‘How much abuse will I get at work today?’
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‘How much abuse will I get at work today?’

There has been an increase in violence and aggression towards NHS staff during the pandemic. Safe staffing is vital to de-escalation

I used to love my job, but recently I have had to brace myself before starting a shift, as I wonder ‘how much abuse am I going to suffer today?’.

Nursing Standard. 37, 9, 27-27. doi: 10.7748/ns.37.9.27.s15

Published: 31 August 2022

The author is a staff nurse who works in London and wishes to remain anonymous

I’m not alone; abuse of NHS staff is on the rise. A 2022 YouGov survey of patient-facing health service staff found two thirds (67%) experience aggressive behaviour from a patient at least once a year. One in five (19%) face aggression at least once a week. And almost a third (30%) of the 800 staff who responded say they experience violence from a patient at least once a year.

In 2018, a law was passed to try and tackle this abuse, making it a specific offence to assault an emergency worker in England and Wales, following in the footsteps of similar legislation in Scotland.

But, despite the threat of up to two years in jail for perpetrators, in reality, little has changed.


Picture credit: iStock

Not worth reporting

I have been verbally abused multiple times over the past year. Shouted at, sworn at, spat at, threatened.

Knowing this experience is one so many colleagues have also experienced only increases my fears, and I worry how long it will be until I move into the ranks of those nurses who are physically assaulted. One of my colleagues contracted COVID-19 after an angry patient spat at him.

Often I don’t even report these incidents – what’s the point? It has become such a part of the job now.

The only way to stop it is to fix the problem from the top. More must be done to tackle the workforce crisis in the NHS and deal with staff shortages, bed shortages and long waiting times.

According to the RCN’s Unsustainable Pressures on the Health and Care System in England report into working conditions, there are only a quarter of shifts where the planned number of registered nurses are working.

Beyond making the daily working life of nurses harder, this increases the risk to patients. Staff shortages aren’t just leading to longer waiting times, they are jeopardising safe and effective care. Research from the University of Southampton found the hazard of death increased by 3% for every day a patient experienced a registered nurse staffing shortage.

How are we expected to meet patients’ needs under these conditions? And where are we, as nurses, getting support from when faced with daily abuse?

‘When I walk into a waiting room, hours into a shift, I have no idea what is waiting for me behind that door’

The COVID-19 pandemic has certainly led to an increase in the aggression we face as nurses. In terms of pressure on the system, it has led to longer waiting times, reprioritisation of patients, and cancellation of routine treatment. It has also prompted irritation and anger from patients over the safety measures in place, such as masks, social distancing and visiting rules.

Patients lash out

When people have been waiting for six hours they are angry and they are in pain: all these things increase the risk to nurses. The public need to feel happier with the services that the NHS delivers to them. But these points shouldn’t be seen as justification. It is completely unacceptable that staff are being assaulted and this problem needs to be managed carefully, as a systemic issue.

When I walk into a waiting room, hours into a shift, I have no idea what is waiting for me behind that door. I want to be thinking about my patients’ medical needs but I can’t because of these other factors.

Our workforce is overworked, understaffed and under-appreciated. We know that patients are frustrated and often in pain and scared. We understand, but lashing out at the people who are here to help you isn’t going to solve the problem.

We feel like easy targets, and it’s a horrible feeling. We’re on the front line and dissatisfied patients see us as the face of the care they receive.

Why I helped to prosecute a patient after I was assaulted at work rcni.com/patient-prosecution

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