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We need to stand up to acts of aggression and not accept them as ‘part of the job’ by ensuring there are consequences to attacks
At work last year, I was physically assaulted by a patient who had wrapped a radio wire around a hospital security guard’s neck. I was kicked and spat at when I tried to help my colleague.
Nursing Standard. 37, 8, 27-27. doi: 10.7748/ns.37.8.27.s15
Published: 03 August 2022
Although this is the first incident where I have helped to prosecute a patient, it is not the first time I have been assaulted. However, this incident stayed with me as I found being spat at so disrespectful. The police had brought this individual to hospital, yet it was me who ended up needing care.
Following his violence, the patient was arrested under the Assaults on Emergency Workers (Offences) Act 2018, charged with assault on an emergency service worker, sentenced to community service, fined and ordered to pay me compensation, which I did not claim.
I did not prosecute for money; I just wanted this person to understand that abuse of any NHS worker will have consequences.
Working in the emergency department (ED), abuse is nothing new for me and my colleagues. We have all been verbally or physically attacked. This leaves me questioning why, as a profession, we don’t report more of these incidents to the police.
Is it because we expect to be attacked and see encounters with aggressive patients as just part of the job? Maybe it is because we have seen previous assaults not taken any further? Or is it because we empathise with patients and don’t want to cause any further distress?
While there are many factors that influence nurses’ decision to prosecute patients who have been violent towards them, I think that we should act against those who harm us. We safeguard our patients, yet we also need to safeguard ourselves.
After the height of the COVID-19 pandemic, we went from being applauded as heroes to being the nation’s punching bag.
The NHS Staff Survey 2021 highlighted that 27.5% of employees suffered abuse, bullying or harassment from patients, their relatives or the public during this year, which is slightly higher than the previous year’s figure of 26.8%.
So how do we reduce abuse towards nurses? Do we need training, an appeal to the public or both?
Are nurses given the skills to handle abusive situations? We are advised on de-escalation techniques, but that does not always work.
While studying my undergraduate degree we were given management of actual or potential aggression (MAPA) training but I cannot now recall the majority of the techniques taught.
Maybe the NHS needs to introduce mandatory staff training on self-defence to help us protect ourselves and our colleagues. And research is needed to explore why nurses face so much abuse.
I wonder about the effect aggression has on nurses’ continued practice and if the government’s planned increase in potential sentence length from one year to two for those who assault emergency workers will have any deterrent effect.
Support and encouragement from my employer, the Royal Wolverhampton NHS Trust has enabled me to continue to stand up against abuse, and I am vigilant about the need to protect my colleagues.
If an aggressive patient comes into the department, I inform the nurse in charge and security. I prepare for the worst and ensure the exits are clear, but I also inform anyone who I suspect has the potential to be aggressive towards me that abuse will not be tolerated and they will be escorted from the department if necessary.
I realise it is only a small minority of patients and/or relatives that abuse NHS staff, but as a profession we need to take a stand.
If you find yourself in a similar situation, I urge you to report the incident, following your trust’s policy, and report it to the police. And seek support if it has affected your mental health.
RCN members can access its counselling service. I recommend speaking to friends, colleagues and family members. I also found mindfulness helpful for my mental health since the attack.
Violence against nurses: why do so many attacks go unreported and how can we protect staff? rcni.com/violence-nurses
Further information
RCN counselling service tinyurl.com/RCN-help-support
Nurse Lifeline – a national, free and confidential peer-to-peer listening service nurselifeline.org.uk