Nick Howson was left in a “heap on the floor” after being assaulted at work and suffering a rib fracture in April.
In most other workplaces, the police would be called and a full investigation conducted.
At Mr Howson’s workplace, it barely raised an eyebrow.
Australian nurses are being assaulted at unprecedented rates, in what experts are saying is the result of cost of living pressures and a lack of consequences.
A damning report released by industry union the NSW Nurses and Midwives’ Association (NSWNMA) in March revealed that almost one in five nurses have been threatened with a weapon, while almost half have been either punched, slapped or kicked.
The percentage of nurses, midwives and carers who have experienced violence in their job has risen from 80 per cent to 88 per cent in just six years, with nurses saying the abuse is pushing people out of the job.
Mr Howson, who is also a union delegate, works in the mental health unit at Cumberland Hospital where assaults are a regular occurrence, saying he was back at work “a couple of days” after receiving the rib fracture.
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He said the assault came after a drug-affected patient believed he and a colleague were talking about him.
Before even having a chance to de-escalate the situation, the patient threw a punch at Mr Howson.
He was asked whether he wanted the police called, but decided against it.
“I ummed and aahed about whether I should. The gentleman was very, very unwell. I sort of looked at it … and just thought it was just a rib fracture. It wasn’t broken,” Mr Howson said.
“I had a couple of days off but thought, well, there is nothing you can really do about it. So I’ll just go back to work.”
Nurses treated like punching bags
It’s not the first time Mr Howson has been punched at work – and he said it won’t be the last.
He has also been bitten, and even ended up in hospital for spinal precautions six months into the job in 2018 after a patient threw him over a wall by his throat.
Mr Howson’s biggest issue is the “dismissive” attitude from NSW Health, who he said are approaching the issue in the “wrong way”.
The NSW union’s survey revealed that 68 per cent of nurses had experienced violence and didn’t report it – believing that it would result in zero consequences or prevention in the future.
“It’s very reminiscent of the old sort of old-fashioned views around women, well, if you dress that way, it is naturally going to happen, you invited it,” he said.
“We don’t invite violence and aggression by being healthcare workers. We should be trying to minimise the opportunities and the reasons behind that aggression, not just hand-wave it away.”
He said even in his area, the local police command had pushed back against nurses reporting violence as it would increase their workload.
“Nobody except other people who work in the profession realises how prevalent it is,” he said.
“And that someone gets aggressive, you do what you need to do, and then you go next door and suddenly you’re talking to the nana who’s vomiting in a bag, and you’ve got to switch between these modes.
“People just don’t realise because it happens behind closed doors.”
Hornsby Hospital nurse and union member Ellie Peach told news.com.au she believed a nurse will have to be killed for real change to be implemented.
“I think someone is going to die,” she said.
“We’ve already had the paramedic that sadly passed away, and I think someone else is going to die, and that’s what it will take for things to change.”
Just last week, Ms Peach said she was called a “filthy sl*t” by a patient, had been spat on and has experienced recurring nightmares about being choked in triage.
“I get sworn at every day,” she said.
“Yes, you get resilient, but resilience can only be pulled so far before the string breaks.”
Union boss furious over ‘disconnect’
NSW nurses union boss Michael Whaites said a huge attitude shift is needed when it comes to violence against nurses.
He said there is now an expectation that nurses will just cop abuse from the public as part of their jobs.
“There is a massive disconnect between the way the nursing and midwifery workforce is treated,” he said.
“You’ve got a system where they’re dealing with one traumatic event after another … That can’t go on. There’s got to be a break.”
In May, the NSW Government announced it would be bringing in one to four ratios for emergency departments, medical surgical wards and post-natal wards, but Mr Whaites said ratios need to be brought in more broadly – particularly in aged care.
Earlier this month, the state government also introduced a taskforce to advise on ways to enhance safety across the NSW public health system, and also ensured security staff have the authority to direct and escort individuals from hospital premises.
Mr Whaites fears it will do little to give nurses the support they need to speak up when violence occurs.
“We know that there is a zero tolerance for violence, but actually that needs to be enacted,” he said.
Separate EDs reduce code blacks
One measure being experimented with in hospitals across Australia is the introduction of separate wards for patients with behavioural issues.
The “Safe Assessment Rooms” or “PANDA Units” (Psychiatric, Alcohol and Non-prescription Drug Assessment) have been found to reduce code blacks – a threat to the personal safety of a healthcare worker – by up to 50 per cent.
St Vincent’s Hospital in Sydney was the first to trial the PANDA system in 2020, with Prince of Wales Hospital and Nepean Hospital following suit.
Construction of a similar unit has been announced for Westmead Hospital and is set to be completed in early 2027.
The solution
Australia is facing a shortfall of more than 70,000 nurses by 2035, as healthcare staff continue to walk away from their jobs.
News.com.au has compiled a list of possible solutions – directly from the nurses themselves – to how we can improve their working conditions.
Right now, each state and territory has its own EBA, meaning nurses in some states are being paid less than others.
It means as pay rates change, many nurses move interstate for better pay or conditions.
Nurses are calling for improved equal pay across the board, as well as free parking for healthcare workers at their own hospitals.
Staff are also calling for mandated 1:4 national ratios across all wards and aged care facilities, which includes a mixed skill element.
Right now, most states have 1:4 ratios in hospitals during morning shifts. However, often just one senior nurse is left with three inexperienced nurses, putting pressure on the system as a whole.
Nurses are also calling for better mental health support, given the increasing rates of abuse they are facing, and are seeking fully subsidised private therapy sessions as a result.
Governments say they are addressing crisis
In response to news.com.au’s series into the nursing crisis, the federal government responded by saying they had recently developed a “National Nursing Workforce Strategy” which had demonstrated “the Government’s commitment to supporting and strengthening the nursing workforce”.
The strategy includes the development of leadership and anti-racism programs, as well as initivatives to grow the Aboriginal and Torres Strait Islander nursing workforce.
“A key focus is growing and retaining the nursing workforce Australia needs now and into the future. It includes actions to support career development, leadership, workplace wellbeing and flexible career pathways, helping more nurses stay in the profession,” a spokesperson for the Department of Health, Disability and Ageing told news.com.au.
A spokesperson for NSW Health said the state government had worked to increase the nursing workforce by more than 10 per cent between June 2023 and June 2026.
“NSW Health recognises and is deeply thankful for the outstanding commitment of our
dedicated and skilled nurses who provide high-quality, safe and compassionate care
to the people of NSW every day,” the spokesperson said.
Get in touch with our investigative reporter. Sarah.Keoghan@news.com.au