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June 16, 2004

Zero Tolerance for Violence in Hospitals

Posted by Michael Mosbacher

Increased Violence in Hospitals -
Doctor calls for Zero Tolerance Policy

84,273 incidents of violence or abusive behaviour by patients within the NHS were reported for 2000/2001. Many more go unreported. And there are even more incidents of disorder and incivility. In a report, Violence, Disorder and Incivility in British Hospitals: The Case for Zero Tolerance, published by the Social Affairs Unit, experienced hospital doctor Theodore Dalrymple shows that it is tolerance of the 'minor' incidents of incivility which leads to the increase in violence towards doctors and nurses. He calls for zero tolerance toward such incivility.

He describes loutish patients dropping litter in wards, having the TV on at full blast regardless of other patients' wants, shouting into mobile phones in busy wards and taking calls during consultations. They use emergency ambulances as a taxi service – one man calling for the ambulance 150 times in one year - with impunity and all but have sex with their visiting partners in multi-person wards. Doctors, nurses, and patients who object to such behaviour are subject to further verbal abuse, or worse.

20 years ago doctors and nurses only had to deal with occasional minor abuse by drunken patients in Accident and Emergency; today hospitals have trained security guards and even police stations on site. While the 'great majority [of patients] are… perfectly reasonable', a troublesome minority is growing. Most hospital patients are middle-aged or elderly; the disruptive minority is young. The behaviour of this minority of patients makes hospitals unpleasant places for both those who work in them and, perhaps more importantly, for the vulnerable and often elderly sick. 'Muggers do not have to be … a very large proportion of the population to have a profound and adverse effect upon the atmosphere of a neighbourhood and upon the quality of life of everyone who lives in it.' The same is true of incivility in hospitals.

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