RCN publishes lone working guidance as almost half of community staff face abuse

The RCN's guidance gives tips for nurses on staying safe when working alone.
Lone working guidance

The RCN has published guidance to support nurses who work alone following research which revealed almost half of community nurses face abuse.

Lone working guidance
New guidance offers advice on how to stay safe. Picture: Neil O'Connor

The college’s ‘Personal safety when working alone’ guidance advises nurses on how to stay safe and outlines employers’ responsibilities.

A survey of RCN members based in the community found 47.5% were subjected to abuse in the previous two years. 

Vulnerability at work

The 2015 survey of 1,324 members showed only 22% said their managers always knew where they were when they were working alone in the community and half felt vulnerable at work. 

District nursing, community mental health nursing, health visiting and community midwifery roles can all require lone home visits.

The guidance also shows the wide breadth of lone working roles including occasions when nurses work in large buildings or small health centres. 

Tips for nurses in lone working

  • Ensure you are provided with the right equipment, including means of raising the alarm, and know how to use it.
  • Check you have a signal and battery life on any personal safety alarm or mobile phone based alarm.
  • If driving, keep equipment such as laptops and medical supplies out of sight and secure in the boot of the vehicle.
  • Carry out a dynamic risk assessment during the work.

This includes:

  • Assessing your surroundings – is there anything to cause alarm such as a potential weapon or a dangerous animal?
  • Assessing the patient – is their behaviour or that of anyone with them alarming? 
  • Acting – if you feel unsafe, withdraw from the situation and inform your manager. If it is safe to do so, use de-escalation techniques. Use your lone worker alarm system.
  • Report any concerns or near misses to your line manager, RCN representative and through your organisation’s reporting systems.
  • Even if a patient has limited or no capacity and you believe there was no intent in an assault, it should still be reported so that risks for anyone else working with the patient are reduced.


Employer’s responsibilities include carrying out risk assessments to reduce potential harm.

These should consider the patient (do they have a history of aggression?); the interaction – will the nurse be breaking bad news or withholding treatment – and the working environment, such as whether the home is in an area with high crime levels, including carjacking.

Employer training

Employers should also provide nurses with a means of raising the alarm, which could include personal safety alarms or lone worker devices.

Training should enable nurses to de-escalate situations where appropriate, according to the guidance. 

RCN senior employment relations advisor Kim Sunley said: ‘Nursing staff who work alone for long or even short periods of time are more vulnerable to physical and verbal abuse.

‘As more care is provided in the community, the number of nursing staff working alone will inevitably increase.’

Further information

RCN lone working guidance

Pocket guide version