Academic journal article Australian Health Review

Workplace Abuse among Correctional Health Professionals in New South Wales, Australia

Academic journal article Australian Health Review

Workplace Abuse among Correctional Health Professionals in New South Wales, Australia

Article excerpt


Health professionals have a right to practise in a safe workplace, a workplace in which the risk of abuse - including physical, sexual, emotional and verbal abuse - is negligible.1-4 Unfortunately, however, workplace abuse directed at front line health professionals is a common problem in several countries,5-11 including Australia.12-20 A recent systematic review of studies of the prevalence of patient-initiated abuse perpetrated against Australian general practitioners found 12 month period prevalence ratios ranging from 48 to 64%.15 Similarly, a large study of nurses who were practising in Tasmania found a 1 month period prevalence of 64%.13

In healthcare settings, incidents of workplace abuse may be perpetrated by patients, the visitors of patients, professional colleagues or non-professional staff. The negative impacts of such incidents are significant and wide ranging. In individual health professionals, exposure can lead to physical injury, anger, fear, sadness, helplessness, stress, anxiety, a loss of self-confidence and, in extreme cases, post-traumatic stress disorder and/ or suicidal ideation,14,16,19,21-25 all of which can place strain on relationships with work colleagues, family members and friends.21,24,25 At the health facility level, workplace abuse has been linked to employee absenteeism, low workplace morale, staffturnover, reduced empathy for patients, reduced productivity at work, and increased risk of errors in the delivery of care,12,13,16,19,21,23-25 all of which can undermine the quality of the delivery of health services.12,19,21,24,25In addition, the direct and indirect financial costs of workplace abuse, incurred by individuals, health organisations and the broader community, are substantial.26

The risk of workplace abuse appears to vary by health profession. Winstanley and Whittington7 surveyed staffof a UK general hospital and found that a higher proportion of middle grade nurses (34%) than doctors (12%) were subjected to frequent verbal abuse while at work. Similarly, a recent Australian study found that, compared with general practitioners and allied health personnel, nurses were more susceptible to workplace abuse.19 The risk also varies according to the practice environment. For example, Farrell et al.13 found that nurses who practised in a hospital emergency department were about seven times more likely to be physically assaulted than nurses who worked in a medical general practice. Although studies have explored the magnitude of workplace abuse in a broad range of healthcare settings and among a range of health professions, little is known about the risk of abuse to nurses, doctors and other health professionals who deliver healthcare to inmates.

Many of the individual and social determinants of violence, such as impulsivity, mental illness, drug and alcohol abuse and a personal history of trauma, are disproportionately common in inmate populations.27-29 The predisposition of some inmates to violence, coupled with the complex and often oppositional nature of the relationship between inmates and correctional staff, place correctional officers at a high risk of being abused while at work.30-32A few studies have explored workplace abuse among mental health professionals who were practising in forensic facilities.30,33 It is not clear, however, whether the high risk of inmate initiated abuseamong correctional officers is similarly high in correctional health professionals.

We conducted a cross-sectional, self-administered survey of workplace abuse among employees of Justice Health, a statutory health corporation established to facilitate the provision of healthcare to people who come into contact with the criminal justice system in New South Wales (NSW). The aims were to investigate the prevalence, sources and consequences of workplace abuse among staff, and to identify demographic and employment factors associated with incidents of abuse. This report describes findings among Justice Health staffwho were employed as a health professional (including medical doctors, nurses and allied health professionals). …

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