Violence and aggression have become normalised as an inherent part of care work. This needs to change, say the NSWNMA and ANMF.

Report after report, nationally, internationally and in NSW, show that nurses and carers are reporting exposure to violence that is increasing in both frequency and severity.

In response, the ANMF has developed a 10-point plan to end workplace violence and aggression in aged care.

“Violence and aggression should not be an accepted part of providing care in the aged care sector. Instead, they should be managed as preventable workplace hazards through systematic risk management, prevention and continuous improvement,” says NSWNMA Assistant General Secretary Katrina Bough.

The Workplace Violence and Aggression 10-Point Plan and Audit Tool is designed to “provide a framework for employers to assess compliance, identify gaps and guide improvement actions”.

The ANMF seeks to embed this tool in the Aged Care Quality Standards. The full 10-Point Plan aims to:

• improve security
• identify risk to workers and others
• include families
• report and act
• prevent violence through workplace design
• provide education and training to healthcare workers
• integrate legislation, policies and procedures
• provide post-incident support
• apply anti-violence approach across all disciplines
• empower workers to expect a safe  workplace.

Katrina says an important part of the plan is that it goes beyond a mere response to incidents “and focuses on preventative measures that identify and control risks before they cause harm”.

“We believe it will promote safer workplaces, stronger reporting cultures, improved support for workers following incidents, and greater accountability at all levels.

“Integrating the 10-Point Plan into the Quality Standards will provide a practical mechanism to ensure that safe care for residents is supported by safe workplaces for aged care workers.”

Unacceptable levels of aggression

International studies have found that occupational violence in healthcare continues to increase globally.

A study published in Occupational and Environmental Medicine found that 61.9 per cent of healthcare workers report having experienced some sort of violence perpetrated by patients and visitors.

A NSWNMA Report into occupational violence released earlier this year found that workers in residential aged care were particularly vulnerable and more likely to experience physical violence compared to other types of violence.

77.46 per cent of aged care respondents to the NSWNMA survey stated they had experienced or witnessed occupational violence.

Alarmingly, they cited three substantial barriers to reporting the violence:

• a lack of faith in the system (they didn’t think it would make a difference)
• workloads (didn’t have the time)
• minimising personal experience (didn’t think the incident was serious enough).

The report found that there were multiple reasons for violence in aged care, including:

• understaffing and poor skill mix
• a high proportion of residents with complex medical conditions including mental health conditions and dementia
• insufficient specialty facilities for residents with high-risk behaviours, and
• expectations of families.

44.21 per cent of aged care workers said the most effective way to address aggression is more staffing.

The report argued that the intersection between gender, industry and experience of occupational violence “must be given serious consideration when looking for solutions”.

According to SafeWork Australia, women are 1.5 times more likely to lodge a workers compensation claim for exposure to occupational violence or being assaulted.

“We cannot address our goals around reducing violence against women without addressing violence in healthcare,” said Katrina.

Everyday violence in the course of delivering care

In a report – Occupational Violence has no place in my workplace – released by the NSWNMA earlier this year, a number of NSW aged care workers shared their harrowing experiences of being attacked as they carried out their care work and their employers’ lack of empathy:

“I was assisting a resident with personal cares, and asked her permission for each stage of showering, which she agreed to,” a residential aged care Assistant in Nursing told The Lamp. “She intentionally waited for me to start washing her feet when she grabbed my head and drove her knee into my nose. My co-worker had to help remove her hands from my hair. Our company seems to ask more what we did wrong than to help put preventions in place.”

“There was a new resident who was still quite fit and strong,” said another RN in residential aged care. “I felt as if he had become obsessed with me. I was the only RN on one particular night, and I had to lock myself in the office to get away from him. He became very angry and was kicking and punching the door and trying to break it down. I was very frightened. I spoke to the manager about him, and he said: ‘Some residents just take a while to settle in’.”