Some assaults take place outside hospitals, as staff leave or arrive for work. Photo / RNZ
By Jimmy Ellingham of Checkpoint RNZ
Each year, thousands of hospital workers are assaulted on the job and new figures obtained by RNZ show a 30% rise in attacks in just two years.
In the 12 months to June, 7777 assaults on Health NZ hospital staff were reported, but one frontline worker says the number could be even higher, as many workers don’t bother reporting incidents.
However, Health NZ says it’s strengthened reporting procedures, and hospital security.
NZ Nurses Organisation delegate Tracy Chisholm, who works at Waikato Hospital, told RNZ that from what she’d seen, many assaults went unreported.
“Finding the time to report an assault is a challenge,” she said. “I’m an ED [emergency department] nurse, I work in an emergency environment, and I would get sworn at and abused every week.
“If you multiply that by 120 nurses every week, it’s almost become an accepted part of our workplace.”
In the 12 months to June 2024, 6635 assaults on hospital workers were reported and 6001 in the 12 months to June 2023, Health NZ’s first year.
Health NZ said the figures could include assaults outside hospital grounds, when staff are leaving or arriving for work, such as the Palmerston North Hospital worker who was threatened at gunpoint earlier this year, getting into their car after a shift.
At Waikato Hospital, more than 340 assaults were reported in the year to June, up from about 260 two years earlier.
“I think, for the most part, we feel safe,” Chisholm said. “We have security.
“ED is lucky. We technically have security 24-7, but when we have those... patients that provide a threatening environment for us, it will depend on who’s around us for how safe we feel.”
This year, RNZ has reported calls from hospital staff to give security officers enhanced powers to detain and intervene when trouble happens.
Chisholm supported that, but the rise in attacks ran deeper.
“Why do people get agitated?” she said. “Why do they abuse us?
“Why do they yell at us? It’s because they’re not getting the care that they want – they’re not getting it in a timely fashion.
“If you think about a 12-hour wait in an ED waiting room overnight – you’ve had no sleep, you’ve had no food, you’ve seen a nurse, if you’re lucky - you’d be getting really grumpy.
“That comes out on the nurses.”
Fixing waiting times required more staff.
Sometimes, the abuse on staff also had a racial element, as many hospitals had healthcare workers from various cultures, Chisholm said.
Sarah Dalton, executive director of the senior doctors’ union, the Association of Salaried Medical Professionals, agreed with Chisholm’s diagnosis about the cause of the increase in assaults.
“I think you have to look to the heart of this issue and that’s people’s frustrations at not being able to access care, and also the failure to properly resource safe waiting spaces for people that, for whatever reason, have behavioural issues, whether it’s alcohol- and drugs-related, or for other reasons.
“I would say most of our hospitals lack safe waiting or treatment facilities for those people.”
RNZ’s also obtained figures that showed the number of hospital staff requiring time off work due to assaults had grown from 310 two years ago to 393 in the year to June.
Patient Voice Aotearoa’s Malcolm Mulholland said the overall increases painted a grim picture.
“It’s a huge number and I think of some of the instances where we’ve seen it reported, where there have been very serious assaults. I just hope that we don’t see the day where we pick up a paper and read that a hospital worker has suffered a very severe injury or – worse – death, due to an assault being committed in a hospital setting.”
Health NZ interim chief human resources officer Robyn Shearer told RNZ complex societal factors were behind the safety challenges, but it was working to keep staff safe.
“Security in our hospitals has been strengthened. In the last two years, we’ve had a $31 million boost to security for Health NZ’s emergency departments.”
Forty-four extra security officers were assigned to larger hospitals and others had the ability to call in more, while its 800 security guards and more than 1600 staff at larger hospital emergency departments had received violence-reduction training. That extra training amounted to 20,000 hours.
Health NZ was also considering measures like the design of facilities, and use of alarms for high-risk situations or when staff were working alone.
“The healthcare system, like many other services, is impacted by wider societal trends, pressures and changes. There are staffing pressures in the hospitals – we definitely recognise that.
“There are things that we’re doing which also include patient flow in our hospitals and we’re in constant discussions with our unions on these matters.”
That would help ease waiting times and the frustration that came with that. To achieve this, Health NZ was looking at areas like improved discharging of patients during weekends, when it could take longer than during the week and clog the system.
Shearer said giving security officers more powers would require a law change.
Staff often faced difficult situations, such as drunk patients, but the focus was on de-escalation and police would be called if necessary.
“The important thing is that we still have to deliver our good-quality healthcare to people who may be quite distressed.
“Sometimes, people are in a situation where they might be intoxicated, or they actually may not be in full control or aware of their behaviour, or they’re just terribly, terribly frustrated and our staff have to manage that day to day. It requires a lot of calm and skill and time.”
In instances of racial abuse, staff members might be swapped away from dealing with a patient and would be supported appropriately.
Staff were encouraged to report assaults, Shearer said.
“We do have really clear mechanisms for people to raise concerns, and work with our teams and unions to address ensuring that those things are escalated, either through local, regional or national forums.
“We have over 3800 people across the organisation who have a specific health and safety role to look at improving and maintaining health and safety.”
Health NZ could not say how many assaulted workers required hospital treatment themselves nor how many incidents involved police.
– RNZ