NHS-I was so shocked by this!

[Yellowdays]

I just read this article in the Guardian. It's really appalling. What a way to have to work, it's like a war zone.

https://www.theguardian.com/society/2023/jun/22/over-half-of-uk-doctors-have-seen-or-suffered-verbal-or-physical-abuse-survey?CMP=ShareiOSAppp_Other

I have never heard a colleague complain about being kicked by a small child.

Also the damage inflicted by a little child is minimal compared to an elderly person with dementia or a compos mentis adult who wants to get you.

I agree it's probably underreported.
What I mean by being shocked is quite how much worse it's become, so quickly.

We possibly work in same location. Security is hard to find because there are only 2 per shift for whole hospital. You can get them to open emergency drug cupboard those on a nightshift so that's helpful.

We had a 2 to 1 so 2 members of staff required to be with patient as so high risk of either self harm, staff harm or absconding. I didn't even have a 1 to 1 for him. It's no wonder retention in the nhs is so poor

Had a 2:1 on a psych ward I worked on. Actively homicidal. Not psychotic. Not for forensic, nowhere else would take, and was very happy to stay there forever as they had 2 people to entertain them personally all day.

Minimal staffing elsewhere meant other patients got jealous of them and kicked off constantly. Ligatures and fights.

Then to add insult to injury, the family criticised absolutely everything that was done, even when their child permanently damaged a staff member's eyesight. Wasn't their fault apparently. Constant complaints to PALS and senior management because we weren't doing enough, despite staff being in harm's way every day and having tried every combo of meds (which patient refused after a few days anyway).

Total waste of time and resources for everyone involved. Went on for months until a consultant finally insisted on discharge. I left shortly after but I'm sure they came back after a few days.

I heard someone troublesome very recently at a GP appointment. It took two people to calm her down.

I agree that receptionists must receive a lot of abuse lately.

Anecdotally, of course, my medic mates (of many grades, positions & ethnicities) have noted that violence & abuse against non-white colleagues has increased since 2016 & the Brexit referendum. To paraphrase a Black GP friend, “People didn’t vote for Brexit because of the economic benefits of leaving the EU, did they?”

Even white British friends have reported an increase in violence & aggression at work, not by patients but by families & friends of patients. One A&E mate says it feels like there is a permanent Police Officer on site at all times.

A couple of friends who work in the public sector are now happy as clams in NZ & Australia because they can have a better standard of living than here with less hours, less arseholes & more time with their kids.

I’m 50, so cracking on a bit now, but there’s definitely more of the ‘me me me’s than the ‘we stand together’ mindset in the last decade or so.

I was attacked by a lady with dementia. She was very violent and had mess herself. Myself and my work colleague was just trying to help and take her to help clean her up. She starting lashing out, biting and managed to get her poo everywhere. It was on her hands so when she lashed out she smacked me in the face, the poo went into my mouth. Wasn't a nice experience but the lady was extremely poorly with her illness. I have worked with dementia patients for nearly 30 years. Sometimes it is the families who are rude but most are lovely.

Has this increased since we moved from locking people away in mental hospitals to 'Care in the Community'? In my youth, most people with learning disabilities (as we didn't say then) would have been living in institutions and most people with mental health problems would have been in-patients in psychiatric hospitals, either permanently or on and off. They were not usually kind or decent places for either patients or staff, but I suppose it took some violent and difficult people out of the community. Care in the Community has, of course, failed because the money generated by selling off the old asylums was not re-invested in decent community mental health and crisis care.

Also in my youth, nobody, but nobody, got away with being violent to staff in schools. The response would have been violence from staff. Not acceptable, probably bred more violence in the long term, but staff were rarely assaulted by either pupils or their parents. Any child who was violent would probably have been expelled and the police would have become involved.

I suspect the response to violence in hospitals would also have been more violence from staff. I'm obviously not suggesting we go back to those days, but we don't seem to have any effective way of dealing with these anti-social people now. We seem to have (rightly) said that staff can't be violent but utterly failed to put in place measures to keep them safe from violent members of the public.

It seems that violence at work either doesn't get reported to the police or the police don't deal with it. Why not? What's gone wrong with society when we just shrug our shoulders and say 'Oh dear, but that's just how it is'. It shouldn't be.

So some people are scared, in pain, frustrated and PP asks we make allowances for them. But plenty report similar in shops, schools, other places (can’t even imagine what call handlers get). What allowance then? What’s so life-and-death about little Johnny’s picture drawing or running race?

@Harebrain 👏

I think part of it is that tech is making people impatient, we don't have to wait for things much any more. So when you're in hospital and feel out of control, have to wait endlessly - people can't handle it.

Yes, the click-and-collect mentality. Everything should be instantly available or else, complain.

Nhs manager here, I have been held hostage (twice), been shot in the leg by a psychotic community patient, been touched and spoken to inappropriately many a time and then the general physical abuse- bites, scratches etc. We shouldn’t have to put up with this, but we all do- sadly it’s part of the job. I still love my job and although I am no longer patient facing any more, I do face verbal abuse via phone almost daily 😂
It genuinely shocks me that the public did not agree with wage increases or strikes for us- we are the lowest paid graduate employees!

I don't count assaults by dementia patients, which are common but not their fault.

And working in A&E I kind of expect it - MH, drug and alcohol issues etc.

But the physically unwell yet mentally sound, now those assaults really get me. The name calling, false accusations, physical assualt, spitting, scratching etc and don't even get me started on family members. I can understand upset and worried family members shouting but more than that and it's just not necessary and really unpleasant.

And I agree that you get no support from management - courses in how to manage such interactions and retro's on how we could have prevented something. Victim blaming at its finest.

OP, your post is dismaying but not surprising.

There are two issues here:

(1) entitlement. People think that the NHS is some kind of magical, miraculous on-demand service with endless resources and that it should be all things to all people at all times. It's not and can never be that.

(2) There are no consequences for unacceptable behaviour. A patient (or their family) can be as abusive as they like because they are not going to face consequences. No one will ever be 'banned' from the NHS so they are free to do what they want.

@Lollygaggle

The first thing is don't put yourself in a position of danger , always try to have someone else with you . Have alarms , handheld alarms and immediate alerts on computer systems and practice what will happen if one goes off. Try not to be alone with a patient in a room.

Have signs up to say zero tolerance of violence /abuse etc

No screens or anything separating reception from patients as tends to escalate violence.

Keep anything that can be used as a weapon locked away or out of sight. Easier said than done in a dental setting.

Watch body language so you can see when things are escalating .

Acknowledge patients frustrations and feelings , keep them informed about delays etc. Apologise early , if necessary .

Ask if they understand that shouting/threatening/swearing makes people feel intimated etc

Then , worst of all, what to do if physical violence occurs , which is basically give yourself time to run.

The majority is how to read the signs that people are losing control , not dismissing their complaint/concern , keep calm yourself and avoid getting into dangerous situation in the first place.

Thank you for this. Very much appreciated.

I was in hospital overnight last week on a mixed ward and I saw, one confused man insisting on going home in the middle of the night who had to be prevented from leaving, one male patient threatening to kill a nurse who promptly called in security, one hugely overweight man who fell and it took several people about an hour to get him up safely. I was in an overflow bed opposite the nurses station so I didn't get much sleep. The staff were amazing but there was a continuous flow of problems. I can't imagine the stress of dealing with that night after night.

The whole issue around doctors’ pay is totally depressing too. My dh has colleagues leaving all the time to work for pharma where they’re paid over double their current salary and have much better working conditions. Others will go abroad to places like Australia where they are paid much better for the same job. My dh is so well qualified with years of experience and endless exams under his belt, he worked long hours over Covid in Covid wards - but his salary has gone down in real terms since he first qualified.

It feels like we need some way to sanction those who abuse the NHS, but I have no idea how this could work 🤷

@Yellowdays

Yeah we get that at work - well the nurses and doctors do. There has been some trouble with patients (understandably I guess as it is a Mental Health Unit) But we also get verbal abuse from visitors too. Some family members or friends. Especially those who have been told they are not allowed in the unit as they passed drugs to their friends and families, then claim innocence to us on reception. Some come in with attitude but say that you are rude to them! They know better than you what times are the visiting hours and cannot understand why they cannot come in when they like! Apparently their son on X ward told them when to come in. The patients haven't yet taken over! Annoyingly the wards give in to some of them. We have asked that all wards let us know what times they want visitors but no one has yet replied!!!

One ex patient is quite dangerous, mainly to women and attacked a female doctor. He also went around a local school and harassed the kids. He has been in side for awhile (prison, not hospital) but is now out again and keeps popping in.

We do not have security and the police rarely come. Even if we tell them about the dangerous one.

Actually I have just remembered that our reception was quite open a few years back. Low walls etc. Someone did skirt over once...

He has been in side for awhile (prison, not hospital) but is now out again and keeps popping in
That sounds very alarming is if he is casing the joint looking for victims/ weaknesses ☹️

@CentrifugalBumblePuppy

Yes we hear this all the time. A lot of the nurses are West African. They have to put up with a lot of abuse. One visitor said to me that there were too many blacks working here. He kept on and on until I told him to be quiet. I wasn't interested in his opinion.

@Becausemymumtoldmeso

Bloody hell!

@Pearlsaminga

Also before he went in jail he came here quite often. He was wanted by the police so you'd think they would come and get him. Trouble is they don't want to 'waste their time' baby sitting him!

Bloody hell @Deathraystare