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590 threats recorded against hospital staff


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Staff at the Lyell McEwin Emergency Department suffer more than three threats to their personal safety each day on average, figures released by the hospital show.

There were 590 ‘code black’ situations between January 1 and June 30 this year.

A code black is where an emergency response team is deployed to help a staff member who feels their safety is threatened.

South Australian Salaried Medical Officers’ Association (SASMOA) spokesperson Bernadette Mulholland inspected the emergency department earlier this month.

She told InDaily 13 code blacks were reported on one of the nights of her inspection and staff told her it was “the norm” for mental health patients to be confined in windowless cubicles for between four and five days at the emergency department.

The advocate for mental health patients in SA hospitals, Principal Community Visitor Maurice Corcoran, told InDaily yesterday there was a strong correlation between a mental health patient’s length of stay in emergency departments and the likelihood of code blacks.

“The longer mental health patients are in an ED (emergency department) the more likely it is that there will be code blacks,” Corcoran said.

Hospital management said this morning that it is considering increasing the number of psychiatric intensive care beds at the Lyell McEwin.

It held meetings last week with emergency department, mental health, medical and nursing staff, as well as unions in response to the SASMOA inspection report.

Mulholland said increasing bed numbers would go a long way to improving safety for staff.

“This has been put to us before but has never eventuated,” she said.

“That is a welcome move for management to pursue that strategy, and I hope they do undertake the strategy.”

CEO of the Northern Adelaide Local Health Network Margot Mains said the hospital was doing everything in its power to improve safety for staff.

“Northern Adelaide Local Health Network has introduced several strategies to improve patient flow and address issues associated with mental health patients presenting to the Lyell McEwin Hospital Emergency Department needing admission,” she said in a statement.

“These include increased nursing and psychiatric staffing overnight, the establishment of a community based mental health walk-in service from 9am to 9pm [and] a 24-hour Assessment and Crisis Intervention Service.

“Lyell McEwin Hospital’s priority is to provide a safe environment for staff, patients and their families.

“Our staff are highly skilled and trained in dealing with patients who may be intoxicated or have mental health or medical issues, such as dementia, which require expert management.”

SASMOA spokesperson and senior emergency doctor David Pope told InDaily verbal and physical threats which trigger code black alarms have often resulted in actual assault of staff members at the Lyell McEwin.

“I’ve witnessed people being scratched, bitten, spat at, punched, bruised, kicked. It’s a regular occurrence,” he said.

“On multiple occasions I’ve actually been injured.

“It’s so regular that it doesn’t become that noteworthy at the end of the day.

“It makes for a very stressful an difficult work environment when your’re trying to care for people but you’re under the constant threat of attack or injury.”

Pope said verbal and physical threats of violence, and actual assaults, would only become more frequent at the emergency department if strong action wasn’t taken by management to increase the numbers of acute psychiatric beds.

“The overcrowding is worsening, the delay in getting patients to beds is getting longer so the result of that is to worsen this problem.”

“Until people no-longer spend many days in emergency departments waiting for beds … then that problem’s going to continue. We expect it to continue to worsen.”

Pope said hospital staff often do not report assaults because they mostly result in minor injury, and when the emergency department is over capacity, staff are not willing to spend time on the paperwork.

“Much of it doesn’t get reported because it is so frequent and the the reporting mechanisms are so difficult,” he said.

An emergency nurse from the Lyell McEwin told InDaily on the condition of anonymity that there were 95 patients at the emergency department on Tuesday – more than double the ED’s capacity.

A spokesperson for Health Minister Jack Snelling said very few code blacks were the result of deliberate aggression towards staff.

“The number of code blacks recorded also includes verbal abuse or threats that do not result in acts of physical violence,” the spokesperson said.

“Code blacks are also used as a preventative measure to stop people who may be showing signs of aggression before an incident occurs.

“Any inappropriate behaviour toward staff or patients in our hospitals is taken extremely seriously.”


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