CPI's Crisis Response Newsletter

Violence Against Nurses
Looking forward to a safer future

Nurses in Victoria can look forward to a safer workplace in the future with the state government adopting all 29 recommendations made by its taskforce examining violence against nurses. The taskforce comprised representatives from government, ANF Victorian Branch, the Victorian Nurses Board, nurse academics, Victoria Police, WorkSafe Victoria and health providers.

Responding to the release of the report Victorian taskforce on violence in nursing, ANF Victorian Branch secretary Lisa Fitzpatrick said the adoption of the report recommendations by government was ‘the first step in the development of a zero tolerance culture toward violence against nurses’.

The report drew on a study by researchers at the University of Melbourne, which investigated incidences of violence against nurses in one regional and three metropolitan hospitals.

The authors of the study Occupational violence in nursing: an analysis of the phenomenon of code grey/black events in four Victorian hospitals also cited findings by the Australian Institute of Criminology which found nurses were the occupational group most at risk of violence in the workplace.

In welcoming the government’s adoption of the taskforce recommendations, Ms Fitzpatrick said it was imperative that sufficient funding be made available to make the changes needed to create a safer environment.

‘A similar project was introduced in New South Wales in 2002 and received $30 million funding over three years and we hope to see a similar funding announcement in Victoria very soon,’ she said.

State minister for health Bronwyn Pike, made no comment on the provision of funding to support the recommendations, but said the report ‘signals a major step forward’ in the development of a coordinated, state wide response to violence against nurses; that will be monitored and evaluated by the Department of Human Services.

Behavioural effects of substance abuse, cancellation of procedures, long waiting times and cultural misunderstandings were identified by the researchers as factors contributing to episodes of violence against nurses.

Commenting on the findings, Ms Fitzpatrick said a change in culture was needed to protect nurses at work.

‘For a long time nurses were reluctant to report violence directed at them because in many instances they believed it was part of the job.

‘The ANF, through its Zero Tolerance Policy, has done a lot of work to stop that culture of silence and we’ve encouraged nurses to speak up,’ she said.

Ms Fitzpatrick said the justice system also needed to come to grips with the problem of violence against nurses, as reports by nurses were rarely pursued in the courts.

‘The report contains important recommendations…to educate and resource the police and judiciary about how and why nurses are subjected to violence at work so that these cases are taken seriously and prosecuted,’ she said. ‘This will send a strong message to the community that violence against nurses is not acceptable.’

Among the 29 recommendations made by the taskforce and accepted by government are:

• the development of guidelines to allow for the search and removal of weapons;
• the development of uniform definitions of, and responses to, code grey (violence and aggression) and code black (armed threat) events across the state’s health care facilities;
• the establishment of a uniform system of sanctions in response to violence against nurses, including warning systems, contracts of acceptable behaviour and the enforcement of sanctions;
• the development of educational programs for the community, police and judiciary promoting an understanding of occupational violence in nursing;
• the consideration of legislative measures making it illegal to assault a nurse, similar to existing laws which protect ambulance officers;
• education and training for nurses to prevent and manage occupational violence and bullying; and
• the development of better and more accurate systems to collect data regarding potential and actual events of violence against nurses.

The report also recommended the Victorian Department of Human Services (DHS) develop and implement a framework for the prevention and management of occupational violence informed by similar policy guidelines devised by NSW Health.

Copies of the study Occupational violence in nursing: an analysis of the phenomenon of code grey/black events in four Victorian hospitals (February 2005) and the taskforce report Victorian taskforce on violence in nursing (November 2005) are available through the Nurse Policy Branch of the DHS on (03) 96167528 or email nursepolicy@dhs.vic.gov.au.

Some of the major findings of the study investigating violence against nurses in the four hospitals revealed:

• violence against nurses is vastly under-reported;
• 2,662 potential or actual aggressive events occurred over a six month period—an average of 14.6 events per day;
• approximately 10% of these events involved physical abuse;
• nurses were the principle targets in 57% of events of physical abuse;
• the majority of incidents involved a patient/client as the aggressor;
• considerable variation between agencies in defining responses to violent or aggressive behaviour; and
• over half of actual or potential events occurred in emergency departments.

Reprinted with permission from the Australian Nursing Journal, April 2006, Volume 13, Number 9.