THEY have been kicked, punched, head-butted and spat on but Hunter hospital staff say most physical assaults go unreported due to an onerous reporting system and a lingering sentiment that it is "all part of the job".
There were 476 assaults on hospital staff between March 2016 and March 2020, data obtained under Government Access to Information (GIPA) legislation shows.
The number of reported assaults at John Hunter, Calvary Mater, Maitland and Belmont hospitals rose from 101 in the 2016-17 financial year to 131 in 2018-19.
But members of the Health Services Union (HSU) and the NSW Nurses and Midwives Association have said the numbers are not a true reflection of the problem, with "under-reporting" an ongoing issue.
"With the reporting system management has in place, I'd be generous in saying that at least 50 per cent of the assaults don't get reported," Boyd Hanson, president of the Greater Newcastle Sector Security Officers Sub Branch (GNSSOSB), said.
"You have to have the time to sit down and put the reports in. The system they use, the IIMS system [Incident Information Management System], is as difficult as possible. If they wanted every single thing reported, it would be easier to use.
"But even if you actually have a spare 45 minutes to do it, and then you get called away to another job, it shuts down and you have to start all over again."
Going home "a bit stiff and sore" with bruises, scratches, and bite marks were "par for the course".
"Serious assaults that result in injuries or a broken bone would be recorded, but the daily occurrences? Not really," Mr Hanson said.
The Newcastle Herald requested access to the number of assaults on staff at the John Hunter Hospital, Calvary Mater Newcastle, Belmont and Maitland hospitals by date and facility between March 1, 2016, and March 30, 2020, via a GIPA request to Hunter New England Health.
The request was made as part of the Herald's "Your Right to Know" campaign.
The district's Right To Information officer, Jennifer Hutchings, decided to withhold access to the identified IIMS report containing the information requested on privacy and confidentiality grounds, but created a document that "partially" responded to the application by releasing the number of assaults at each facility by financial year.
Ms Hutchings accepted the information sought was in the public interest, but considered the Newcastle Herald's motives for making the access application to be a "weak" reason to disclose the information.
"You have identified yourself as a journalist and indicated the information is of public interest. I consider this a weak consideration in favour of disclosure," Ms Hutchings said in the decision.
Mr Hanson said as president of the GNSSOSB, he had never been granted full access to former NSW Police and Health Minister Peter Anderson's interim report into the safety of staff, patients and visitors in NSW public hospitals - only snippets.
But the sub branch, part of the HSU, had been fighting for more security at the Hunter's hospitals for eight years.
"We get called to aggressive incidents all the time, you're lucky to go a single shift where you don't get called to what's called a code black or a duress where there is aggression involved," he said. "We get everything from verbal to physical assault.
"We have had nurses being punched. And ourselves. We get kicked and punched all the time. We had someone threatening to stab us.
"But the hoops you have to jump through if you do put it all down is not worth all the crap. I got kicked pretty hard when dealing with a young mental health patient, and so did the guy who was with me that day, but we didn't report it because we see it as part of our role and because - while we were a bit stiff and sore, we weren't injured.
"Unless you get a broken bone or something, you're not really going to report it."
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Another security guard at one of the region's hospitals told the Herald that verbal abuse was "water off a duck's back" now.
"You get conditioned to that," he said. "But I've been elbowed in the head, I've been kicked, I've been spat on.
"Spitting is the worst, I think. A kick in the crown jewels - I've copped a couple of those too.
"You get some big blokes in there - hyped up on whatever they are on, and I tell you what, you do get edgy.
"Big blokes, six foot four and four pick handles wide, who are on something, and it takes a lot to stop them."
Mr Hanson said at a campus the size of John Hunter Hospital, there should be a minimum of eight permanent full time security officers on the floor.
He said most days and nights the site has between four and five security officers on shift - one of which, a senior security guard, is supposed to stay in the office to monitor alarms.
There were times security could not escort staff safely to their cars after a late shift.
Mr Hanson said management included "health and security assistants" in security officer numbers at Belmont and John Hunter hospitals - but these roles were essentially wards-men who stepped in to help until security arrived, if they weren't busy with their other duties.
"We're supposed to go in twos, but you do have situations where there is more than one incident going on," he said. "If you have three at the same time, you've got no one, and it does happen.
"I'm not saying there aren't shifts occasionally where you don't have any incidents. But those are rare."
Mr Hanson said "throwing numbers" at the problem may not resolve the issue, but it would certainly help security officers better protect staff, patients and each other.
"We've had patients that look seven kilos wringing wet, and we have had police officers, male nurses and security guards struggling to hold them down. We have had nights where we go from one incident to the next to the next. Then you'll have periods where we are more quiet. But you have to look at it from a worst case scenario."
Gerard Hayes, secretary of HSU NSW, said union members across the Hunter's hospitals were sick of being treated like "punching bags".
"The cuts and bruises are one thing, but violence in hospitals can also leave profound psychological scars," he said. "Hunter New England Health has a moral and legal responsibility to provide a safe workplace."
Brett Holmes, the general secretary of the NSW Nurses and Midwives Association, said the current reporting systems for assaults on staff were "inadequate" and could be manipulated.
"It has prompted a culture of under-reporting of violent incidents or aggressive behaviour," he said.
Mr Holmes said they had received reports of serious physical violence towards nurses in the Hunter - including head-butting, kicking and spitting, together with verbal abuse and death threats.
They'd had nurses suffering back and head injuries after being pushed into walls or doors by patients.
"One nurse was punched in the stomach by a patient, while her colleague was kicked in the chest. Other nurses have suffered injuries to arms and elbows after being physically threatened."
Mr Holmes said "substantial improvements" must be introduced to ensure no one felt unsafe in the workplace.
Karen Kelly, Hunter New England Health's executive director of metropolitan health services, said they had a zero tolerance policy to violence.
"Our hospitals have strategies in place to manage patients who become threatening, agitated or aggressive," she said. "Our focus, as a health service, is to support our frontline staff to deliver care in a safe workplace."
Ms Kelly said all staff completed "security awareness training" during their orientation, and additional training was provided to frontline workers to give them the skills to recognise and de-escalate threatening situations.
"Emergency department (ED) and mental health staff are also provided with specialised training," she said. "Secure access to clinical areas is maintained via swipe card access. Our security staff use closed circuit television systems in public areas at our major hospitals to monitor patient and visitor activity."
Ms Kelly said all ED staff wore personal duress alarms, and there were fixed alarms in each department.
"Staff have the support of our on-site security staff who respond immediately to incidents," she said. "We expect all staff to report verbal, and physical assaults and threats. Staff have the support of their managers to use the formal state-wide reporting system, which allows us to track and manage incidents. The system is due to be upgraded to a more user-friendly system later this year, which will make reporting of all incidents easier.
"It is important managers know of incidents, manage them effectively, and, most importantly, support the staff involved. The data collected from the reporting systems is also used in forward planning for security."
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