Personal safety and the abuse of staff in a Scottish NHS Trust.
BACKGROUND: An employer's 'duty of care' is enshrined in statute and common law. This responsibility extends to identifying areas of risk to employee's safety and emotional well being. OBJECTIVE: To identify the views of NHS staff on their safety and exposure to assault and other forms of abuse. DESIGN: A survey by questionnaire and semi-structured interview of the staff of an NHS Trust. SETTING: A large Scottish NHS Trust. SUBJECTS: All 5365 staff of the Trust. RESULTS: Two thousand two hundred and ninety four (43%) employees contributed to this survey. With regard to exposure to hazardous substances and serious infection, most staff were satisfied with safety standards and guidelines. Over a 12 month period 23% of the workforce had been assaulted, mainly by patients and 63% had experienced verbal abuse, again, mainly from patients. There were differences among occupational groups but overall 16% had been bullied; 18% had suffered discrimination; 22% had experienced harassment, and 13% had been victimized. Only 42% of individuals reported their most distressing incidents; 56% of them regarded the outcome of their reports as satisfactory. CONCLUSIONS: Staff are generally satisfied with the steps taken to safeguard them against hazardous substances and serious infection. Assault by and abuse from patients is a considerable risk, especially for trained nurses. In terms of bullying, harassment, discrimination and victimization, the abuse of power by colleagues is also a distressing and under-reported phenomenon which needs to be addressed by regular audit and the creation of a climate in which employees feel secure enough to report such abuse and to have faith in the mechanisms set up to deal with such complaints.