Report: New Zealand Nurses Under Attack Aren’t Reporting Incidents

Nurses in an Auckland hospital are arming themselves with safety alarms as attacks against hospital staff are on the rise.

At the Counties Manukau District Health Board meeting last week, a Middlemore Hospital nurse said only about one in 50 nurses was very confident in dealing with aggressive patients.

New Zealand Nursing Organisation professional nursing adviser Suzanne Rolls said while it was not a new problem, it was getting worse.

“The nature of the aggression and violence is escalating, and the frequency of this violence is escalating.”

Despite this, Middlemore emergency department nurse Elyse Oh said at the meeting staff found complaints “are not being made”.

“There’s about three incidents per day, which equates to 1000 a year.”

The number of violent incidents reported by Middlemore staff rose to 85 in 2017 from 30 in 2016, a report on violence presented to the board last week showed.

The most common incidents were insults, swearing and personal threats against female staff, and multiple accounts of physical aggression.

As a result, nurses were being given personal alarms to use if their safety was at risk.

In the report Counties Manukau Health said it was in the process of implementing de-escalation education as part of a national roll-out.

Staff also had access to a new app created by police which warned them of incoming patients under the Mental Health Act who could have an increased risk of aggression.

Rolls said it was not just emergency department nurses at risk of violence, but those in the community and in mental health sectors.

Some community workers were now using locators as a step to keep themselves safe, she said.

But being able to keep people safe went beyond an individual or an individual report – it was about looking at the whole system, Rolls said.

“While there is a chronic unsafe staffing situation, this is a risk factor for violence and aggression.”

Why Nurses Aren’t Speaking Up

At the board meeting, Middlemore’s acting chief medical officer Vanessa Thornton said a lot of people had not had practical experience in dealing with violence and de-escalation.

It’s very hard for junior staff to have an approach. Generally in the ED we try get a charge nurse involved early so a junior nurse can learn from them.

What Elyse and ED staff have done here is consistent with what’s known across the region. Staff accept aggression and we need more awareness that maybe it isn’t acceptable,” she said.

Counties Manukau Health acting chief executive Gloria Johnson said the incident reporting system the board relied on “is actually not a very good way of measuring it.

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