Clapped in the street - and assaulted: Staff call for behaviour change in A&E
- Credit: Whittington Health
Since September 2020 staff at the Whittington Hospital's emergency department (ED) have experienced verbal and physical abuse, hate crime, and sexual assault.
Now a senior medic is warning would-be patients that "aggressive behaviour" will not be tolerated, with doctors, nurses and other hospital staff encouraged to report abuse to the police.
Heidi Edmundson, a consultant in the Whit's ED, has been leading a project for the last year to improve two: patient experience and treatment of staff.
The focus came out of feedback sessions and from the Project Wingman airline staff who helped look after medics during the height of the pandemic.
Heidi told this newspaper: "We are understanding and accepting of high levels of stress and emotions - but at what point does that become verbal abuse, and then at what point does that become a crime?
"And if it is a crime, do we know we can report it?"
Heidi built on work started by nurse Victoria Golden and focussed on making sure that whenever incidents of bad behaviour in the ED occurred, staff were reporting them.
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She said that since September, 151 crimes have been reported. Of those, 19 were physical assaults, 21 were hate crimes, and 20 involved threatening behaviour.
She said there was a sexual assault where a member of staff was "groped while she was giving a blood test".
Heidi, who said she had always been interested in staff wellbeing, has met with the police to discuss how best to support staff to report crime, and to ensure staff knew when a crime had been committed.
Of meeting with the airline staff, she added: "What also came out was the level of abuse staff were experiencing. Being in a room that was separate from the ED and hearing it discussed in a different context it made me think about how we could do this differently. That grew into an idea."
She said the first step was to encourage staff to report incidents through the NHS's internal DATIX system, even though "on a busy shift the last thing you want to do is to fill in a form".
Heidi said "each and every" report is then discussed.
She said: "What we were really looking at was what sort of behaviour are people experiencing and is that behaviour a crime? And similarly, at what point do you go through different escalations."
She talked about occasions when staff have been forced to get between an angry member of the public and a medic "to stop them being punched", or when "people had to literally hide behind desks".
"On one hand there's maybe this idea that in the emergency department that's just what you live with," she said. "But what I could see was that this behaviour - it does leave its mark on people."
She said alcohol often exacerbates the issue, particularly as people were upset by rules limiting visitors to hospital, and requiring masks and social distancing.
"We understand that it's very harsh - people want to be with their loved ones. But we are doing it to protect people.
"I want to very much send out the message, both in the department and to people who use it, that if you come in here, we want to help you with your medical problem.
"We want to treat you, that's our job. But we want to make sure that your behaviour is okay, and if you do commit a crime, you will be reported to the police."
Heidi said showing respect for staff is key.
"A lot has been made of the fact that during this pandemic we have been 'heroes', who have been clapped for in the streets," she continued.
"But it's important to remember that we are all just people like everyone else and we have found the pandemic difficult for the same reasons as everyone else.
"We have found it frightening and scary, and we would give everything to have the department back as it was."
Heidi said unless it was unavoidable, members of the public should call 111 to book a slot at A&E - or otherwise be prepared for long waits.