Nurses, doctors and other frontline health workers are being subjected to abuse and threats of violence on an increasingly regular basis, with the issue exacerbated by staff shortages, union officials have told a meeting of the Oireachtas Joint Committee on Health.
Officials from the Irish Nurses and Midwives Organisation (INMO), Siptu, Fórsa and the Irish Medical Organisation (IMO) told the committee that in the absence of adequate security in healthcare settings, assaults and other abuse have become an almost daily part of the job for their members and is taking a huge toll on some. They said the situation is being exacerbated by experienced staffing quitting or moving away from jobs in high-pressure settings.
Sylvia Chambers, a senior nurse with 18 years’ experience, who works in the emergency department (ED) of a Dublin children’s hospital, said she was considering a change of career due to the high level of stress caused by the abuse, adding that many others had already made the decision to leave the ED.
“I have never experienced aggression like we have in the past few years,” she told the committee.
“There are numerous incidents where we are verbally attacked. I have been spat at. I have been verbally abused. I have been threatened that when I leave work that evening I will be stabbed as I get into my car.
“I have had grown men six-foot-four towering over me throwing objects at me. It is [on] a daily basis and I do not feel safe going to work. I don’t feel safe. My colleagues don’t feel safe. This all comes down to security. This comes down to overcrowding.”
Ms Chambers said that the waiting facilities in the hospital where she works are not adequate given the long waiting times, and that this can contribute to aggression levels from parents. She said, however, that while she appreciates the frustration of parents waiting a very long time to have their children treated, there is often aggression displayed with staff at reception as parents seek to check in.
“It’s just not appropriate and we cannot provide appropriate nursing care,” she said. “Staff are leaving due to this because they are stressed. In the last 18 months we have had 30 nurses resign from our emergency department alone. We are on our knees when it comes to our staffing levels.”
She said abusive parents could generally not be ejected from hospitals and so the provision of continued care to their children could become “nerve-racking”.
INMO general secretary Phil Ní Sheaghdha said HSE figures showed there were 5,593 assaults against nurses and midwives alone between January 2021 and October 2022. She said, however, that the figures were a gross underestimate as they referred only to those incidents that were reported and excluded those that took place in large voluntary hospitals, psychiatric and community settings.
Though there is a lack of detailed data, a previous report found that just one in 50 assaults on health workers in Ireland and the UK resulted in an arrest, with only about one in 200 reaching the prosecution stage, the committee was told.
The figures were given to the committee by Dr Laura Finnegan, a member of the IMO’s non-consultant hospital doctors’ committee. Social Democrat TD Róisín Shortall described the numbers as “shocking”.
Siptu’s health sector organiser Kevin Figgis said many other types of staff were affected by incidents of abuse or violence but that in the most extreme cases they could be treated differently.
Support staff such as porters or kitchen staff who were assaulted would receive their pay for just three months as opposed to the year-long supports provided to nurses and doctors.
“When we sought to have this difference addressed,” he said, “it was treated as a pay claim.”
He told the committee there have been instances of ambulance workers arriving at the scene of an accident and being assaulted as they tried to treat the injured. “It’s incredible,” he said, adding that it was not just the staff member themselves that suffered in the more extreme cases but also their families.
“Their children can be affected by it and we have represented people where it has absolutely devastated their lives.”
He said, however, that even in large hospitals staff felt unsafe as “some of these health facilities are absolutely vast and there is not nearly enough security staff”.
Ashley Connolly, head of the health and welfare division at Fórsa, said the collection of more accurate data by the HSE was important as a first step towards addressing the problems. Representatives complained that staff were left to report incidents to An Garda Síochána themselves and that increasingly people chose not to report as they felt it would make no difference.
Sinn Féin TD Seán Crowe, who chaired the meeting, said it was “appalling” that different grades of healthcare staff would be treated so differently in instances where they had been assaulted at work.
Asked about the incidence of racial abuse in hospitals, Dr Finnegan said she had witnessed colleagues subjected to it and said the fact that “they have to go through that additional level of degradation is absolutely despicable”.
All of the union representatives said the issue added to an existing mix of challenges, with many healthcare settings overcrowded and short of staff. Dr Clive Kilgallen of the IMO said that, based on UK figures, up to 400 additional patients might be expected to die each year due to ED overcrowding.
The issue of staff suffering long Covid was also raised, with the unions telling politicians that an impending end to the special provisions for staff affected by the condition is causing huge concern.