There is no place for body cameras in nursing practice

Staff safety should be a priority but cameras would put an unacceptable barrier between nurses and the people they are trying to help

Staff safety should be a priority but cameras would put an unacceptable barrier between nurses and the people they are trying to help

Picture: Calla

The issue of keeping nurses safe in the workplace was at the centre of a controversial debate at this year’s RCN congress. The discussion was about whether wearing body cameras would act as a deterrent to those who might threaten or do harm to nurses.

I do not believe there is a place for body cameras in nursing. 

They raise ethical concerns regarding confidentiality and would limit the ability of nurses to demonstrate trust, which is at the core of establishing the necessary rapport to build a therapeutic relationship with a patient. 

Wearing body cameras would lead to individuals who are exhibiting behaviours perceived as challenging being managed and contained, rather than holistically assessed and receiving the therapeutic interventions needed for recovery.

Significant risk

Nurses often work alone with some of the most vulnerable members of society. Some work in environments where violent situations could and should be anticipated, planned for and, where possible, the risks mitigated. However, all healthcare workers regardless of setting are at significant risk of harm.

While visiting people in their own homes, many nurses go from visit to visit alone. It is not until the shift is over and they fail to call in or return home that an alarm is raised. They may have encountered violence at the first visit. 

Even those working on a busy ward may be working alone behind curtains and not be missed until, for example, another nurse needs the keys that they happen to have in their possession. 

Many nurses do not wear a uniform as it provides an unwelcome barrier to the partnership working that is key to their practice. How would a camera influence the balance of power within these relationships?

As nurses we should not live in fear. We should not be afraid of our patients. We should not fear coming to work. We should have our concerns heard and appropriately acted upon. We should all strive to achieve the best outcomes for all our patients. 

Our employers have a duty to provide a work environment that is safe, as well as being somewhere patients can receive treatment and be free from harm. However, we all know this can be difficult to achieve with suboptimal staffing levels.

Feeling the strain

Unfortunately, as all areas of the health and social care system are being forced to do more with less, everyone is feeling the strain, including patients and their relatives. This can often lead to frustration that can evolve into verbal aggression and harassment. A situation that goes unresolved due to a lack of resource can easily escalate when a nurse can finally attend to the person’s situation.  

All staff should receive training in conflict resolution, de-escalation and breakaway techniques. When a situation does escalate, despite reasonable attempts to diffuse it, then restraint may be necessary. It is crucial that restraint, continuous supervision and control are not first line techniques for managing behaviour. 

Security often wear body cameras but usually they are only called once a situation has already escalated. Staff may find themselves in a situation with a violent or aggressive person and be unable to summon help. If unable to break way they could become subjected to a torrent of abuse and physical violence, which could result in significant injuries, loss of earnings and, for many, the inability to return to work at all. When such a situation does occur, staff need to know that they will be supported by their employer.
Staff should be supported to return to work and to secure a conviction. The employer should demonstrate learning from the events and put things into place to prevent anyone else needlessly being subjected to the same aggression.  

About the author

Shelley Pearce is staff nurse in the emergency department at the Queen Alexandra Hospital      

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