We have all read the headlines – ‘Attacks on Healthcare Works on the Increase’ – ‘Three out of Ten US Hospitals Report a Steep Increase in Worker Attacks’. It really is alarming. Pretty much whatever country you look at you will see an upturn in patients and visitors physically attacking nurses, doctors and support staff. In 2014, the World Health Organisation (WHO) raised the issue pointing out that hospitals and clinics are becoming targets in war zones, but that even in non-conflict zones violence was a daily issue.
This change in the environment that people work in is naturally leading to changes in way clinics, hospitals, care homes and doctor’s surgeries operate. Some of these changes are obvious others are far more subtle.
The presence of security staff
Hospitals have always used security staff, to some extent, but they have traditionally just guarded the grounds and equipment. Now, they are there to guard patients and staff and are now being used in the emergency area of most hospitals. They are there to stop in if patients or the people who are with them become violent. Their presence has a calming effect and makes most people think twice about letting their frustration get out of control. They are also appearing in doctor’s surgeries and clinics.
For a couple of decades CCTV has been a common sight in hospitals, but mostly only around the perimeter and in the entrance area. Some hospitals are now installing it in corridors and even on wards.
Security personnel are also increasingly wearing personal cameras. The presence of the cameras seems to make people more aware of what they are doing, so they are reducing incidents as well as providing evidence for prosecutions.
In the past, the vast majority of attacks on staff would have gone unreported and nothing would have happened to the perpetrator. Staff and managers often made allowances for the fact that the attacker was in a stressful situation, maybe taking strong medication and in pain. This tolerance and understanding is still there but staff and management are realising that things have to change. They cannot really afford to be lenient with those who attack others in clinical environments, so attacks are being recognised as a serious issue and being dealt with as such.
In some hospitals, there is now a zero tolerance policy. Prosecuting offenders sends out a strong message that hospitals are to be safe places where standards of behaviour have to be high.
The introduction of new equipment
As well as more surveillance, new equipment is being issued to staff. In many hospitals, personal attack alarms are available for staff. The design of NHS lanyards has been changed to include breakaway clips. These ensure that in the event of an attacker grabbing the lanyard it falls off. This stops the attacker from using the lanyard to keep the member of staff within reach and ensures that staff cannot be choked with the strap.
There is no doubt that more changes will be needed to tackle the issue of violence in clinical settings. Those changes will come in gradually, but are going impact how healthcare is delivered in many countries.