Nurses rally over assaults

A spate of attacks highlights growing risk of dementia-related violence – and need for better staffing.

A series of assaults on staff at a Blacktown Hospital aged care unit has highlighted the increasing risk of dementia-related violence in the health care system.

The assaults also underline the need for fast action to provide a safer working environment for nurses and other health workers.

More than 50 nurses and midwives rallied outside Blacktown Hospital to call for action following eight assaults on staff in a specialised aged care unit over a three-week period.

Nurses in the 8-bed unit were punched in the face and chest, choked, indecently assaulted and spat at.

The NSWNMA’s Blacktown Hospital branch called on the state government to urgently fund extra staff and additional security measures.

The branch said the unit did not have enough staff with the required skills to deal with people with severe behavioural issues.

Branch steward Katie Conciatore said nurses were happy to attend the rally and show support to their colleagues in the specialised aged care unit because, “Every single nurse knows what it’s like to get hit. We all get hit at some point.”

She said violence in the unit had got worse in recent years.

Nowhere else to go

Blacktown Hospital and western Sydney hospitals generally had seen a significant increase in assaults by people with cognitive impairments including dementia.

“We are getting a lot of patients with severe behavioural disturbances admitted from nursing homes or their own homes.

“Previously, many of these patients would have been admitted to the Rupertswood aged care psychiatric unit at Mount Druitt hospital, but it was shut down in 2017.

“As a result, there is nowhere else to place these patients other than 
in hospital.

“Branch members have said they are frightened to call in sick because that would leave the unit short staffed and increase the chances of their colleagues getting hit.

“The unit was originally commissioned to care for people with moderate behavioural problems.

“It was never supposed to accommodate patients with severe behavioural issues because when it was commissioned we had Rupertswood.

“The model of care proposed in 2014 was not accepted due to lack of funding. So, the unit was never appropriately staffed even for people with moderate behavioural problems.”

Blacktown branch held a meeting to give staff a chance to voice their concerns and discuss measures to improve the running of the unit.

The branch called for a review of the model of care to provide a long-term staffing solution.

It also called for a number of short-term measures – some of which management has accepted.

LHD agrees to more staff

After meeting NSWNMA branch and state officials, Western Sydney Local Health District management agreed to increase nurse numbers from two to three on each shift.

It also agreed to allow staff to temporarily transfer to other units in order to get a break.

Management also approved the development of an education plan to give all unit staff the required skills.

The branch is pushing for a multi-disciplinary approach to care with regular behavioural management meetings.

Katie said this should include greater input from social workers, occupational therapists and doctors to provide better pain management.

“Behavioural patients don’t respond to unmet needs in the way other patients do. If they are in pain they are more likely to punch rather than verbalise.

“We need a dedicated social worker to work on getting patients placed in appropriate facilities that provide a calmer and more familiar daily environment.

“Hospitals are not an appropriate environment for dementia patients with severe behavioural issues. The unit is too loud and there are too many people around, which gives rise to increased aggression.”

Katie said there had already been a noticeable improvement in behaviour in the unit as a result of better staffing and greater involvement from a social worker, which resulted in some patients being placed elsewhere.

“We are also getting security specials to come in so they can intervene before a code black has to be called.

“It is great that management are helping, however these are short term solutions. We need permanent funding for a model of care that suits moderate to severe dementia behaviours.”

NSWNMA General Secretary, Brett Holmes, said the recent spate of violence at Blacktown Hospital was of grave concern.

“Clearly, there is a need for additional funding to be allocated for appropriate resources within this unit,” he said.

“Nurses and midwives show up to work to care for their patients. They do not show up to be assaulted in their workplace.”