Addressing Aggression & Violence: The Need for Good Leadership

While Health and Social Care remains one of the most rewarding careers that anyone can undertake, it is a sad fact that statistics tell us that health care professionals are among those most likely to experience violence and aggression within their working lives.

Many commentators have opined that this may be a natural extension of the increasing culture of complaints within our public services, with people feeling that they have the right to threaten and use force if they are not being granted what they feel they are entitled to. A case may also be made that health care workers are viewed by some as being soft targets, who cannot take punitive action and who are unlikely to seek redress. While these viewpoints are somewhat cynical, they undoubtedly have some merits. We also need to consider, however, that the very nature of a healthcare need means that the healthcare worker is dealing with people who are under major stress that has probably arisen unexpectedly, which can cause any of us to feel angry and aggressive. This includes family members, who can feel helpless and out of control.

Whatever the reasons, aggression and violence are increasingly becoming a part of the healthcare landscape. This is causing a number of challenges for senior managers and leaders of services, presenting dilemmas such as staff training versus budget cuts versus possible litigation if staff are not properly prepared. There may also be the possibility of managers being seen to deal transparently with complaints from a service-user, with the danger that staff may feel unsupported or even blamed for incidents when they are investigated.  We can also add into the management mix the time that has to be spent reacting to incidents when they occur, such as report writing and investigation.

The challenges for leaders are therefore complex, and cannot be answered within one short article. Given the emotive and time-consuming nature of dealing with the aftermath of incidents, however, a case can be made for managers adopting a cardinal rule of dealing with aggression itself – that preventative strategies are the most desirable. If we adopt this as a mantra, then the following measures may well serve as a guide to management practice:

Prioritisation as part of a general Health and Safety Culture: Amid publicity about hospital-acquired infections and litigation over slips, trips and falls, which may lead to prioritisation of infection control and accident prevention regimes, it may be all too easy for managers to give violence and aggression a low priority. Simple actions such as robust lone-working policies, or ensuring that staff have personal alarms and/or the means of escape from areas where aggression may be likely, can work wonders in terms of reducing incidents and ensuring staff feel that leadership is sensitive to their safety needs

Staff Training:  

There are a number of training courses which traditionally are considered mandatory, such as Manual Handling and Infection Control, but a strong case can be made for equipping staff with the skills of preventing, de-escalating and managing aggression through to physical restraint training. This may well seem like an avoidable expense – but when set against the cost of staff sickness resulting from violence, and possible litigation, this is undoubtedly money well spent.

Simplified Reporting:

Management cannot act on incidents if they do not know about them, and research tells us that many incidents go unreported, either because staff feel they do not have time to report, or because staff feel that tolerance of aggression is part of their job. Simplified electronic reporting, coupled with the importance of using these systems, will encourage staff to report each incident – which in turn allows managers to correctly identify trends and target resources accordingly


“No blame” Investigation:  

In order to gain accurate information and take appropriate action to help prevent future incidents, staff need to be able to honestly reflect on what has happened. An empathic approach on the part of investigators. which is clearly aimed at benefiting the entire service in future, is far more likely to elicit the necessary information than one which is perfunctory and blame-orientated.

Article provided by Securicare who specialise in behaviour training and online care certificate.

About Sandra Nelson