Key points

• Australasian College for Emergency Medicine is calling for specalist security staff to be stationed in all emergency departments across Victoria amid rising violence and aggression.
• Emergency department staff are treating people with higher levels of psychological distress and a complexity and severity of illness never seen before the pandemic.
• Rising incidents of physical and verbal abuse are being fuelled by elevated drug and alcohol use. Other sick Victorians and their carers, who are frustrated by record-long waiting times, are also lashing out at staff.

Australia’s top emergency medicine college is pushing for around-the-clock specialist security guards to be stationed at every Victorian emergency department, as doctors warn of unprecedented levels of violence in hospitals.

Australasian College for Emergency Medicine national president Clare Skinner said staff reported escalating levels of violence in every emergency department across the state, where security remained variable and particularly patchy in smaller hospitals and regional health services.

Australia’s top emergency medicine college is pushing for specially trained security guards to be rolled out at every Victorian emergency department, 24-hours a day.Credit:Damian Shaw

Skinner said rising incidents of abuse were partly fuelled by elevated drug and alcohol use. Other sick Victorians and their carers, frustrated due to record long waiting times in EDs, were also lashing out at staff.

“The vast majority of patients and their carers are lovely, but increasingly we are seeing people affected by drugs and alcohol, or who arrive in ED understandably very distressed, and they become very frustrated when they’re unable to access care in a timely way,” she said.

Australian College of Emergency Medicine federal president Clare Skinner wants a new commission to overhaul Australia’s healthcare.

Emergency department staff are treating people with higher levels of psychological distress, and a complexity and severity of illness never seen before the pandemic, with some facing protracted delays in seeing a general practitioner, she said.

Doctors have said soaring numbers of people in the grips of mental health crises risk becoming distressed after spending days in stressful emergency departments waiting for a hospital bed.

In response, the medical college is demanding a pre-election promise from the state government and opposition, to fund 1000 fully staffed ED-accessible beds amid record demand for hospital admissions.

Skinner said security guards should be informed about trauma, employed directly by the hospital, and trained in de-escalating violent situations that arise in emergency departments in a way that is “not about enforcement and sensitive to the needs of the patient”.

Emergency doctor Stephen Parnis said he could not a recall a time when rates of aggression and violence had been higher. He told his 25,000 Twitter followers on Friday of the “roars and rage” echoing through the walls during his emergency shift at a major Melbourne hospital as distressed and violent patients arrived by ambulance.

“My sense is that violence and aggression in emergency departments are at levels that none of us have ever seen before,” the physician said.

Emergency doctor Stephen Parnis.Credit:Eddie Jim

“There are many people in great despair. What we are finding more and more is that people end up in emergency departments because they haven’t been able to get access to healthcare elsewhere, and it’s the only place where they can go.”

While Parnis welcomed the push by the emergency medicine college, he called for more help for Victorians with a disability, who were often stuck in hospital for more than 100 days after they were well enough to be discharged due to delays with the National Disability Insurance Scheme. Elderly patients are also spending longer than necessary in hospital because they struggle to find beds in aged care homes, he said.

Ahead of the November state election, the emergency medicine college is also pushing for extra non-clinical staff such as patient support assistants to help patients with tasks such as going to the bathroom, that do not require clinical training.

They also want a 20 per cent increase in full-time inpatient specialist and allied health support workers in the public hospital system, to ensure access to services seven days per week and outside business hours including ED-based social workers.

“We are seeing a perfect storm of lack of capacity, huge demand, overcrowding, understaffing,” Skinner said. “Healthcare workers are feeling the effects of burnout and moral injury and we need to urgently turn this around so we have a system that is fair and safe for Victorians if they need it.”

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