will be crucial to force the systemic change needed to deal with violence in our hospitals, says expert.

Nurses are more likely to suffer violence at work than police and prison officers, a researcher at the University of Technology Sydney has found. Dr Jacqui Pich, who recently presented her research to an international conference in Toronto on violence in the health sector, told The Lamp we need to ask “why is it safer to work in a prison or be a police officer?”

Dr Pich’s findings come from more than 3500 NSWNMA member responses to a survey about workplace violence. The results found that younger nurses are more at risk than older nurses, and that the private sector is only slightly better than public (see story on pages 12–13 for all the survey results). There was no difference, however, in the types of violence nurses experienced across sectors.

“Emergency departments and mental health and drug and alcohol nursing have been places where we think about violence. But the findings are telling us it doesn’t really matter where you work; 
you can be in a public hospital in a big city or you can be in a small country hospital, you are still exposed to risks.”

The high response rate Dr Pich received from nurses and midwives to her survey shows that violence is an “issue close to their heart: they take it very seriously and we have 
an obligation to do something with the results”.

Dr Pich said she was surprised both by the degree that violence extended outside of the workplace, and how long lasting the impact of violence can be: “We tend to think when we call it ‘workplace violence’ that it happens in your workplace. But it happens outside of work, and it happens in cyberspace.

“The use of social media has taken off and we haven’t managed to deal with it effectively. People are using social media to take photos, to threaten and to stalk people in ways that extend well beyond the workplace.”

Impact of violence is long lasting

Workplace-related violence is having long-term personal and professional impacts on nurses and midwives too. More than three quarters of those surveyed reported verbal and non-physical forms of abuse, and these experiences can “cause a lot of symptoms like you would have with PTSD, such as trouble sleeping and flashbacks”, said Dr Pich.

“People are leaving the profession, withdrawing from certain types of patients, and experiencing feelings of professional incompetence or self-doubt.”

The responses to the survey included “really desperate comments that people are so unhappy that they are scared to 
go to work, and that they attempted self-harm”.

The result is a decline in the quality of care and a climate where errors are more likely to occur. “The bottom line is it is going to have an impact on patients’ safety.”

Dr Pich said while reaction in Canada to her findings was shock, researchers also recognise that it is an international trend.

“It is a similar experience with nurses overseas, so it is not just isolated to Australia.”

Reporting system broken

One of the major hurdles to addressing workplace-related violence is that it is hugely under-reported, said Dr Pich.

“Often management will say ‘I haven’t got any reports and this is not a big problem’. But we know that it is happening and nurses aren’t reporting it for a multitude of reasons.

“Often the system is designed so that they won’t report it because it is going to take time, or it is a difficult system, or because the violence is so common, or they know if they report it nothing will happen. There is a big gap between what happens out there and the policies to protect people.”

Dr Pich says what is needed is systemic change driven by the power of the NSWNMA.

“Nurses are the most vulnerable and experience the most violence of all the healthcare professions. The NSWNMA is in a good position to drive this push for change.”

Dr Pich says this research provides a solid basis for the union to take evidence to the NSW health minister and say “this is not good enough” and use it to drive change.

“We need to have a series of recommendations for change, and it needs to include ways to evaluate those changes and it needs to be an ongoing process.”

“And we need to really keep it out there. Because if something really bad happens it hits the media and everyone is really interested, but things like this are happening every day.”

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