Coping with violence.......

What's the job?

Forensic mental health.

Lack of staffing is increasing the risk massively.

I can turn off as soon as I get home, not affecting home life, but I'm having nightmares and dread being shifted onto certain wards.

Employer has a duty of care to their employees.

You have a duty of care to yourself.

If the former isn't happening then exercise the latter. Easy to say but you get my point, sounds like you're already thinking that way if you're asking the question.

That would be unsustainable for most people and it sounds like you're at your limit. Personally I couldn't consider a job that came with a real and ongoing threat of violence.  Hats off to all those who have to deal with this reality.

No shame in admitting it to yourself and others. You've been tough enough to deal with it this long and everyone has their limit.

Once?

Not sure your age, but guessing by general STW demographic probably 40s or 50s, so you're definitely not getting any younger. Nightmares and dread sounds like the edge (if not more) of effecting home life. No experience of dealing with that sort of difficult situation myself, I wouldn't ever have wanted to do it, certainly not approaching end of my 40s.

It's never bothered me before, in 30 years of care work.

I've always cared more about the emotional distress suffered by the patient than the potential harm they could inflict on staff.

Some questions

- can you get out into another 'branch' / division/ department of the sort of stuff you do or could readily transfer over to doing  (but where there isn't the violence) ? (Apologies thst ai don't know much about what you do and the 'set ups').

- can you financially cope if you left ?

- would a break for a while help ? It sounds pretty stressful, maybe can you talk to your own GP and get signed off for a period?  (I've seen my other  half get to the absolute end of her tether and stressed to the limit in her past job - as a teacher - one look at her from the GP and she was signed off for months. Slowly returning helped (though eventually she did also get out completely, for her own good and went back to something unrelated that she did 25 years ago).  Even thst just buys time to come up with Plan B without having to jump at the 1st job.

When stress builds from something like this, it takes a long time to 'decompress' - because it also takes along time to reach the point of needing to do something about it in the first place.

Best wishes

If you need to ask the question then its too much.

I couldn't do what you do

Massive respect

but also massive respect if you recognise you are at the point where you know it's time to go.

My wife and I have had to deal with varying degrees of violence directed at us from our daughter, but that is justifiable (to us) due to her ASD and learning disability and the fact she's our daughter. It's also offset by experiences filled with fun and joy.

I don't think I could be a carer as a job, or in any profession where I'd be subject to frequent acts of violence.

As I said on another thread recently all who hold positions of care for people suffering mental health conditions, mental illness or developmental conditions with challenging behaviour do an invaluable job..... but its often an undervalued, underpaid job in environments lacking the correct resources.

Staff turn over has always been high in the care homes we've had experience of. I've seen many really good people leave because they got to breaking point.

I'm after clarification here. Violence from whom? I'm assuming that you mean from your clients/ patients/ residents (I'm genuinely unsure of the correct term to use) towards yourself.

As burntembers says, there’s no way on this earth I could do what you do, or anything in caring, mental health, anything like that, I couldn’t deal with it, so my respect for those who can and do knows no limits.

I think, as others have said, that you know the answer, but it’s phrasing it to yourself in a way that gives you the question you need to justify that answer.

If that makes sense? Sorry, I know what I want to say, it’s difficult to know exactly how to put it.

I think high stress jobs like that have a finite life.

Once you've had your quota of stress thats it.

Can you move to a different role at all?

but I’m having nightmares and dread being shifted onto certain wards.

This is quite a serious problem IMO as this kind of stress can have long term impacts on your own mental and physical health. Some people deal with it better than others but also some people think they can deal with it until they can't, by which time the damage may already be done. My advice would be to speak to your GP ASAP. As others have said getting signed off for a while may give you time to evaluate and come up with a plan B.

You have my respect and admiration, I could not do your job. I really hope it works out for you.

95% of people i work with are ex-clinicians that reached a point in their career for one reason or another that they wanted a change.

If you have any kind of clinical experience it's highly likely you can transition into a really valuable role outside of direct patient contact.

As others have said, generally if you’re asking the question then you’ve had enough.

Step back for a moment, and work out what your red lines are with regard to your work.

For me it was when what was happening at work was stopping me from enjoying my life outside work.

As a GP, it sounds to me as if you’d benefit from some time off work and some counselling to work out what your way forward is.

As a service provider you're probably averse to using the service but from the sound of things you need to get a care plan for you in place. You have logged each assault formally and in your own diary? Own diary should also log your nightmares and dread episodes.

From reading but no experience this goes a lot like PTSD accounts. Sort your care or get out before you can no longer bend and break into pieces.

Hope you can get the help and support that you need.

Violence was a career so I'm well acquainted with the impact of that and from painful experience my advice would be get the **** out my dude.

Each traumatic event is a rock added to our shoulders, eventually the weight will prove too great.

Sounds like you're feeling that weight, time to drop the bag and find something less burdensome my dude.

Get yourself a base of support to work through it because moving in a different direction will stor up some emotions and thoughts that will be uncomfortable but will need facing down.

You've been selfless in helping others who couldn't help themselves find a way to manage their challenges, now it's time for self-care and focussing on what you need.

Time to call it a day?

Probably. I think it comes to a point where you can rightly say, "That's enough now, some-one else can do this shit" By all means speak with your bosses, but leave them in no doubt about how you feel, and that you're looking to change roles

I'd get yourself signed off for a bit (Yes, I know, but you're not letting anyone down, they'll all understand) and get some help.

I think you do an incredible job, but I think all caring roles take their toll and eventually you need to step back. Under resourcing means that point is probably being reached sooner than it would with proper staffing and support.

You need to be reporting all these incidents as your employer owes that duty of care to your current and future colleagues.

You may feel that its not affecting your home life but you may not realise it does. MrsMC spent 25 years at the pointy end of child protection, going alone into homes where violence, substance abuse and neglect were the norm. To my knowledge, she was never attacked, but social workers are and *very* rarely they are killed. I was so relieved when she stepped back to work adoption, your family will feel the same.

having nightmares and dread being shifted onto certain wards.

PTSD here.

That’s not really coping that’s displaying symptoms. Ime the change from nightmares to worse can be quite sudden and preventing that should be a priority for you and your employer and then dealing with the damage already caused. Life is too short to get fubar’ed by work if it can be avoided .

I think understaffing in the NHS in patient-facing roles is a massive contributor to this.

I hope that with a change of government will lead to an increase in funding and associated increases in staffing.

Hi Pete - sorry to hear, what do your managers say? if they aren't aware of the disturbed sleep then you definitely should check back in and let them know that and of the problem wards (I bet they already know which they are but  probably stuck with the lack of resources if the rest of the NHS is anything to go by)

What’s the job?

I assumed you were going to say professional boxer!!

When is it enough?

as has been mentioned already…once…

You can only step up to be a punchbag because of inadequate staffing for so long. If management are just shrugging about their duty of care to you, then it's probably time to start prioritising your mental health.

I mean, getting attacked virtually every day? Not many people could manage that on a long-term basis, and I'm guessing the pay is not great either.

Step 1 find another role

Step 2 remember all the valuable service you have given. Focus on the good you did and the years you have given. Don’t look at the end as a negative

I’d get yourself signed off for a bit (Yes, I know, but you’re not letting anyone down, they’ll all understand) and get some help.

Sounds to me like to need to get signed off asap. As youve described your situation, i wouldnt worry about cost or implication to your employer at all.
If the people responsible for aquiring and keeping staff are going to under resource and over stress the staff they have got, then they need to accept that they are going to burn those staff out. Better resourcing and staffing may cost money in the moment, but it would reduce downtime and increase retention.
Operations like that are propped up the people willing to put up with the most crap.

I guess it all boils down to Tories wanting to destroy the health sector again.

Sounds to me like youve served far beyond your tour of duty. Get out and get a chilled out job in a bike shop or something, before it finishes you off.

I am surprised that TJ hasn't spoken up on this thread yet, as I believe he worked in NHS Mental Health ?

I would certainly be speaking to occupational health, and potentially looking at taking some time out if nothing else to take stock out of the environment as it will be impossible to think clearly going in to work each day

It seems it is happening in a lot of health sectors, my wife is a radiotherapist specialising in breast cancer. She has been physically slapped this week, and have had to "red card" two patients this week, literally refusing to treat one due to the abuse. She hasn't known a week like it in 20 years

Chhers folks, much appreciated.

You've helped to clarify my thoughts.

I've started looking for other positions today!

I’m after clarification here. Violence from whom? I’m assuming that you mean from your clients/ patients/ residents (I’m genuinely unsure of the correct term to use) towards yourself.

It's usually having to restrain very ill people who wish to harm themselves or others.
Obviously, they don't want to be restrained, hence the conflict.

My home ward is usually very peaceful, but lack of staff means we are often called to assist on other, 'bouncier' wards.
It never used to be like this.
Time for a change I think.

edhornby
Full Member
Hi Pete – sorry to hear, what do your managers say? if they aren’t aware of the disturbed sleep then you definitely should check back in and let them know that and of the problem wards (I bet they already know which they are but probably stuck with the lack of resources if the rest of the NHS is anything to go by

Cheers Ed.
It's a hospital wide issue.
Everyone in a patient facing role is in the same boat, in fact most have it harder than me. Looking like everyone's grandad has it's advantages, people usually want to talk to me rather than hit me!
Unfortunately, we have several extremely unwell patients at the mo, who can tie up resources for days on end.

My home ward is usually very peaceful, but lack of staff means we are often called to assist on other, ‘bouncier’ wards.

I know this might not sit well in terms of impact on colleagues, and I fully hear that as most trust are, staff are being asked to support on wards they normally would not be on.

Do you dislike your 'normal' job on the better ward? If not I would certainly be speaking to your manager and occupational health. If the manager is at all savvy they will realise that it is better to have 1 strong skilled person on a ward, rather than having to find 2 new people.

I am surprised that TJ hasn’t spoken up on this thread yet, as I believe he worked in NHS Mental Health ?

Pallitive / elderly / dementia care. 

Nightmares?  Feelings of dread?  You are already over the line. 

This is burnout, this is PTSD starting.  You need to apply a little selfcare and look after your own mental health.  You will have been running in a stressed state for so long your hormone levels are permanently elevated and its become normalised.

There is no shame in understanding this has happened to you.  Its happened to me. Its took a panic attack outside the hospital gates before my shift until I realised the state I was in.  You are not being daft or soft.  You have hit your limits. 

At the very least you need to be out of that role withing a short time.  If you feel able to you could go to your boss and explain and I will be fairly sure you will get both a sympathetic reaction and quick action

MY advice tho is go off sick now.  Don't even think about going back in.   I will bet my house that your GP will sign you off sick if you go in and honestly tell them how you are.  Do it.

Occupational health and all that shit is in your future.  I ended up on internal redeployment and working on a ward that suited my skills and had another good 10 years.

Good luck.  this is not a nice place to be.  Go off sick!

In my case a botched reorganisation had me working on an acute medical ward rather than rehab. I didn't have the skills for the job. After the panic attack I saw my boss that day.

the big boss came did a walkround that week co incidentaly. She asked me how I was enjoying my new role. I relied. " Im stressed to my limits because I don't have the skills and I'm scared I'm going to kill somone." she replied ~" Honesty is good" 🙂
I was off the ward in a week in a temp place and then redeployed. I didn't go off sick but only because the action was swift.

Ta folks.

Love my job btw, will be speaking to my boss tomorrow.

Much appreciated everyone.

Violence and assaults by patients are commonplace.  Its a part of the job.  I worked in a low risk area and I still got assaulted  - usually by frail old ladies it must be said 🙂  Its very rarely people with any criminal intent.  Its normally mental health crisis or delirium. 

IN forensic mental health its a high risk area.  When you are dealing with people like that it just gonna happen.  Good training, systems of work environment, staffing  can reduce incidence of assault but its totally impossible to eliminate it.   Same with where I worked. 

Just a quick update.

I'm looking for another role.

Management don't care, it's pointless talking to them. They are protecting their own jobs and have no answers. Apparently we all signed up for this. They are threatening people who won't get involved with restraint with 'redeployment'.

But.....after speaking up I've had a wonderful few days. I've had the time to look after my own patients, to help them along the pathway toward discharge, to take them to work for several charities who understand that everyone deserves another chance, to sit down with their consultants and plan for their future, to help them be the best people they can possibly be.
God, given the opportunity it's the best job in the world.

But somebody else has had to go and deal with the violence, to witness the horrific self harm, to cut the ligatures from young people's necks.
And it is all completely unnecessary, if we had consistant staffing.

Thank you all so much for listening.

Love, light and peace to you all.

Are you in a union? I'd say management's response is utterly unacceptable to the point of bullying/constructive dismissal on the face of it; if you can make an approach with union backing and a clear suggestion that you'll take things further if necessary changes their attitude somewhat.