Nursing staff encounter a range of potential hazards, often on a daily basis, but few are as distressing and difficult to manage as violence.
You have a right to be safe at work irrespective of whether you are based in hospitals, in the community or other healthcare premises. Employers are required by law to identify hazards to which staff are exposed and take all reasonably practicable steps to eradicate or minimise them.
If you have been assaulted at work:
Once you have reported an assault, violence or the threat of violence to your employer, your employer should:
Check your employer’s sickness absence policy for any exceptions to normal rules for absence management and/or the payment of occupational sick pay following injury at work. You may be entitled to certain NHS injury benefits or allowances if you work in the NHS.Back to contents
You may refuse to treat a patient if there is a serious threat of violence but this needs careful consideration. It may be possible for care to be given whilst the patient’s violence is managed.Each situation needs assessment and you should discuss this with your manager and the rest of the care team. Read your employer's policies on managing violent patients. Remember that your employer has a responsibility to ensure the safety of both you and the patient.
Your employer cannot dismiss or discipline you for leaving your workplace because of danger which you believe to be "serious and imminent" and which you could not be reasonably expected to prevent. This includes taking any appropriate steps to protect you or others from danger.
Read our advice on refusal to treat.Back to contents
Under the Health and Safety at Work Act 1974, employers have an obligation to protect the health, safety and well being of their employees. The legislation also requires employers to assess the risk of violence towards their employees and put in place measures to reduce that risk. An effective system of risk assessment is therefore crucial. Some examples of measure that could be taken include:
The importance of your safety is equal to that of your patients. You need support to identify and avoid working in unsafe conditions, and you need to know how to manage situations that become unsafe.Back to contents
As a lone worker, your organisation must provide you with a safe working environment. In turn, you have a responsibility to follow safe working practices.
If you often work alone and there is the threat of violence, or you are aware that more violent incidents are taking place, read the guidance in You're Not Alone (RCN Lone worker campaign).
Always remain watchful for your own safety and that of your colleagues. If you feel that your employer is not dealing with the issue sufficiently, contact us.Back to contents
Although some types of violence may be related to a psychotic condition, anger or fear are just as likely to lead to violence in mental health settings. Training should be provided to help you to deal with physical violence and verbal abuse. It should also help you to prevent verbal abuse developing into physical violence (de-escalation).
Do not accept verbal and physical violence as an inevitable part of your job.
Always report incidents and discuss them with your manager, the wider care team and your RCN Safety Representative. If you feel that your employer is not dealing with the issue sufficiently, contact us.Back to contents
The Health and Safety Executive provides guidance to employers on how to manage the threat of violence in the workplace.
NHS Protect publishes a range of guidance on issues relating to violence against NHS staff.Back to contents