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Violence in the workplace

This guide is for RCN members concerned about the threat of, or actual, violence in the workplace and includes advice on what to do if you have been a victim of violence.

What to do if you have been the victim of, or witnessed, violence in the workplace

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:

  • Contact the police immediately to report the assault. This is important, even if you have been assaulted by a confused patient. If you do not, then any later criminal injuries compensation claim (see below) will be refused. Your employer’s policy may offer guidance but it may be out of date on this point.
  • Check your employer's sickness policy and see our sickness advice if you've been injured.
  • Read your employer’s policies on violence in the workplace and check for any specific processes in place that you should follow.
  • Report your concerns to your manager as soon as possible and document the assault on an incident form.
  • Read our advice on personal injury and accident at work. While violence in the workplace is not an ‘accident’, similar principles apply in relation to reporting incidents and what action to take if you have suffered an injury. You may be entitled to compensation from the Criminal Injuries Compensation Authority (CICA) if you were injured in England, Scotland or Wales or the Northern Ireland Criminal Injuries Compensation Scheme for injuries sustained in Northern Ireland. Call us on 0345 772 6100 if you would like to discuss making a claim
  • Think about whether you need emotional support.

Once you have reported an assault, violence or the threat of violence to your employer, your employer should:

  • Carry out an assessment of the risks to health and safety through a risk assessment (or review current risk assessments). 
  • Decide on the arrangements which must be implemented to prevent injury occurring and put in place protective measures.
  • Appoint competent people to advise on health and safety.
  • Provide information and training to employees.
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Sickness absence if you have been injured at work

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.

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Refusal to treat a patient

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.

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Your employer's duties

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:

  • improvements to the physical environment
  • alarms systems
  • signage
  • safe staffing levels
  • training for staff. 

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.

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Lone working

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).

NHS Employers provides a range of guidance for lone workers including a guide for lone workers.

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.

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Mental health nursing

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.

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Further information

RCN guidance on work-related violence and managing risk 

RCN guidelines on the clinical practice for the short-term management of disturbed/violent behaviour in in-patient psychiatric settings and emergency departments.   

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.

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Need more advice?

Call RCN Direct on: 0345 772 6100