Managing and responding to violence in the medical workplace
It is a sad reality for many frontline doctors that they may become a victim of violence and aggression at any moment.
Dr Katherine Tan
Chair, AMA Federal Council of Public Hospital Doctors
We often care for patients and their families at stressful and traumatic points in their lives. Feelings of frustration, confusion and anger are understandably common life-and-death situations.
However, when this frustration leads to violence and aggression, it places patients, healthcare workers and non-clinical staff lives at risk.
We are seeing cases of violence becoming more prevalent in public hospitals, as widespread ambulance ramping, bed block and delays caused by the logjam crisis deepen.
Responding to the rising threats of violence against doctors, we have developed a new position statement — Managing and responding to violence in the medical workplace.
While the AMA has an existing suite of position statements relating to safe work environments, this is the first position statement to offer a comprehensive approach to violence in the medical workplace, particularly public hospitals.
The World Health Organization estimates that up to 38 per cent of medical professionals will suffer from physical violence at some point in their careers.
And Safe Work Australia regards healthcare as an industry with an elevated risk of workplace violence, with some estimates predicting that up to 95 per cent of Australian healthcare professionals have experienced the effects of physical violence and/or verbal abuse.
Doctors and healthcare staff who fall victim to workplace violence not only risk serious physical injury, but also profound psychological impacts such as anxiety and decreased job satisfaction. It is also proven to have negative impacts on patient outcomes.
It is in absolutely everyone’s best interest to eliminate violence in medical workplaces.
This is why the AMA is going on the front foot, taking a leadership role in addressing this crisis.
Our latest position statement offers practical measures hospitals and other medical workplaces can implement to reduce the risk of violence. Some measures will be obvious and familiar to you — things like educational material to be shown to patients, informing them of no-tolerance policies, and making physical adjustments to include unimpeded exit points and video surveillance.
But, crucially, the position statement advocates for a shift in culture and management processes to reduce the risk of violence in the workplace.
Our position statement endorses recent changes to state legislation in South Australia and Queensland that place the responsibility of staff psychosocial wellbeing onto the boards of hospitals, and we encourage this change across all jurisdictions.
While everyone has a role to play in ensuring safety, this change is important because it encourages a top-down, systems-based approach guided by those in medical leadership positions.
The position statement also stresses the importance of post-incident support — both immediately and longer term — and the benefits of risk audits to assess the level of risk in your workplace and the appropriateness of mitigation measures.
Violence in medical workplaces remains under-reported and poorly studied, in part due to perceptions that violence is an inherent part of the job. Violence is absolutely unacceptable, and everyone deserves to be safe at work. A change of mindset is needed, whereby a culture and system of reporting, monitoring and evaluation of incidents is embedded.
Don’t get me wrong, governments have a huge role to play here too, and our position statement calls on governments to invest in continuous monitoring and evaluation mechanisms to enable medical workplaces to report incidents with confidence.
There are major benefits in deidentified data being made available to state and federal authorities, encouraging collaboration on research relating to violence in medical workplaces and pursuing evidence-based solutions.
We call for all state and territory government to place greater protections on all medical professionals.
While our latest position statement is primarily focused on hospital settings, the principles are also applicable to other medical workplaces, such as private practices, general practice clinics and other community settings.
It is our hope this position statement can spark long-overdue, serious discussions about violence in medical workplaces. I encourage you all to read the document and consider how you can help be part of the solution.
