Mental health nurses are speaking out against brutal violence inflicted by their patients, including being punched, kicked, burnt and stabbed and choked, after the number of assaults more than doubled in two years.
In an article in the Kai Tiaki Nursing New Zealand magazine, mental health staff have revealed horrific details about assaults suffered at the hands of patients they were caring for.
In the two years to 2012, the number of incidents increased from 1140 to 2314.
Annalie Gannaway who, while working at Christchurch's Hillmorton Hospital, was repeatedly kicked in her face, head, legs and stomach.
She activated her wrist alarm to find it was not working and was eventually rescued from the violent onslaught when another nurse walked in by chance.
"I felt totally isolated and vulnerable," she told the magazine.
A Nelson-based community health nurse has been permanently disfigured after a patient locked her in a room, punched, fractured her skull, stabbed, choked and burnt her with scolding water.
And Christchurch nurse Noel Walker was physically assaulted four times in six months.
"(My wife) was frightened every time I went to work and (my sons) picked up on that.
"I felt bad about the impact on the children, they saw me beaten up, saw the physical evidence, I could see the shock on their faces."
Between 2010 and 2012, there had been a steady increase in assaults reported at Waitemata, Waikato, Capital and Coast, Hutt Valley, Hawkes Bay, Tairawhiti, Nelson Marlborough and Southern District Health Boards, the article said.
The Ministry of Health would not comment on the increase in reported assaults, and deferred comment to the DHBs.
New Zealand Nurses Organisation spokeswoman Lynley Mulrine said that was not a good enough response and they needed to be proactive in working with DHBs on assaults.
There were a number of measures that could reduce the number of assaults, she said.
"It is about having good health and safety processes in place - you've got to always be thinking about the layout of the areas that the nurses are working in, accessible and (staff were in a) line of sight."
Waikato DHB spokeswoman Mary Anne Gill said the increase in reports by 2012 was a positive result for them as a campaign in 2011 urged staff to report all assaults against them.
"Prior to then our staff took it as 'Well, it's part of the job', and we said quite clearly to them 'No, it was not part of the job'.
Hawkes Bay DHB nurse director of mental health David Warrington said there was a zero tolerance to violence policy at the hospital, and there was an exceptional culture of reporting adverse events such as staff assaults and injuries.
Capital and Coast clinical director mental health, addictions and intellectual disability directorate, Nigel Fairley said the DHB took all reasonable steps to minimise exposure to attacks and they were "constantly looking at ways in which we can reduce that risk to staff".
Staff were encouraged to report every incident of assault, even if no harm was caused, he said.
Neither Hawkes Bay nor Capital and Coast DHB responded to questions about what may have caused the increase in attacks.
Nobody was immediately available for comment from Waitemata, Hutt Valley, Tairawhiti, Nelson Marlborough and Southern DHBs.
By the numbers:
* 4821 total reported assaults nationwide between 2010 and 2012;
* 1140 in 2010;
* 1367 in 2011; and
* 2314 in 2012.