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The Shame of Occupational Violence

It's hard to imagine how anyone could act violently against those who dedicate their lives to caring for others and yet there were 3325 reported incidents against Nurses and Midwives in Queensland for 2014/15 .

According to the Occupational Violence Prevention in Queensland Health’s Hospital and Health Services Taskforce Report this is a problem requiring a multi-faceted solution.

A recommended definition for this aggressive behaviour proposed by the report is:

"Occupational violence is any incident where an employee is abused, harassed, threatened or assaulted by patients and consumers, their relatives and friends or members of the public, in circumstances arising out of, or in the course of, their employment, irrespective of the intent for harm."

Patients everywhere can experience discomfort, fear, frustration and anxiety - everything that goes with being seriously ill. This mixed with "patients with history of substance abuse and violence, and cognitive impairment" can be volatile. The highest incidence of occupational violence within our healthcare system were in:

  • Emergency departments

  • Mental health

  • Front-line services

  • Waiting rooms/areas

When the report explored the triggers for occupational violence some common themes were found:

  • communication issues and patient/staff attitudes

  • waiting times

  • frustration and dissatisfaction

  • nicotine, drugs and alcohol including withdrawal

  • patient or relative unrealistic expectations of care

  • dissatisfaction with service, quality, delay or lack of care

  • emotional and stress responses by patients/relatives included trauma

Case studies from other states and countries were scanned in the report and it reminded me of a study by Upali Nanda - Impact of Visual Art on Waiting Behavior in the Emergency Department. This research studied the effects of using visual art featuring tranquil scenes of nature in two Emergency Departments in Houston Texas. They found that the intervention reduced fidgeting, pacing, front desk queries and importantly aggressive behaviour. While this only addresses a fraction of the solution it is relatively low cost and easy to implement as most waiting rooms have some kind of screen.

By seeking to understand the contributing factors the report then sets out recommendations to keep our healthcare environments safe for staff. In many parts of the state pilot programs are being conducted and assessed. It is commendable to see this problem acknowledged with uniform endorsement for improvement from all levels of management and all organisations involved in running Queensland's healthcare system.

Despite the inevitable frustrations it behoves us to act respectfully in our dealings with healthcare staff and to condemn any physical or verbal violence. It will help these individuals continue with their mission of care.

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