Not only did a recent study reveal that abuse by patients is considered “part of the job“, but patients brandishing knives, head butting nurses, spitting at doctors and throwing urine on hospital staff are among daily incidents in the state’s health system, documents reveal.
Health workers through all hospitals, nursing homes and health care facilities are regularly faced with intoxicated patients, abusive visitors and relatives. Angry, out of control people threatening violence.
Relatives who have become so bullying and demanding that staff dread to work with a patient. Health workers tolerate abusive visitors and patients with no real recognition by management of the psychological risks.
Nurses on wards have been expected to spend up to 8 hours, nursing agitated patients, for weeks at a time.
It’s not uncommon for nurses to take sick leave rather than present to work, knowing they will have the agitated patient for the consecutive third day.
So you want to grow up to be a nurse?
This article is applicable in all hospitals, nationally.
According to a a journal article (Ending the Silence on Violence, 2000), many [nurses] have suffered injuries including broken noses, split lips, torn skin and bruising at the hands of aggressive, confused or irate patients and their friends and family. Not to mention torn ligaments and tendons that require surgery. Then psychological injury.
The trauma of having an agitated, violent patient for more than two shifts consecutively is mentally and physically fatiguing. Dealing with an isolated violent attack, traumatic and exhausting. This intensifies or decreases on the experience of the health worker and familiarity of the patient and visitors.
Some examples taken from real scenarios, names are changed. I realise this occurs to all health workers however I’m relating these incidents to nurses.Scenario 1:
A care worker [Marie] was employed in a nursing home. Marie was initially employed as a casual. She was a good worker. She soon held a team leaders responsibility. The nursing home had some aggressive patients. One in particular, needed two care attendants to manage them. One day, being short staffed, she had to escort this patient on her own. They became aggressive and attacked her. Causing her a long term physical and psychological injury. She claimed Workcover but was dismissed by her employer instead.Scenario 2:
Annie, a veteran nurse for some 20 years, was relieving one night to a ward. She was asked to sit with a potentially agitated patient, relieving a nurse who took a meal break.
The patient called her into the room for help, not realising how aggressive the patient was she turned her back on him. She was beaten unconscious with an IV pole. A passing patient, who risked his own safety to drag her out of the room. Annie had multiple injuries. The last time I had spoken to her she was hiring a solicitor as she was being treated with contempt by the Workcover system.
Much is not reported as health care workers do not want to be on the work cover system.
It is common knowledge the system is abusive.
Unless the injury is debilitating or escalating, the aggression is rarely reported and few incident or injury reports generated.
Not all assaults are reported. Many incidents are only reported when aggressive patients escalate or when the situation becomes unmanageable.
Unfortunately nurses do accept unacceptable levels of violence as “part of the job”. This is also well described in a recent South Australian study.Scenario 1:
Scenario 1: A nurse who was concerned that their colleagues were experiencing higher than normal levels of fatigue whilst caring for an agitated patient, over a matter of weeks. They expressed concern to management that nurses were being allocated with this patient for 8 hour shifts up to 3 times a week. When suggesting to management to give the nurses a break, by splitting the shift into 4 hour blocks, having a break day in between. Management refused, claiming “the nurses are enjoying caring for this patient’ its not necessary” Even if it meant physically holding the patient to the bed and calling the security guards one or more time a day! Eventually the nurse’s made an incident report when the situation became unmanageable.Scenario 2:
[Fred] a lovely first class patient was given a drug that had a side effect of hallucinations. Fred was woken up that night to take his blood pressure. Fred thought his nurse was satan coming to take him to hell. Fred kicked his nurse in the stomach half way across the ward. It was never reported. As Fred was so distressed, ( in tears) the next morning to find out what he had done. Why upset Fred further? His nurse wore the bruising for days.
“After [an aggressive patienty attacked a nurse with a syringe] the syringe incident, there was no debriefing, no hospital counselling, not even a formal- acknowledgement of the incident report.’” says Mie Cartiege.
Mi Cartiedge is now one of Ballarat Hospital’s volunteer peer support members for critical incident and stress debriefing. However, as he pointed out, the network was set up purely on an informal basis.
[Source: Ending the silence on violence.Full Text Available: Harulow S; Australian Nursing Journal, 2000 May; 7 (10): 26-9 (journal article) ISSN: 1320-3185 PMID: 11894340]
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