Reacting to violence and abuse


Random, possibly drug-fuelled, violence is in the news this week due to the very sad death of an 18 year old boy, hit by a stranger for no reason last Saturday night.

But nurses and other frontline emergency workers are no strangers to this type of violence and abuse [which is why NSWNA is part of the Last Drinks campaign.]. Last month, in an article in The Australian called ‘The Long Night of the Screamers’, columnist Janet Albrechtsen wrote of her shock at the kinds of behaviour she unwillingly witnessed when she had to spend a night in the Emergency Department of St Vincent’s Hospital in central Sydney.

“… to fully understand what our doctors and nurses do, it’s worth noting that the “c” word was in full swing that night. A constant stream of patients, mostly men but some women, filled to the brim with alcohol and drugs were screaming abuse at the staff.”

Picture: Craig Greenhill  Source: The Australian

…As a naive newcomer to this other world, I noticed there seemed to be more police than medical staff in the room. Among the patients on the 50 beds in the emergency department, was I the only patient there who was not under the influence of alcohol or illegal drugs?

A former police officer Tim Priest took up this theme in an article in this Monday’s Daily Telegraph.

A recent University of Wollongong survey of 91 emergency nurses at two NSW south coast hospitals gave a shocking insight into the level of abuse directed towards nursing staff. Thirty-nine nurses reported almost daily abuse while 23 nurses reported being assaulted at least once a month.

Priest’s suggested solution? Emergency department managers must call police to every violent incident and the police must arrest and charge those responsible.

Sounds simple, but the police would probably not thank him for this suggestion as they would find themselves dealing with multiple medical emergencies in the cells.

Emergency departments do find ways to deal with people as they calm down and the drugs wear off. As the head of Emergency told Janet Albrechtsen, by the morning, these same nurses and doctors who have worked a long shift, then sit down and talk to the patients about their problems.

Ian Miller, an RN who blogs from Canberra, told of an incident in ED seen from three points of view. The full picture only comes into focus from hearing all three points of view.

What do you think? How can we make ‘zero tolerance’ really mean zero tolerance? Are these stories of violence and abuse familiar to you or are they sensationalist? How do you cope if you work in an environment like this? Do you agree that abusive patients should be arrested?

 [The 3rd international conference on Violence in the Health Sector takes place in Canada in October – this is an international issue.]

Image credit: Picture: Craig Greenhill  Source: The Australian



  1. I am a nurse and work in psych in the public health system. Everyday I am threatened and have been physically assaulted several times.

  2. If you ask me, abuse and violence is on the increase in every western society. The problem is legal system is failing by constantly justifying criminal mentality, whilst the media promotes violent programs and the rest of us hope for the best. Unless we deal with the problem it won’t go away. If anything it will get worse.
    Disrespect towards health professionals is also on the increase; not just in hospitals but also the wider community. Again there are a number of factors that have contributed to this and the problem will only get worse if nothing is done. What good will it do to arrest violent patients when there is so much internal abuse and horizontal violence in the health system?
    The system is broken and it needs to be fixed. But who is going to do that? Not the current government who refuses to invest in our health. Not the bureaucrats who run the health system by cutting costs by introducing unskilled labourers and demanding that skilled workers do more with less. Not the NUMs who turn their back on the problem by blaming the staff, so that no one speaks up. Not the staff who are too busy dealing with the chaos and blaming each other. And certainly not the patients who are frustrated with the whole system and don’t know where to turn.

  3. The problem of violence and abuse is not confined to the emergency department or even the psych units, yet these are the areas that receive all the publicity. Patient (and relative) behaviour is just as bad, if not worse in the wards. Ward staff are regularly assaulted and battered by patients and nothing is done. Nobody wants to do an incident form, as the quite reasonable perception is that nothing will be done. NUMS fall over themselves to placate rude and unrealistic family members and do nothing to support their staff. I think Lucy has the right idea – leave nursing because it is just not worth being a punching bag and then being complained and lied about.

  4. There is more than one form of aggression. For example there are those who darn right out aggressive, those who are passive aggressive and those who are a combination of the two. The aggressive patient hits out and tries to injure you. The passive aggressive is nice to your face and complains about you behind your back so that you get into trouble for their lies or false perceptions; while the combined aggressive usually abuses you, then accuses you of abusing them. All of these acts are forms of violence designed to cause physical, emotional, and or financial pain.

  5. The shocking story of NSW Police applying unnecessary force upon a psychotic man on the street in CBD Sydney has finally been told. Another chapter of ‘police heros’ … men and women in police uniforms, acting in a frenzy to ensure their own agenda is met.

    I would prefer not to have NSW Police get involved in calming down a genuine patient. Most cops are reluctant to place their firearm in the ‘gun safe’and thus there is always a risk of accidental shooting.

    Now they have pepper sprays and tasers, there will be more and more deaths of people who simply needed a bit of space.

    So many cases of police making the wrong decisions – causing pain and injury – all in the name of ‘do what I say’ … because they are police!

    When in Court, they always claim ‘I was just following orders’ or ‘policy’ or ‘I thought I was correct’.


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