Overwhelming rise of in-hospital assaults against frontline workers

Aggression and violence against frontline workers are reaching alarming new heights, with new research highlighting that the current strategies being deployed to protect hospital workers are extremely insufficient.

Rampant in-hospital assaults are just another stress-inducing issue being thrust upon the shoulders of frontline workers. New research from Edith Cowan University (ECU) has found that the current strategies that are supposed to protect frontline workers are failing.

The statistics show that in-hospital assaults have increased by 60 per cent in Victoria, 48 per cent in Queensland, and 44 per cent in NSW from 2015 to 2018. That increasing pattern represents a prevalent rise in aggressive behaviour towards frontline workers, especially nurses, with a 2017 survey stating that 87 per cent reported experiencing patient-related violence.

A recent survey of Queensland health workers by the Australian Workers’ Union, which was covered previously on HR Leader, revealed that close to 70 per cent of staff have either been a direct victim of assault or witnessed an assault in the workplace.

“Participants in our study in Perth were overwhelmingly telling us that the occurrence of violence is on the increase. It is not a matter of if, but when,” said PhD candidate Joshua Johnson from ECU’s Simulation and Immersive Digital Technology Group.

“Additionally, our participants were telling us that the style of violence has become more aggressive in nature. Over the last 20 or so years, it has progressed from verbal or occasional physical abuse, where someone might be throwing a cup at a frontline worker, to the assaults we’re seeing now,” said Johnson.

There were various factors within the study that were pinpointed as potential catalysts for aggressive behaviour towards hospital staff. Factors such as mental illness, psychiatric disorders, or drug and alcohol use can influence and increase the likelihood of violent and aggressive tendencies.

Other contributing factors are well documented, with understaffing and the overcrowding of emergency departments (EDs) resulting in longer wait times for patients and causing communication breakdowns between staff and patients, which again can cause frustration and aggression.

Strategies in place to combat the impact of violence or improve the staff’s ability to cope with that violence have been implemented. However, they are perceived to be very ineffective, leaving frontline workers without the proper tools to deal with this widespread issue.

“Some of the training that staff receive at hospitals to manage aggression and violence is great. These training sessions span over a few days and include both lecture-based material and role-play or hands-on techniques.

“However, other participants in our study reported that they only received two hours of training once every year, and that this training is only lecture-based. This training could also happen during very busy work periods, meaning that staff are unable to step away from their duties, or it takes place on days when staff are not at work, meaning they have to attend the training on their day off,” said Johnson.

This disparity of training between staff can create a disorientated environment where some are well equipped to deal with an aggressive incident, compared to others who may panic and hesitate in the moment. As frontline workers, the pressure is already immense, and having a lack of training to deal with an assault only adds to that.

“There appears to be quite a large variation in the quality of training that is being delivered at different hospitals, as well as the frequency of this training. There is a definite need for hospitals to focus on reducing those barriers to accessing effective training, and a standardised delivery of training should be investigated,” said Johnson.

As mental health and wellbeing become a pillar in the workplace, violence and aggression towards staff go beyond the physical safety of the worker but also into the realm of their long-term mental health. In an already stressful position, if frontline workers are subjected to constant violence, it wouldn’t be surprising to see their mental health and wellbeing deteriorate rapidly.

In terms of attraction and retention, it becomes a negating factor for the healthcare system as frontline workers would be more likely to look elsewhere if they were constantly subjected to these acts of violence.

“Previous research has shown that student nurses who are planning on moving into the field often reconsider their chosen field when exposed to these aggressive and violent incidents while on clinical placement,” added Johnson.

“This demonstrates that exposure to these events greatly impacts staff and student mental health and could potentially lead to people leaving the field. This, in turn, puts greater stress on an already strained system and further exacerbates the issue.”