Health care work is a rewarding profession but it doesn’t come without its challenges. Lone health care workers have experienced verbal abuse, violence and aggression from patients and relatives, people with weapons or people who are under the influence of drugs or alcohol.
While not all lone health care workers have experienced violence, they are more than three times likely to experience verbal or physical abuse than people in other professions with only police officers and security guards at higher risk.
What is a lone worker?
A lone worker is anyone who works without a colleague nearby or when someone is working out of sight or earshot of another colleague. Lone workers exist across many different industries including petrol station workers, freelancers, security guards and private contractors.
Here are some situations where a health care worker may be working alone:
– Mental health nursing, health visiting and community midwifery
– Caring for a patient or client at their home
– Outreach work
– Escorting a patient alone from one part of the hospital to another
– One-on-one consultations in a clinical room
– Being the first person to arrive or last person to leave a building
– Therapeutic observation of a patient
Why are lone workers at higher risk?
Research conducted by NHS Protect in the UK found that lone health care workers are at higher risk due to these two reasons:
– Lone workers are unable to call out for help from a colleague so they are unable to prevent an incident from occurring
– Lone workers are more limited in their ability to defend themselves or restrain a person than they would be if they had colleagues nearby if an incident occurred.
What should employers do to minimise risks?
Employers have a legal obligation to keep staff safe at work but they also have a moral and ethical responsibility too. Here are five ways employers can minimise violence against their lone health care employees:
Lone Worker Policy
Every organisation should have a lone worker policy implemented so staff are aware who is accountable and what the roles and responsibilities are of different people in their workplace so they know who to speak to if a problem arises.
Risk assessments are critical for identifying and managing the risks to lone workers to reduce potential harm. Every organisation must have a risk assessment sheet to adequately train employees on how to perform a risk assessment to ensure their safety with a new patient or client.
Here are the main reasons for performing a risk assessment of a client:
– To understand any known history of aggression or criminal history
– To understand any past or current substance abuse
– To understand any known emotional or psychological concerns
– To be aware of any identified hoarding/squalor issues
– To know if they have any pets, and if so, request that they are tied up or put in a separate room
As well as performing a risk assessment for clients and patients, risk assessments should be done by employers on staff members.
Here are some risk factors employers should look for in employees that makes them more vulnerable:
– Employee is inexperienced
– Employee has a medical condition
– Employee is returning to work after a long time
– Employee is pregnant
Here are some factors that may cause a patient to become aggressive to a health care worker during interaction:
– Breaking bad news
– Withholding treatment
– Discussion about behaviour
– Safeguarding procedures
The working environment of lone healthcare workers should also be assessed for risks. Here are some common ones:
– Outreach work in streets
– Client’s home
– Unfamiliar environment
– Working alone in a health care building
– Working in an area with high crime levels
– Carrying equipment such as drugs or computers
– Travelling by public transport, cycling or taxis
Raising the alarm
With advances in technology there are a number of personal safety alarms or lone worker devices available on the market. Employers should provide lone health care workers with the appropriate equipment should they have to raise an alarm. A mobile phone may not always be easily accessible or easy to dial in a situation which is escalating and may put the person at higher risk.
A duress alarm can be worn around the neck or wrist and with the press of a button can get the health care worker in contact with a person at a monitoring centre in a few minutes. If it’s a serious situation the monitoring centre will call the emergency services to get help to the person in distress or they can call that person’s supervisor or manager.
Mobile phones can be enabled with specialist software. GPS and apps can also be used to support lone workers at the press of a button.
Supervisors or work colleagues could also perform regular checks on lone health care workers or get employees to have a buddy so they can check up on each other to make sure they are not in any danger.
Employers should provide mandatory training to all lone workers before they start working. Organisations need to ensure good records are kept by employees and risk assessments are performed regularly so all information is up-to-date.
Self-defence classes could be a good way for lone workers to learn how to defend themselves should they need to. While training alone won’t reduce the incidence of violence, it is an essential part of an organisation’s approach to managing violence and aggression towards lone workers.
Organisations should have systems in place to support lone workers after an incident has been reported. Employees should be supported and debriefed if something has happened to them while they were working. Reviewing of risk assessments should take place and employees should be advised on how to access counselling support and liaising with the police. The incident should be investigated so that this doesn’t happen again to a different employee and all staff should be informed of it occurring.