Verbal abuse and physical violence are hardy perennials in hospital emergency departments, but staff tend to regard it as ''part of the job,'' new research shows.
That meant estimating how prevalent workplace violence was at hospitals was difficult, as it was chronically under-reported the research, published in the latest issue of the New Zealand Medical Journal, said.
''Given that many incidents of violence and aggression occur within the ED that do not require intervention from security, it is reasonable to assume that the actual incidence of events was higher than each of these recorded numbers.
''Thus, many events may well have occurred but were not formally recorded using the standard reporting systems.''
Researchers asked emergency department staff at a major hospital to report all relevant incidents of verbal or physical abuse: of 7896 presentations, 107 resulted in a report of some kind of violence.
In that same month, no standard incident reports were filed, and just 21 security incident reports.
Such under-reporting did not surprise Jenny Hanson, director of nursing (medicine), at the Southern District Health Board.
''Verbal abuse tends to happen relatively regularly and staff tend not to report it,'' she said.
''However any physical abuse is reported and then investigated via our incident system.''
The SDHB did not keep formal statistics on all staff abuse from patients, Ms Hanson said.
The study, led by Christchurch hospital nurse researcher Sandra Richardson, said there were several possible reasons for under-reporting of violence in emergency departments, including a belief nothing would change, that it was part of the job, a lack of time for proper reporting, or a culture of not blaming certain types of patients - such the mentally ill - for their actions, as doing so might seem harmful or disrespectful.
''The risk of such responses is that it not only hides the true extent of any problem, but also serves to excuse and by default validate the behaviour as well as the individual.''
There has been past research highlighting violence in hospitals: a 2011 Massey University study of workplace violence found the health sector had the highest rate of assaults and violence, with 55% of respondents reporting having experienced a violent act at work.
Researchers concluded there were no simple answers to ED violence, but a first step should be research to assess the true scale of the issue, and to get all clinical staff to recognise the issue.
''Without staff buy-in the true nature of the problem remains hidden,'' Ms Hanson said.
