The College publicly welcomed the Government’s 2024 Budget investment to place 24/7 security staff in ‘high risk’ EDs as an important first step. But one year on, too many instances of violence are still happening in our EDs across the country. Progress on boosting security staff has stalled and there has been no additional expansion of services or support.
A snapshot survey sent to the Directors of Emergency Medicine (DEMs) at the 20 ACEM-accredited EDs across Aotearoa New Zealand confirmed that ED violence is pushing the healthcare workforce to breaking point.
ACEM’s When Care Meets Conflict: Violence in Aotearoa New Zealand’s Emergency Departments report uses survey data, doctors’ testimonies and international research to investigate the concerning issue of violence in EDs, explores the causative factors and provides government and hospital-level recommendations for addressing this significant problem.
The report found the prevalence of ED violence is unacceptably high; violent incidents are under-reported; access to appropriately trained hospital security officers is highly varied; and systemic issues are the main causative factors of violence. Among the concerning key findings:
- Eleven (85 per cent) of 13 responding DEMs reported that there had been an incident (or multiple incidences) of violence exhibited by a patient or accompanying person in their ED within the past week. This included physical violence in 64 per cent of reported incidents.
- More than three-quarters (77 per cent) of respondents reported that verbal violence occurred daily or frequently (one or more times a week) in their ED
- More than one-third (38 per cent) reported that physical violence occurred daily or frequently (one or more times a week) in their ED.
- Less than half (46 per cent) of the DEMs indicated that they ‘always’ report incidents of physical violence, while only one DEM reported that they ‘always’ report verbal violence. showing that violent incidents in EDs are not always reported to hospital executives.
- Less than half (46 per cent) of 13 responding DEMs reported having access to ED-based security officers. Of these six EDs, five had access to around-the-clock, ED-based hospital security officers. Only one reporting ED in a regional area had access to around-the-clock, ED-based security officers.
ACEM Aotearoa New Zealand Faculty Chair Dr Kate Allan said it is time to restart the national conversation about violence in EDs, with urgent and coordinated action needed to ensure the safety of staff, patients and whānau.
“EDs and the staff working in them are always available for people to manage urgent and life-threatening medical emergencies. However, violence in EDs is a significant and growing problem,” Dr Allan said.
“Physical violence against ED staff is happening all over Aotearoa New Zealand, and it is happening every day.
“Too often viewed as an inherent part of the job, violence in EDs takes a toll on staff morale, contributes to burnout, and is a significant factor in experienced healthcare professionals choosing to leave the workforce.
“We urgently need to address major underlying contributors of so much of this violence in EDs – overcrowding, access block and long wait times caused by deficits in the broader healthcare system.
“All people must be safe to receive, deliver and support care in Aotearoa New Zealand’s EDs. We stand ready to work together on turning our recommendations into reality and making improvements that can support more healthcare staff to focus on delivering crucial care and help make EDs safer – for everyone,” she said.
ACEM’s When Care Meets Conflict: Violence in Aotearoa New Zealand’s Emergency Departments report can be read here.
Background:
ACEM is the peak body for emergency medicine in Aotearoa New Zealand and Australia, responsible for training emergency physicians and advancement of professional standards. www.acem.org.au
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