It's a Tuesday evening in the midst of a busy emergency department in a hospital in Queensland. Sarah, a nurse with a wealth of experience, approaches a patient's bed to administer medication. Without warning, the patient lashes out, striking her across the face and leaving her with a fractured cheekbone. Unfortunately, incidents like this are common and a reality that healthcare workers across Australia are having to face all too often.
The sobering truth is that violence in healthcare settings has reached crisis levels in recent years. Research shows that violence within Emergency Departments has increased by more than 50 percent in some parts of Australia, with in-hospital assaults rising by 48% in Queensland alone between 2015 and 2018. For many healthcare professionals, the issue is no longer if they’ll face workplace violence, but when.
The Numbers Tell a Disturbing Story
Queensland's healthcare workers are facing an unprecedented wave of workplace violence, transforming hospitals from places of care and healing into potential danger zones. Recent data from Safe Work Australia reveals a 56% increase in compensation claims from workers who’ve been assaulted or exposed to workplace violence over the past five years.
The statistics present a deeply troubling picture for female healthcare workers in particular, who've experienced a 73% increase in violence-related claims over the past decade. This is compared with only 33% for men. This difference between men and women reflects the complex nature of healthcare violence, where women face higher rates of verbal abuse and sexual harassment, while male workers encounter more physical assaults.
A comprehensive study from the University of Queensland examined more than 3,000 global studies and confirmed that violence against healthcare workers is both rising in frequency and severity. The research made note of over 370 healthcare worker fatalities that occurred globally in just a seven year period, including 161 in conflict zones. This is a stark reminder that healthcare violence can have fatal consequences.
Nearly 70% of health workers in Queensland who were surveyed reported either having been assaulted or having witnessed an assault in their place of work. Following such data, there has been an urgent call to slam the brakes on this fundamental shift in healthcare culture which essentially normalises violence.
The Australian Medical Association, Queensland, has also reported that emergency department doctors are experiencing increased violence in the workplace. This has been linked to patient dissatisfaction, particularly around waiting times and the system used for prioritising cases.
Understanding the Spectrum of Healthcare Violence
Violence within healthcare concerns far more than just physical assault, which can range from pushing to severe assaults including weapons. It can also include verbal abuse, intimidation, shouting, swearing, threats, as well as sexual harassment.
Healthcare professionals who work in emergency departments and mental health units face the highest risk. This is often due to long wait times, high-stress situations, and where there are patients under the influence of substances or experiencing mental health crises, contributing to a pressure-cooker environment. Workers on the night shift face disproportionately higher risks, often working with reduced staffing levels and limited security presence.
Recent reviews of conditions by Queensland Health have documented cases where staff have been hit, bitten, threatened, or subjected to prolonged verbal abuse while attempting to provide patient care. There is even evidence of some attacks being premeditated in nature, as patients or family members bring in weapons, including things such as knives. Such attacks go far beyond spontaneous aggression.
The psychological impact of these incidents can be long-lasting. Healthcare workers frequently report developing anxiety, depression, post-traumatic stress disorder (PTSD), and what is termed "moral injury" - a feeling of failure at not having been able to provide adequate care to a patient.
Legal Obligations: What Employers Must Do
Under Queensland's Work Health and Safety Act 2011, healthcare employers are obligated by law to protect employees from violence and aggression. In fact, these duties extend far beyond traditional safety measures and include being proactive in terms of eliminating possible risks. For some organisations this may also include participation in comprehensive violence prevention programs.
For healthcare organisations, the requirement is to eliminate risks to worker health and safety where reasonably possible, and where such issues cannot be eliminated entirely, to minimise risks through all reasonable measures. This includes providing safe work environments, adequate facilities, and necessary training and supervision for workers to perform duties safely.
Safe Work Australia guidelines emphasise that tackling workplace violence requires comprehensive approaches which go beyond simply having security guards on site, but which also include environmental design, staff training, systematic risk assessment, and ongoing consultation with workers about violence, asking workers to cooperate in prevention strategies.
Fortunately, there have been a number of recent legal amendments to the way in which organisations are required to document incidents. The idea is to capture violent incidents that may not result in serious physical injury but which expose workers to serious risks to their psychological health and safety. This recognition of the impacts on a person’s psychological well-being creates additional reporting obligations for healthcare employers.
Queensland Health requires managers and supervisors to put in place clear processes to identify, prevent, assess, and manage risks of violence. These procedures must follow enterprise risk management practices and involve regular consultation with staff on prevention strategies.
Innovation in Violence Prevention: Queensland's Ambassador Program
Queensland is leading Australia in innovative violence prevention approaches through programs like the Ambassador initiative at Royal Brisbane and Women's Hospital. This groundbreaking program employs specially trained security staff who focus on engaging with people and calming the situation before it escalates, rather than relying on physical intervention.
The Ambassador program represents a shift from the traditional ways we perceive security to ones which emphasise empathy and provide a team who integrates successfully with clinical staff. Ambassadors receive comprehensive training in communication, de-escalation techniques, and a better understanding of the unique dynamics of a healthcare environment.
Early results from the program show measurable reductions in violent incidents in a number of pilot wards, with both staff and patients reporting an improvement in how safe they feel. The success of this has led to trials at other Queensland hospitals and interest from healthcare systems across Australia.
Overall, the program's effectiveness stems from its focus on early intervention and positive engagement rather than waiting for the situation to escalate and the need for a physical altercation. Ambassadors of the program work to identify potential conflict situations early on and address underlying concerns before violent situations arise.
The Importance of Incident Reporting
Preventing violence in an effective way depends, for the most part, on comprehensive incident reporting that captures all forms of violent behaviour, not just physical assaults that result in visible injuries. It’s unfortunate therefore that Queensland healthcare workers often face barriers to reporting, including bureaucratic processes, fear of blame, and the misconception that violence is simply part and parcel of what they do.
Under Australian work health and safety legislation, regulators must be informed of serious injuries. Recent amendments have expanded these requirements to include violent incidents that expose workers to serious psychological risks, even when physical injuries are minor or absent.
The timing of these reports proves crucial for both the support that workers will receive, as well as legal compliance. While workers generally have 20 days to report workplace accidents, the psychological effects of violence can take time to appear. For this reason, reporting systems need to allow for delayed recognition of these conditions.
Healthcare organisations must implement user-friendly reporting systems linked to immediate support services for those workers who’ve been affected. This includes access to medical treatment, psychological support, and appropriate adjustments to the working environment during recovery periods.
Workers' Compensation: Understanding Your Rights
Healthcare professionals are covered under Queensland’s worker’s compensation system. This includes both the physical and psychological trauma which can follow experiencing violence at work.
Under the Workers' Compensation and Rehabilitation Act 2003, healthcare workers can claim compensation for injuries in situations where work was a significant contributing factor. It’s important to note that Queensland operates a no-fault system, meaning workers don't need to prove who was responsible in order to receive compensation.
The claims process follows a structured pathway which begins by seeking medical treatment from qualified practitioners. Healthcare workers must give detailed information about the incident and its effects to the doctors treating their injury. These doctors can then issue work capacity certificates showing whether the worker can do their usual duties and recommending adjustments or time off if needed.
Psychological injury claims make up a significant portion of violence-related claims. These claims must satisfy the same criteria as physical injuries, demonstrating that the job itself was a significant contributing factor. On the other hand, claims for psychological injury can face additional scrutiny and be rejected if it is shown that the actions which led to the injury were justified, known as reasonable management actions, or if workers have less than six months' employment.
Learn more about injury compensation for healthcare workers in Queensland.
Creating Safer Healthcare Environments
The path forward requires a coordinated effort across different areas. First off, environmental modifications play a crucial role, including improved lighting, controlled access points, secure staff areas, and panic button systems. However, these physical changes must be combined with comprehensive staff training in violence recognition, de-escalation techniques, and appropriate response protocols.
Having the right amount of staff seems essential for violence prevention, as understaffing and the obvious delays which result from this create conditions that negatively impact the levels of frustration and aggression which patients feel. Healthcare organisations must also address the cultural normalisation of violence by implementing zero-tolerance policies backed by clear consequences, all the time being as consistent with this as possible.
Looking forward, technology offers new opportunities for violence prevention, from AI-powered risk assessment systems that identify causes of violence to body cameras that provide evidence for investigations and prosecutions. It’s worth noting, however, that technology must complement, not replace, human-centred approaches that address the underlying causes of healthcare violence.
The Human Cost of Inaction
Behind every statistic lies a story. In this case, it is a healthcare professional who has seen their lives turned upside down because of an act of, possibly preventable, workplace violence. The impacts extend way beyond individual workers and end up affecting entire healthcare teams and ultimately, the quality of patient care.
If left unaltered, healthcare workers often feel unsupported, especially when violence is seen as just part of the job instead of a serious risk that needs proper action. This attitude fuels staff burnout, turnover, and recruitment challenges, worsening the workforce crisis. The financial toll is also high, with millions spent each year on compensation claims, not to mention the wider impacts on productivity, staff morale, and the day-to-day functioning of healthcare organisations.
Moving Forward: A Shared Responsibility
To put it plainly, creating safer healthcare environments requires action from all sides. Organisations must move beyond reactive measures to adopt prevention programs, like the Ambassador program, that address environmental, organisational, and cultural factors, backed by government funding, staff training, mental health support, and stronger legal protections.
Finally, it’s also worth bearing in mind how workers help in this process by reporting incidents, joining training, and supporting colleagues, while professional associations continue to push for safer workplaces. Violence in healthcare cannot and should not be treated as something unstoppable. As initiatives within the Queensland health system show, effective prevention is possible with commitment and evidence-based strategies. The real question is whether we have the will to make hospitals safe places to work again.
