There were 1,148 assaults against healthcare staff in 2013. Photo / Janna Dixon
There were 1,148 assaults against healthcare staff in 2013. Photo / Janna Dixon
Numbers of hospital staff being physically abused by patients are on the rise.
Hospital staff are being punched, kicked, spat on, bitten and verbally abused daily on the job.
And the problem is getting worse, with figures obtained by the Herald on Sunday showing assaults have soared since 2010 when 817 doctors, nurses, orderlies and psychiatrists were attacked at work.
There were 860 incidents in 2011. That rose to 1,148 in 2013, the last full year figures were available.
They include a nurse from Tairawhiti DHB who was punched in the face and bitten on the arm while helping a patient go to the toilet; a Counties Manukau DHB doctor who was kicked in the groin; an aggressive patient who tried to kiss a Capital and Coast DHB staff member; and a Waikato DHB worker who was assaulted and abused for telling a patient not to smoke inside.
The majority of incidents occurred in emergency departments and mental health units.
New Zealand Nurses Organisation professional services manager Susanne Trim wasn't surprised by the rise, saying those on the front-line were dealing with an increased number of intoxicated patients and others suffering from methamphetamine-fuelled psychosis.
She said the pre-admission use of alcohol and drugs by patients was "really exacerbating things".
"There is an increasing acting out from patients and sometimes it's relatives, too."
Trim, who has been a nurse for 40 years, was only aware of a handful of nurses who had not been victims of some sort of verbal or physical attack.
Dr Stephen Child, deputy chair-man of the New Zealand Medical Association, which represents doctors, said despite the increasing attacks, he was not aware of any staff member pressing charges.
"We are sworn to a code of ethics and the Hippocratic Oath, which basically says that as part of our profession we are supposed to do what is in the best interest of the patients, over and above what is in our best interests," he said.
"But we are human beings so at times there can be a sense of disappointment when there is that kind of response and absolutely no gratitude from a patient."
He said the vast majority of assaults were by patients who were in an altered mental state, either due to conditions like dementia or mental health issues, or because of drugs and alcohol.
All doctors had undergone training in how to deal with agitated patients and hospitals took numerous measures to ensure staff safety, including posting security guards at high-risk units.
Given that about 900,000 people sought medical care each year, Child said attacks were still "pretty rare".
But Richard Wagstaff of the Public Service Association, the union for mental health nurses, said the numbers were "unacceptable".
"We get reports of assaults on a regular basis, throughout the country.
"We don't believe that it should be a part of the job but for too many mental health nurses it is and that's a real concern," he said.
DHBs were having to work with tightly constrained budgets that meant there were often not enough staff to carry out their work safely. "There has to be enough people there and the facilities have to be as good as possible to minimise the risk," he said.
'There are days you get sick of it'
Dr Tom Mulholland has developed strategies to reduce the chances of getting hurt after 25 years on the job.
Emergency doctor Tom Mulholland has been spat at and pushed around on duty at Auckland City Hospital.
Not even his imposing stature - he stands at over 1.9m and weighs about 100kg - has spared him from abusive patients in his role as senior medical officer in the hospital's Emergency Department.
"There are some days when you get sick of it and sick of drunk people and think maybe I should [do] something else.
"There are plenty of doctors who don't work in ED because of the abuse," he said. "It takes effort to treat all people the same sometimes and remember why you do the job."
Mulholland has not been punched on the job. But colleagues have not been so fortunate, with some even suffering fractured bones. Twenty-five years' experience on the frontline of ED had given him strategies to reduce the chances of getting hurt on the job.
"It's important to have a sympathetic approach," he said. "The hardest ones I find to cope with are people who complain about waiting long periods and occasionally get aggressive.
"They don't see the ambulances pouring in with patients suffering chest pain, trauma and life-threatening conditions.
"Many times I have told families someone has died and then walk into the waiting room and get an earful from someone who may have been waiting for a few hours for something that could have been better managed by their GP."
Mulholland said nursing staff often received more abuse than doctors. Auckland City Hospital had a zero tolerance for violence, with plans in place for "known" patients.
The hospital had several "secure rooms" and security staff were often deployed in the ED on busy Friday night shifts.
Attacked on the job
• Whanganui DHB, December 2010 — Patient punched a doctor in the jaw and attempted to break their stethoscope.
