Exclusive: Nurses working alone are victims of hundreds of assaults, investigation shows

Hundreds of nurses who work alone in the community have been victims of violence, with assaults over as three-year period at 31 trusts including sexual assault, hostage situations, headbutting, biting, strangulation and use of a weapon, an investigation by Nursing Standard shows

Picture: Neil O’Connor

Hundreds of nurses who work alone in the community have been victims of violence, an investigation by Nursing Standard shows.

Over a three-year period there were 1,544 assaults against lone workers such as district nurses or mental health nurses, including sexual assault, hostage situations, headbutting, biting, strangulation and use of a weapon.

The data comes from 31 NHS community, learning disability and mental health trusts that responded to a survey. Fifteen other trusts were unable to differentiate lone workers in their figures and ten did not respond.

Staying safe

RCN senior employment adviser Kim Sunley said the assault figures were concerning. ‘Robust risk assessments, personal safety training and an effective means of raising the alarm, such as a lone worker device, can all help to keep people safe.

‘Some situations may simply be too dangerous to tackle alone, and in those cases we recommend employers relocate care or arrange for patients to be visited in pairs.

‘All employers are responsible for the safety of their staff, and the RCN has set out a series of guidelines to help employers reduce the threat to lone workers.’

The 31 trusts reported 306 assaults against lone workers in 2015, 480 in 2016 and 758 in 2017, a rise of 148% over the three-year period.

De-escalation techniques

Greater Manchester Mental Health NHS Foundation Trust said it had 121 assaults against lone workers in 2017, but said no comparable figures were recorded for the previous two years. Its director of nursing Gill Green said a survey showed staff felt able to report incidents and managers were proud to have a high reporting culture.

Ms Green said: ‘In a mental health setting, service users can present with challenging behaviours, but our staff have a strong track record of using effective de-escalation techniques.

‘The majority of our interactions with service users take place within community settings, and we always emphasise the importance of risk assessments, and plan joint visits as required.

‘Our lone working policy includes measures to ensure staff stay safe, including regular contact with lone workers, buddy working, personal panic alarms and code words.

‘If a service user has a history of violence and aggression visits are never to be taken alone.’

Care and safety

South London and Maudsley NHS Foundation Trust recorded 16 assaults against lone workers in the three-year period, as well as identifying cases of stalking and harassment against its staff. A trust spokesperson said: ‘The care and safety of our patients and staff, including our lone workers, are among the trust’s core priorities.

‘Staff employed for duties which involve some degree of lone working, including those who work in the community, and their managers, work closely with our patients and service users to form and maintain good relationships to minimise the risk of any incidents occurring.

‘Staff are also fully equipped with telecom devices including a mobile phone.’

‘People think we carry drugs’

North London community nurse Drew Payne said the issue of assault against lone workers is not taken seriously enough by employers and called for robust risk assessments and structures to be put in place to deal with incidents.

Mr Payne said wearing a uniform was a safety issue for nurses working alone. ‘People still believe we carry drugs – I actually turned down a job requiring uniform, with shifts that ended at 10pm, as you stand out like a sore thumb.’

Jail for assaulting nurses

Overall, 70,555 assaults were recorded against NHS staff generally in England in 2015-16, up 4% from the previous year and a rise of 18% since 2011-12.

Yet in the same time frame, the number of cases in which criminal sanctions were imposed fell from 1,380 to 1,250.

The RCN is working with MPs to develop legislation making it a specific offence to assault nurses in all settings, which is due to reach its next parliamentary stage in April.

Anyone convicted of an offence under the proposed law could be fined, jailed for up to 12 months, or both.

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