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The NSW Nurses and Midwives’ Association (NSWNMA) has welcomed the state government’s long-awaited release of its final report into hospital security, but fears it won’t be enough unless additional nurses are employed.

NSWNMA Acting General Secretary, Judith Kiejda, said many of the measures outlined in the final report were already current policies, but they had not been applied or enforced to better protect staff or patients, and increased clinical staffing should be a part of the solution.

“We’ve highlighted before just how normalised acts of verbal and physical violence have become for nurses and midwives going about their work in our public hospitals,” Ms Kiejda said.

“The government has committed to adopting these additional measures, but they haven’t prioritised the need to ensure our hospitals and health facilities are staffed appropriately, particularly in some of the regional sites.

“In rural and regional areas, our nursing staff are regularly put at risk and this is often compounded by short staffing.

“We agree there is a need for more hospital security across the state, but security personnel cannot be expected to provide the clinical care being sought by patients coming through the front door.

“Additional violence prevention and management training, as well as refresher courses, are welcome measures but you still need the presence of clinical nursing staff to reduce incidents or help to de-escalate situations.

“Extra security is important, but it’s not the only solution that is required. It’s not going to help improve the triaging of patients or reduce waiting times in our emergency departments – the right number and skill mix of nursing staff is essential – as well as proper support for staff to report incidents when they occur.

“Unless the government is prepared to acknowledge this, we fear it will be some time before incidents of violence and aggression towards hospital staff is significantly reduced.

“We need the government to support our nurses and midwives by implementing safe staffing, that can be achieved by mandating nurse-to-patient ratios throughout NSW.

“Victoria and Queensland both have mandated nurse-to-patient ratios in their public health systems, NSW needs to step up.”

Multiple reviews, roundtables and inquiries have failed to stem the endemic violence that permeates our public health system.

In the middle of May, three nurses and an elderly patient were attacked with a pair of scissors by another patient at Royal Prince Alfred Hospital . It was not an isolated violent attack. At the beginning of May, a security guard was stabbed in the face at Calvary Mater Hospital. At the end of the month, a paramedic was punched in the face in Surry Hills. There are hundreds of other assaults either not reported or not exposed to public scrutiny.

In 2016, the then-health minister Jillian Skinner convened a roundtable of stakeholders, including the NSWNMA and other health unions, to formulate a response to the growing violence across our public health system.

The product of these talks was a 12-point plan that centred on the problems of aggression in EDs, but which also recognised that violence was endemic across the entire system.

NSWNMA General Secretary Brett Holmes says three years later the cold, hard statistics and the very real human tragedies highlight that not enough has been done to reduce the violence.

“The NSWNMA is extremely concerned that this plan has not proven effective in ensuring the safety of members working in NSW Health workplaces,” he said.

“Our members continue to report increasing levels of exposure to violence as well as an increase in the severity of the incidents that are experienced.”

Other voices share the Association’s concerns. In June a Daily Telegraph editorial said: “Our hospital and health care professionals are under siege from a rising tide of violent behaviour that has seen the very hospital workers who are trying to help members of the public become their victims.

“No one deserves this sort of treatment, least of all those who have dedicated their lives and careers to helping others.

“The unions which represent health care workers are, quite rightly, fed up with a government that after every incident tries to calm things down with reviews but which never acts properly on their findings.”

Time to walk the walk

Former NSW State MP Peter Anderson conducted the latest government review following a shooting at Nepean Hospital last year. He delivered a 21-page report in January.

Brett Holmes says the Anderson report fails to address key issues that are pivotal if violence is to be reduced.

“We understand the issue is complex and that there is no silver bullet. But that is no excuse for dithering. There has been plenty of talk but not enough action to reduce the violence.

“There was a plan put together three years ago that needs to be fully implemented. But a successful implementation requires the government to commit funds and resources, including sufficient staff with the appropriate skills.

“We are yet to see any such commitment while the violence continues to spiral.”

Brett says the original 12-point plan and the Anderson report had their limitations.

“There was a focus on emergency departments despite violence being experienced more broadly across NSW hospitals. There also needs to be more transparency and an improvement in incident reporting.”

A Victorian state government inquiry into violence placed strong emphasis on the need for adequate funding and resources to counter the violence in its hospitals.

It recommended the establishment of an Occupational Violence Prevention Fund that would provide funding for the safety and security of public health system staff.

“It is absolutely paramount that this money is used for the dedicated purpose of addressing violence and security issues within public hospitals. Under no circumstances should this money be used for discretionary spending unconnected with the priorities of security and safety in the hospital,” its report said.

Read the NSWNMA’s submission to the Anderson Inquiry: https://www.nswnma.asn.au/wp-content/uploads/2019/01/Safe-and-Secure-Anderson-Review-of-NSW-Hospitals-with-Appendices-Jan-2019.pdf

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