Nurses call for increased security after assault on patient in emergency department

The Nurses Organisation is calling for increased security presence in emergency departments as wait times grow, following a brazen assault of a patient in North Shore Hospital's ED.

A woman who was brought to North Shore Hospital by ambulance was punched in the face by another patient, as they waited to get into the overcrowded emergency department.

The assault is understood to have happened on Tuesday night, after the man was brought to the hospital by police officers who then left.

The man also threw things around and abused a nurse, before punching the patient, knocking her to the ground.

North Shore Hospital said security guards were on-site within a minute of the patient being assaulted in the ambulance bay on Tuesday night.

The assault has highlighted what nurses say is an increasing risk of violence in emergency departments.

College of Emergency Nurses and the Nurses Organisation spokesperson Sue Stebbings told Morning Report an increased security presence is needed in emergency departments as wait times grew.

"We're very concerned about the safety at work, there are escalating risks and the increase in factors that we know can trigger these incidents are happening with the increased waiting time, overcrowding and not enough staff to provide the care that we want to," Stebbings said.

Individual emergency departments had their own security arrangements but they would all likely be reviewing their approaches following the violent incident at North Shore Hospital, she said.

"We can't take it away completely but we can certainly reduce it and a particular concern is the safety of the other people wanting care, that's one of the more distressing things we accept that we can be trained to keep ourselves safe but keeping other people safe is a huge concern."

Along with reducing waiting times, having appropriate security presence and escalation plans in place in emergency departments could aid hospital's in reducing the risk of similar incidents occurring, Stebbings said.

The physical design of emergency departments played a big role in factors that can trigger unrest, she said.

"Security guards can't be everywhere all the time and I guess it depends on the physical design of each department, certainly arrival and where people are waiting is an important area.

"Sometimes cameras or just looking at the layout so there's easy access [and] places aren't crowded, unfortunately with the crowding, spaces in the department are being used that aren't fit for purpose."

Stebbings said she was aware that security presence was being increased in EDs around the country.

North Shore Hospital said it was making changes in order to improve staffing levels, amid concerns about safety and overcrowding.

Hospital manager of emergency and acute medicine Brett Paradine said he would meet with staff this week to discuss improvements.

But he said such incidents did happen.

"Emergency departments can be really challenging environments, our patients are sometimes cognitively impaired, impacted by some form of substance or alcohol abuse or coping with the initial impact of an acute injury that can affect their judgement or and the way they behave," he said.

Paradine said the hospital was about to trial adding two staff members after hours to help ease pressure.