Dealing with Patient Violence in Hospitals

Physical and verbal attacks on hospital staff are more common than you might realise and even though the perpetrator of violence might be able to point to mitigating circumstances for their actions, this does not make it justifiable or acceptable.


The Health and Safety at Work Act 1974 means that employers have a duty of care to protect their staff and to safeguard their health, safety and welfare as much as is reasonably practical. To further support this aim, the Management of Health, Safety and Work Regulations 1999 states that employers must assess risks to employees and to put in suitable control measures to minimise these risks. Both pieces of legislation apply to all forms of workplaces, including hospitals but the National Institute for Clinical Excellence (NICE) has also issued guidelines on dealing with violent behaviour which occurs in hospitals specifically, especially within psychiatric units and in accident and emergency departments.

The Law

Violence perpetrated on hospital staff is a crime – it’s that simple. Hospitals work with the police and, with the victim’s consent, a hospital will report any incident of assault or threat of assault. The police can also get involved when a staff member becomes a victim of racial or sexual verbal abuse or any other action that can be intended to cause fear or be deemed as intimidation and charges can often be brought.

Risk Assessment

Hospitals must carry out a full risk assessment with regard to the possibility of a potential violent attack occurring on a member of staff. The scale of the risk will obviously be greater in certain geographical areas of a hospital, such as those mentioned above, and also the nature of the job of the hospital employee. Once a full risk assessment has been carried out, staff members should then receive relevant ongoing competency training in order to become more equipped in recognising patient anger and in anticipating the likelihood of a violent attack. They will also be trained in techniques in how to attempt to diffuse a potentially hostile situation and to de-escalate any potential incidents before they occur.

What if That Fails?

Taking the heat out of a potentially violent situation is always going to be the first option a staff member will use but physical restraint, the use of rapid tranquillisation and removing the offender into a secure area of seclusion are also options that can be used if all else fails. Of course, hospitals will have security staff that they can also call upon if a situation gets beyond reasonable control and can also resort to calling the police if necessary.

Major Reasons Why Violent Attacks Occur

Although a person can become violent for a whole host of reasons, hospital staff will have received training in how to spot the most likely situations where violence might manifest itself. These can include:

  • Patients who are under the influence of drugs or alcohol – especially within the accident and emergency department
  • Those suffering from head injuries
  • Those trying to come off drugs/alcohol and who may be experiencing withdrawal symptoms
  • In-patients who may be suffering from dementia or a psychiatric problem which causes them to either become confused or where their perception of reality can sometimes become distorted
  • Those with poor communication skills
  • Frustration with delays, prolonged waiting times

The fact of the matter is, however, that hospital staff should not have to tolerate any violence or the threat of violence at work and both patients and visitors to hospitals should be clearly left in no doubt about the likelihood of facing criminal charges should they commit or threaten any acts of violence, whether physical or verbal, on any member of staff.

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