Judith Kiejda, Assistant General Secretary, NSW Nurses’ Association

1. Potential impacts of the economy, politics and government policy on workplace violence in the public health sector in New South Wales Judith Kiejda, Assistant General Secretary, NSW Nurses’ Association

2. Background • Increasing violence – 5 stabbings in 12 months, 2 fatal • Health care and social assistance industry highest risk for injury • 360 reports to police in one 12 month period for one health care facility • 400 physical assaults in one Area health service in one 12 month period

3. Types of Violence • Aggression by patients/family to staff • Aggression by patients/family to other patients/members of the community • Violence from criminal acts spilling into the health care facility • Aggression between staff and managers

4. Systemic pressures • Changes to workplace health and safety laws • Third restructure in 5 years • Negative media portrayal of public health sector • Increasing public expectations • Changes to IR legislation • Flow-on economic pressures from GFC

5. Economic pressures • Economic situation being exploited by business community • Creating fear that requirements bad for community and economy • Safety viewed as an expense rather than as an opportunity to improve efficiency

6. Influence of politics and media • Politicians continue to promise better health care services but with no tax increases! • Achieved by leaner, meaner and more accountable services • But this means less of everything – managers, support staff, education etc

7. Influence of politics and media • Many experienced staff leave but are hired back at consultancy rates • Moves excellence from public to private sector • Errors occur due to unsustainable workloads • Media and politicians cause public to have unreasonably high expectations

8. National health and safety laws • Due to commence 1 January 2012 • Unrealistic and aggressive timeline • Major restructure of health services impacting on implementation • Lack of reference to violence as a workplace risk • Significant departure from current law

9. NSW Public health restructure • Under continuous restructure for 5 yrs • 16 AHSs into8 AHSs into 16 LHNs under 3 clusters into 17 LHDs! • Complete restructure of the Depart of Health into the Ministry of Health • Little time and resources left for support and direction of staff

10. Violence–Why it’s getting worse • Increase in patients affected by drugs, alcohol, mental illness etc • Public with unrealistic expectations taking out frustrations on staff • Reduced funding • Small facilities with low staffing being vulnerable to patients/criminals

11. Violence–Why it’s getting worse • Unsustainable workloads • Increased stress • Difficulties recruiting staff • Increased bullying/harassment • Increase in workers’ compensation

12. Violence–Why it’s getting worse • Reduced management resources for violence review and monitoring • Restructuring process has lead to reduction in health and safety advice • Lack of education • Skilled staff leaving

13. Strategies and resources • Existing violence and bullying strategies in NSW include: • Facility design guidelines; • Security policy/manual re minimum standards; • Zero tolerance of violence policy; • Legislation requiring consideration and management of risk of violence; • Education, training in aggression minimisation, duress response and restraint techniques.

14. Barriers • Diminishing resources in public health care system • Right wing political climate • Anti-union sentiment in the media • Trend toward user pay systems • Privatisation

15. Conclusion • With rationing of funding, health services are focussing on channelling resources into essential direct patient care services • Neglecting safety, security, maintenance, staff education, purchase of new equipment

16. Judith Kiejda NSW Nurses’ Association jkiejda@nswnurses.asn.au 0414 674 119