Hospitals should not be the violence front line

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Before the 2010 election, the Coalition outlined a plan to spend $21 million putting 120 armed protective services officers into hospital emergency departments. That’s right: armed guards. As the Coalition saw it then, violence against staff in hospitals would not be tolerated under any circumstances, and guns were the answer. Doctors and nurses were horrified. Rightly so, because the last thing any emergency department needs is a volatile person in the presence of a deadly weapon.

In 2011, the Baillieu government quietly shelved its hare-brained idea after a parliamentary inquiry relayed what it described as ”unanimous” opposition among medical groups. Since then, the Baillieu and Napthine governments have said and done a lot about curbing violence on the streets, but there is scant evidence they have done much to prevent violence against hospital personnel. Certainly there has been a lot of airy talk about frameworks, policies, programs and initiatives. But so much talk and so little action is disappointing and perplexing.

Hospital staff are the crisis managers, the front-line carers for people in all kinds of chaos and despair. With the use of crystal methamphetamine rising rapidly across the community, hospitals (and ambulance employees) are dealing every day with instances of aggressive and dangerously unpredictable people. As well, an increasing number of people with mental health issues are presenting directly to emergency departments instead of local services.

Nurses and doctors are duty-bound to demonstrate the utmost care and courage in dealing with people on the edge, yet they are regularly threatened with knives, chairs, syringes or fists. There were more than 100 code-black (response to serious threat to person) incidents at 11 Melbourne hospitals in 2012-13 and almost 14,000 other incidents of aggressive or threatening behaviour. The Auditor-General has suggested the number of aggressive or violent incidents in hospitals may be hugely under-reported, in part because the system of reporting is cumbersome and finicky.