Almost half of nursing staff based in the community have been subjected to abuse during the last two years. That is according to a Royal College of Nursing (RCN) survey. In more than 11 per cent of cases, this involved physical abuse or assault as well as verbal abuse.
Some 44 per cent of lone working nursing staff feel that the risks in their role have increased over the last two years, due to an increased caseload and lack of staff, higher expectations from patients and relatives, an increase in work out of hours, substance misuse issues and antisocial behaviour in the areas visited.
Half of staff surveyed feel vulnerable at work, with almost 10 per cent feeling vulnerable often or all of the time. The RCN suggests concerns about nurse stress levels and a risk of burnout.
Only 22 per cent said that their managers always knew where they were when they were working alone. According to the college, this raises concerns about how a nurse could seek help if they were the victim of a serious attack.
Tina Donnelly, Director, RCN Wales, said: “We are currently seeing a major push in Wales, and across the UK, to deliver care in the community to alleviate the pressures faced by acute care services, and the staff who work there. To hear that community nurses are facing increasingly challenging work environments, where they may be subject to physical abuse or assault, is truly worrying. Not only is this a real concern for the current workforce but these issues will potentially deter nurses from entering district and community roles – a sector where recruitment is now more crucial than ever.
“The focus on bringing care into the community is a vital plan for the future of the NHS for many reasons, such as coping with the pressures of an increasingly ageing population with evermore diverse needs. However, nurses shouldn’t have to risk working in any situation that is potentially dangerous to their health – mentally, physically or emotionally.
“For nurses who may have to work alone in the community there needs to be appropriate safeguards and support in place to tackle these dangers head on – whether this be via visiting patients with a colleague or having access to other safety mechanisms such as devices to raise alarms.
“Nursing is an already challenging profession, with many pressures, but it is unacceptable to have the added burden of fearing for your personal safety. We must ensure that district and community nursing teams are sufficiently protected to ensure that nurses aren’t facing risks that will heighten stress levels in the workplace and have a detrimental effect on their professional lives.”
Some 63 per cent of staff have reported abuse in the last two years, but 45 per cent of those staff said that no action was taken. Almost half of staff (46 per cent) said that risk assessments were carried out rarely or never, and only about one in 25, less than 4 per cent, said they always had adequate information about those they were due to visit.
Only a third (34 per cent) have had personal safety training, and only 13 per cent have access to a lone worker protection device, which is worn when working alone and which can raise the alarm if the staff member feels under threat. These were launched in 2009 in England and were initially government funded but many staff have reported that they have now been withdrawn as a cost cutting measure.
A nurse reported: “One specific incident, I was locked in a family home, they refused to let me leave. I was there some time and received no call from the office to determine my safety and after the incident there was no follow up with the family, no additional safety plan and in fact it was down to me to visit again. I took a student for back up!” Another said: “I was verbally abused by a patients’ relative. I informed the office – still had to visit and no further action was taken other than documenting it on patient notes. Did not feel supported, was wary about visiting that patient due to the relative. But felt I had to, because I would have failed my patient by not giving them the treatment they required in their home.”
