Policy briefing

Policy briefing: personal safety when working alone

Read our essential guide to new RCN guidance on how nurses can stay safe when working alone.
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Essential facts

Nursing staff who work alone are more vulnerable to physical and verbal abuse. New guidance from the RCN advises nurses on how to keep themselves safe and assess any danger they face.

Working alone does not just apply to nurses working in the community and visiting patients at home. It includes any situation in which someone works without a colleague nearby, or within sight or earshot. This can include working in a hospital at night and being with a patient in a consultation room.

NHS Protect has found the risk of injury from a physical assault is 9% higher for lone workers compared to those who do not work alone.

An RCN survey of more than 1,300

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Essential facts

Nursing staff who work alone are more vulnerable to physical and verbal abuse. New guidance from the RCN advises nurses on how to keep themselves safe and assess any danger they face.


NHS Protect found the risk of injury from a physical assault is 9% higher
for those working alone. Picture: Neil O Connor

Working alone does not just apply to nurses working in the community and visiting patients at home. It includes any situation in which someone works without a colleague nearby, or within sight or earshot. This can include working in a hospital at night and being with a patient in a consultation room. 

NHS Protect has found the risk of injury from a physical assault is 9% higher for lone workers compared to those who do not work alone.

An RCN survey of more than 1,300 community nurses, taken in June 2015, revealed that in the previous 2 years, nearly half had been subjected to abuse while working.  

It found that 1 in 9 had experienced physical as well as verbal attacks, and only 13% of nurses had access to personal alarms or lone worker protection devices. According to some respondents, devices have been withdrawn as part of cost-cutting measures.

The RCN guidance states that all employers should have a lone worker policy, must carry out risk assessments and must implement measures to reduce or eliminate risk.

These measures can include buddy systems, mobile phones, regular checks by colleagues, and equipment such as sat navs and torches for visits at night to unfamiliar locations. 

Nursing staff who carry out clinical procedures in a patient’s home often prefer wearable technology to raise the alarm. A widely used option in England is the Identicom system, which is a safety device concealed in an ID card.

Nurses can refuse to treat a patient if there is a serious threat of violence, but this needs careful consideration. It may be possible for care to be given while the patient’s violence is managed.

Expert comment

Kim Sunley, RCN senior employment officer:

‘The concern about lone workers is that they can be out of sight and out of mind, and we know that health workers are particularly vulnerable to physical and verbal attacks.

‘There is much under-reporting by nurses when it comes to violence and aggression, which is worrying. Nurses need to report any incidents, including near-misses, so that they and colleagues are not put at risk in the same situation again.

‘The RCN is calling for lone workers to be given, as a bare minimum, a work mobile phone, and I would urge nurses to use any lone-working devices they are given and follow employer guidance.’

Implications for nurses 
  • Always take any safety equipment, such as an alarm or phone, with you. Be familiar with policies and risk assessments before working alone.
  • Carry out dynamic risk assessments. This is a way of continuously assessing situations to ensure the risks of violence are quickly recognised, assessed and responded to. 
  • First assess your surroundings, looking for anything that could cause alarm, such as a potential weapon or a dangerous animal. Think about ways of leaving if things get difficult. Second, access your client and anyone with them to see if their behaviour is cause for concern. If you feel unsafe, withdraw from the situation and contact your manager. 

 


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