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'Take a stand against violent behaviour in A&E'


Posters telling people not to be aggressive towards staff are commonplace in many organisations - the post office, train stations and yes, even hospitals.

It seems shocking that the one place where staff are under enormous stress - life and death type stress - and struggling to look after people that they should be subjected to spitting, swearing and physical assault. That was a view echoed by Simon Burns, the health minister who came to support the launch of the proposed redesign of A&Edepartments to reduce violence towards patients and staff at the Design Council last week.

The project involved frontline NHS staff in three pilot trusts, design experts, psychologists and behaviourists to understand the problem and try to fix it.

It did what many staff can’t do - look at the environment from the perspective of an anxious relative, or patients who are confused or intoxicated, or just frustrated by waiting.

The project has been applauded for its simplicity in redefining signage and making the wait more tolerable for patients by providing more information about when they’ll be seen, but it has also built in a greater degree of support for staff witnessing such events.

The nurses from the University Hospital Southampton Foundation Trust pilot said they had become accustomed to “low-level aggression”, and didn’t really see it as a problem. But by recognising it, challenging it and changing it, they had made A&E a safer place.

Nurses are typically resilient and stoical, dismissing bad behaviour as part of their job. But this project shows shrugging off the problem is not the best solution. Nurses have the knowledge to make a difference, now they need the confidence to say enough is enough.


Readers' comments (41)

  • Not long ago I was hit and punched by a well-built male patient who became aggressive at waiting whilst I was attending to another much-sicker patient. Despite having a zero-tolerance policy my trust took no action against this patient because he then wrote a letter to the manager saying he had had fantastic care (no apology for assaulting me!) and they wanted to use said letter for brownie points on some audit report!

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