Its never ok

Ending violence: what your hospital must do

Nurses, midwives and personal care workers have rightly responded that the changes to end violence in our health system are not happening fast enough.

The responses come after Royal Melbourne Hospital released a video to educate the public ‘Help us help you – violence and aggression are unacceptable’ on Monday 26 February. 

Violence and aggression happens across all health services including emergency departments, mental health units, community mental health, birthing units and midwifery services, rehabilitation, aged care and palliative care.

The Andrews Government has put in place the right policies, more than $40 million in infrastructure funding and introduced new contractual obligations on hospitals.

For the first time Victorian public health services have government support and funding to end violence. To keep the faith of their employees hospitals must respond faster to change their culture and introduces practices to make their employees safe. 

ANMF staff and Job Reps and Health and Safety Reps are representing members on health services high-level occupational violence committees. We are working hard to assist health services implement the required changes informed by the ANMF’s extensive guide for health services to end violence and aggression in health services. If you want to get involved in effecting change register your interest in being part of the solution via our online form

ANMF is using all of this work to influence change in the private and not-for-profit sectors.

What should health services actually be doing to end violence?

Everyone talks about increased security, but what do the other required changes actually look like? The ANMF’s 10 point plan to end violence and aggression: a guide for health services provides 114 detailed systems and strategies hospitals must implement to ensure the safety of their staff.

All members are encouraged to read this document to understand what your hospital needs to be doing to keep staff, patients and visitors safe.

ANMF (Vic Branch) Secretary Lisa Fitzpatrick said: ‘Nurses and midwives should not have to put their own life at risk to save a life. We have the solutions to create safe health services, we now need a greater sense of urgency from the hospital executives and management to make keeping staff safe their first priority.'

‘Patients and visitors must also just stop unacceptable violence and aggression in a place where people are trying to help them.’

We can’t list all of the 114 ways a hospital should be operating to ensure a safe workplace but here are 10 strategies from 10 point plan to end violence and aggression: a guide for health services. Please read the guide and question what is happening at your workplace.

  1. The chief executive officer must chair the occupational violence committee to be able to drive the change quickly. The CEO and board must receive statistical violence and aggression data and the detail of incidents, effect on employees and information about preventative action.
  2. Risk assessments (informed by consistent training) when patients or visitors arrive to determine whether they are a risk of violence, and putting in place controls to reduce the risk.
  3. The health service must have a collaborative relationship with local police and assist and support staff to pursue their right to prosecution of offenders of violence and aggression. 
  4. An easy to use and consistent incident reporting system.
  5. Communication and handover between hospitals and departments within hospitals about a patient’s previous behaviour or if they have a behavioural contract  (clinical information is handed over but often not violent or aggressive behaviour information).
  6. Security audits undertaken by appropriately qualified people to determine what security is needed such as CCTV and personnel.
  7. Appropriate support and follow up for employees who have experienced violence and aggression.
  8. Incident investigation to reduce risk of further occurrences. All middle managers must have regular mandatory OHS incident investigation and post-incident support training.
  9. Staff must be included in incident investigations and discussions about preventative strategies.
  10. Training for staff in how to identify a risk of occupational violence and aggression, and preventative strategies and de-escalation, rather than self-defence.

Keep reporting at work and to ANMF

For the first time violent incidents in health services are being reported to Victorian Parliament. Please continue to report any violent or aggressive incident through your workplace channels. Remember to also advise ANMF so we can provide further support. Let ANMF know via our online form at


Nurses, midwives and carers who've experienced violence and aggression should contact the Nurses and Midwives Health Program Victoria for confidential support and referral.

(This article has been edited. The original article incorrectly stated there were 89 detailed strategies in the ANMF’s 10 point plan to end violence and aggression: a guide for health services. It should have stated there are 114 detailed strategies.)

Royal Melbourne Hospital video

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