A Lower Hutt nurse has only just returned to full hospital duties six months after a violent assault in the emergency department.

Vicki Bulmer was severely concussed when a patient "on a rampage" attacked her and several of her colleagues while they tried to provide care to her.

Bulmer was working in the emergency department of the Hutt Hospital on December 26 when an emergency call came on, which she believed meant a patient needed urgent medical care.

"Unbeknownst to me it was a security incident, but it came up as a generic emergency," she said.

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"As I was responding to the alarm, I want to go through some automatic doors. The person who assaulted us pushed through the doors and came through them swinging."

The patient, who had been brought in by a specialist team for care and was "unhappy with her life" punched Bulmer in the face.

"I didn't see it coming. The force made me stagger back and I hit my head against a reinforced concrete wall."

The attacker punched two of Bulmer's colleagues and threw a wooden children's play table at another, causing the victim neck and back injuries.

"She was on a rampage, really," she said.

The patient was sentenced in the Hutt Valley District Court yesterday for the attack, which took Bulmer months to recover from.

"I had three months off work with the head injury, then a further two and bit months graduated return to work.

"I wasn't able to look after my four young children ... I had to wear ear muffs at home because I couldn't tolerate any noise. With 1-year-old twins it's not ideal.

"You don't realise until it happens to you how much energy it takes to do just normal tasks every day, how much concentration is required."

Bulmer said the sentencing came at a good time and provided some closure for her and her colleagues, though she wasn't sure the sentence reflected the level of violence involved.

The attack was "pretty traumatising".

"You go to work and expect to feel safe. In the more than 15 years working in the emergency department, I've never felt as unsafe as I currently have been."

Staff were dealing with under-resourcing and patients having to wait a long time for care.

"It all impacts on people's attitudes and quite often we're experiencing violence, whether that be verbal or physical."

She and her colleagues' leave after the incident added up to about a year, which left the District Health Board "in a lurch".

"I think it's a shame that perhaps the public don't quite realise the extent of violence that is occurring, that this is not an isolated case. This happens regularly."

Hutt Valley DHB acting chief executive Dale Oliff said safety will always be the highest priority.

"Unfortunately we work in a field where distressed or disturbed patients can, from time to time, react in a way that is out of character to them.

"Our responsibility is to make sure staff are as supported and prepared as they can be for such incidents while allowing them to do their job to the best of their ability, without impinging on the treatment of patients."

Attacks on staff on Boxing Day and January 15 highlighted areas where the DHB could improve, Oliff said.

They have now put in additional external security support in the emergency department, held a formal internal debrief with affected staff, held an independent formal incident review, attached ED furniture to the floor, reviewed incident escalation processes, added CCTV cameras in ED, and provided more de-escalation training.

Changes have also been made to the duress and emergency alarm sounds so a duress call is distinguishable from a medical emergency alarm.