Why are violent assaults against healthcare workers on the rise?

Carer and resident

In NSW, The Australian has reported that Bureau of Crime statistics show assaults against healthcare workers increased 55% over the last five years. In Queensland, violent assaults rose 50%, and in Victoria, assaults increased by 34% over the same period.

Lauren Hutchens, Health Services Union (HSU), NSW manager of the aged-care sector, told HelloCare that most of the reports the union receives from aged care workers about assaults relate to staff being assaulted by residents who are living with dementia.

“We get reports of it quite frequently … generally it’s from residents who have dementia and generally they’re known [by staff] to act violently.”

Hutchens said it was well-established that staff shortages “make the situation worse”.

“If you have enough staff and consistent staff on, you can start to pick up the behaviours, so you can say this person is about to act out. 

“And if you have enough staff on, a carer can work one-on-one to try to de-escalate [the situation].”

Another serious assault the HSU is often informed of is residents inappropriately touching staff. 

This issue has occurred “to the point we’ve had people leave the sector because they’re quite traumatised,” Hutchens said.

Hutchens believes having more male carers on staff in aged care would help to prevent these situations from arising.

“If someone is known to act in that way, one of the first things we ask for is if there are male carers who can be directed to do that work. Or in the absence of that, there are two carers allocated to work with that particular resident. But if you have staffing issues or you don’t have male staff on your roster, that can be quite an issue.”

Sometimes violent or aggressive behaviour can be the result of a change in medication, and having access to a good physician can be helpful in these circumstances, Hutchens noted.

“Our members know that if you have more staff on who can identify behaviours, who can look at implementing de-escalation strategies, then you can actually stop violent behaviour. But in the absence of that, and when you’re already stressed, people get slapped … or punched.”

Hutchens said the HSU does not generally receive reports of family members being violent or carrying out assaults. 

“There is verbal abuse, but that’s generally due to frustration. More often they’re feeling that their family member’s needs are not being met.”

A senior emergency nurse based in Melbourne, Helen Dannefaerd, told The Australian that assaults occurred daily at work.

“I’ve been called every name under the sun,” she said. 

“Other times it escalates and becomes physical. I’ve been spat on, kicked, bitten. I have friends who have been punched in the face.

Melbourne emergency nurse Jackson Campbell, who founded nursing platform and support group The Nurse Break, told The Australian, “I’ve heard all kinds of abuse. People being kicked, punched, strangled and worse,” he said.

Mr Campbell said Victorian nurses received inadequate training on how to deal with violent patients, and there were not enough security guards to help when situations escalated.

“We get two-day courses on how to retain people, but there’s not enough training on how to hold people down,” he said.

“With the aged-care system failing in regards to its management of medical issues, dementia people can become quite violent,” Campbell said.

The Royal Commission into Aged Care Quality and Safety noted there was a “high incidence” of assaults by residents on staff, as well as by staff on residents, and residents on residents. 

Better reporting of assaults might help with the new SIRS, but – as with so many of the problems in aged care – the answer really lies in having more staff on the ground in aged care homes and more staff with better dementia training who can ward off problems before they escalate. 

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