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Community nurses warn of rising tide of abuse and assault


Almost half of nursing staff based in the community have suffered abuse during the last two years, according to a recent survey by the Royal College of Nursing.

The survey of more than 1,300 nurses working in community-based roles, found 48% had been subject to some form of abuse.

“I was wary about visiting that patient because of the relative, but felt I had to”

Survey respondent

Of those, 11% said this involved physical abuse or assault as well as verbal abuse.

Many who took part in the survey in May and June this year felt the risks attached to their role had increased in recent years due to a range of factors including rising caseloads and lack of staff.

Meanwhile, 50% of respondents said they felt vulnerable at work, with almost 10% feeling vulnerable some or all of the time.

However, just 22% said their managers always knew where they were when working alone.

The survey findings echo 2011 research by the RCN and Sheffield Hallam University, which highlighted similar issues around lone working.

Some nurses interviewed at the time reported that abuse was simply seen as part of their job by employers and they were forced to “grin and bear it”.

The latest poll also highlights a lack of support. Of nurses who suffered abuse in the past two years, 63% reported it but 45% of those who had raised the issue said no action had been taken to address it.

Almost half – 46% – said risk assessments were rarely or never carried out, and less than 4% said they always had information about the patients they were due to visit.

One survey respondent described being locked in when a family refused to let them leave.

“After the incident there was no follow-up with the family, no additional safety plan and it was down to me to visit again,” said the nurse.

Another described feeling unsupported after being verbally abused by a patient’s relative.

“I informed the office, but still had to visit and no further action was taken other than documenting it on patient notes,” said the nurse.

“I was wary about visiting that patient because of the relative, but felt I had to because I would have failed that patient by not giving them the treatment they required at home,” they added.

The survey found only a third of respondents – 34% – had received personal safety training and just 13% had access to a protection device that could raise the alarm if a nurse felt under threat.

“It is hard to give the best care when you go to work in fear”

Peter Carter

Such devices – which were launched in 2009 – were initially government-funded but many staff reported they had been withdrawn to save money.

Lone working was among topics up for debate at the RCN Congress in Bournemouth this week.

RCN general secretary Peter Carter said the latest survey painted a disturbing picture.

“It is horrifying to hear of a worsening situation and one where people who go to work each day to care for people end up feeling alone, afraid and under attack,” he said.

“It is hard to give the best care when you go to work in fear and we really need all employers to take the safety of their staff seriously,” said the RCN leader, who steps down next month.

He said nursing staff should feel confident in raising concerns and be able to visit in pairs or have access to a safety device.

“Sadly, it seems the safety of staff is something that is subject to compromise when money is scare,” he said.

“This is an utterly false cost saving. Not only do staff often need time off following physical assault but the risk of stress and burnout is severe and can continue into long-term absence,” he added.


Readers' comments (10)

  • Maybe if you didn't blow 700 quid on a laptop/tablets and who knows how much on an untested POS patient records system which I haven't heard one good thing about. (I designed computer systems for a few years and I think it's absolutely laughable) Maybe you'd have enough cash for one of those 2 way alarms (£11 a month) I was told are available.

    SystmOne is rubbish... I hope they didn't spend more than a tenner on that. And the laptops I'm seeing everywhere (Lenovo Thinkpads RRP 650-780)? Could do the same job with a £200 one. Why do they need to be touch screen? Why do they need to convert to tablets? How many Nurses have honestly used the 'tent' mode? (Seriously, you can fold it so it makes a tent perfect for doing presentations on, perfect for middle management sucking up to big bosses)

    This is where the NHS is blowing it's money, again someone flying a desk sees something shiny and buys it without thinking. Your RCN leader signed off on those laptops saying they were great. Great waste of money more like. That's why community nurses are not safe, and they're meant to be stopping up the hoards from flooding the A&E's...

    Someone (With a brain) needs to go and look at what the NHS is spending cash on... cuts need to be made and it's certainly not to staff...

    Another instance are the small metal trolleys in wards. They cost about $30 to make. We buy them for £250...

    NHS wastes so much money it's ridiculous... and who suffers? Front line staff and by extension the patients.

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  • michael stone

    A fundamental question, which ALL community management should regularly ask its community nurses (not just CN 'team leaders' but ALL of the nurses), is:

    'Do you feel safe, and do you think we are doing our best to keep you safe ?'

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  • The tablets are at least an improvement on laptops, wish I had a tablet! Laptop takes hours to load, constant connectivity issues and we get in trouble for not inputting patient data same day. As for safety this has been going on for years, when I was working out of hours in community several unpleasant incidents happened to me, no action at all taken and suggestion of safety device it was "why do you want one of those?" We were told by senior managers to double up, they knew full well we could barely cover our patient load without doubling up, there was no chance. So glad to work days now. However still our managers have deemed we do not need any safety devices without any consultation to us. To get one we need to jump through lots of hoops and prove why we need one; I think they should just be issued to lone workers.

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  • Beware new technology, designed to do everything from viewing Facebook to healing leg ulcers - the more comprehensive, the more hackable your data may be.

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  • Aside from laptops, tablets and software - which seems to be the pre-occupation above - what about health and safety? I suggest that people bone up on H&S at Work legislation and Employers' Liability legislation.

    Employers have a duty of care towards employees and, if they try to wriggle out that duty, they expose themselves either to negligence claims or dereliction of duty.

    If they try to take it out on employees, there is other legislation in place to protect those employees.

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  • Matthew  Carr

    I think Anon 911 means the combo laptop tablets. Tablets are horrible in a clinical environment... infection control bye bye.

    As for loading slow? Mostly down to what's on it and the software. If the software is rubbish it's going to load slowly, if the user downloads stuff to the laptop or doesn't remove old data... again it's going to go slowly.

    There are better and cheaper alternatives to Thinkpads. The extra cash could be better spent on improving safety, I mean why can't we get a rapid alert to local PSO's and Police? Or even take them with us on primary visits?

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  • if this occurred in any other workforce where its staff were abused or assaulted, it would be taken seriously, but alas as it is "only a nurse" nothing gets done

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  • Sing of the times, unfortunatly. Dont see any solution other than talking to patient relatives and stating that care will be abandoned or prosecution is nec. Why should nurses be expected to serve IN FEAR? its disgraceful

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  • I feel that the patients lash out due to the fact that they are frustrated that they are not getting enough time spent with them and enough care provided. Due to the fact that the nurse cannot stay long enough to provide them with that full care and time desired as they have so many other patients to see in such a short sapce of time. This is all due to staffing levels being so low. The government need to stop spending so much money on warfare and start looking at the wellfare of its citizens. It seems like whenever they need to make cuts its in the NHS or Eduction.

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  • I was kicked in the breast by a angry dementia patient caused a bruise that was picked up on a routine mammogram called me back twice could be a tumor lots of sleepless nights and no support from management team If this happened to a member of the public and not NHS staff there would be a investigation but apparently it is part of my job

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