Source: Northern Territory Police and Fire Services
When CJ worked in a patient-facing role, it was common for staff to accept occupational violence as just part of the job.
Everyone has a role to play in creating a safe public health care setting.
Nurses make up half of the healthcare workforce, with roles in clinical care, leadership, education, and research. It is without question that nurses are pivotal to the healthcare system and wellbeing of communities.
Of course, when you’re a nurse, there are plenty of not-so-pleasant things you may encounter during a shift. From blood and other bodily fluids to challenging conversations, and an entire range of germs – it all comes with the job of helping people and making a positive difference to the health of others and the broader community.
But there’s something else nurses are likely to encounter in a shift that should not be a part of the job: violence and unacceptable behaviours. It was when working in different settings, such as on the ward, the emergency department, and outpatients that CJ* really witnessed and experienced it first-hand.
“It happens every day. Some members of the public might think violence is typically perpetrated by people who are intoxicated, or it is related to mental health. But the truth is, what we see is that perpetrators of occupational violence and unacceptable behaviours can be anyone,” she said.
The violence not only comes from the patients, but can come from relatives, carers, partners, visitors and other members of the public who engage with the health service. And it’s not always as clear cut and obvious as physical assault or verbal abuse.
Occupational violence also includes unacceptable behaviours such as snide comments, undermining and gaslighting, sexism, racism, sexually inappropriate behaviours, intimidation, and discrimination. It can also take the form of defamatory comments on social media, or filming staff without their consent.
“I have brown skin and I have an Asian background and I’ve had people ask for a white nurse. Another example – people try to pretend they can’t understand what I’m saying, when you know that they can understand,” says CJ.
“Verbal aggression and inappropriate behaviours are more common than physical assault, and they’re just as hurtful and detrimental to our wellbeing.”
Everyone has a role to play in creating a safe and positive health care setting. This includes nursing and clinical staff, and patients and members of the public being kind and respectful when communicating.
“I always try to do my best to deliver quality care in an imperfect system, but sometimes, I just felt like it’s not enough,” says CJ.
“Say you look after five people, and four people you had positive interactions with, and they were thankful. But then all it takes is that one person to make an awful comment. For some reason, it’s always the negative comment that would stick with me.”
CJ says when she worked in a patient-facing role, it was common for staff to accept that occupational violence was just part of the job, and nurses didn’t always speak up. CJ’s passion for trying to shift this culture and make a positive change to violence against health workers led her to complete a PhD in the area, with a focus on preventing occupational violence in emergency departments.
She is now Director of Occupational Violence Prevention and Management for Canberra Health Services and is working hard to effect change in the industry and be part of the solution.
“In our research, we found that nurses want a comprehensive strategy to feel safer at work. For example, a good strategy should at least strive to identify and meet patients’ health needs, have education and training for nurses, include a team response to occupational violence, and ensure that nurses are supported to recover from incidents if they occur. This is what we are actively working on at Canberra Health Services, and I’m happy to be a part of it.”
She closely consults and collaborates with health workers, managers and agencies in patient-facing roles to ensure everyone feels supported and safe to report incidents, and that appropriate action is taken to prevent incidents. She also works to influence policies and procedures to help prevent incidents happening in the future and to reduce the harmful impacts of occupational violence on nurses. This work contributes to the Towards a Safer Culture ‘The Next Steps’ Strategy – a government funded initiative supporting the fundamental rights of nurses and midwives working in ACT public health services to be safe and protected in their workplaces.
“I really try to be the support that I wished for when I was facing violence and unacceptable behaviours as a nurse,” says CJ.
“What I would also like to tell other nurses is that their safety is just as important as patient safety! Don’t be afraid to call out violence and unacceptable behaviours. And don’t be afraid to report incidents, as each report helps us to better manage these risks and make decisions on what is best and safest for both patients and health care workers”.
* For personal privacy, surnames of interviewees have been removed.
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