When I hear of pushes to up security in hospital emergency departments, I must admit there’s a part of me that is hesitant.
Of course, I want all health care workers to be safe on duty including ED nurses.
But I also know many Māori already feel discriminated in ED and other hospital and clinical spaces. And the research proves it.
Yes, it’s a fact that health care workers are five times more likely to be assaulted on the job.
And my sincere thoughts go to the majority of ED nurses who told us in the recent NZNO survey that they had to deal with shouting and swearing, physical aggression and threats over the festive season.
The last kaupapa Māori-lensed study in 2021, by Dr Elana Curtis, on ED and Māori found that there was “increasing evidence that EDs may not operate equitably for all patients, with indigenous and minoritised ethnicity patients experiencing longer wait times for assessment, differential pain management and less evaluation and treatment of acute conditions.”
I know too from talking with many whānau Māori and Māori survivors of abuse in State care, that they don’t feel these spaces are culturally safe. They feel judged when they walk into them because they are Māori.
Having more security guards, more big brother cameras, more surveillance is unlikely to make them enter these spaces and instead stay at home and get sicker – making worse Māori health inequities.
In the coming weeks, NZNO will formally apologise to thousands of adults, who as children were taken from their whanau and put into institutions run by the State or Government, where they were abused.
More than 80% of them were Māori. That abuse broke generations of Māori, led many into gangs and prison.
Sadly, nurses were among those professions who did the abuse or turned a blind eye to it.
I’ve had the privilege of talking with many of those survivors who tell me they still don’t trust nurses today or any institutional spaces run by the Government which includes public hospitals.
When they get sick or have a medical emergency, they don’t go to ED.
Systemic and institutionalised racism has already burnt them once, they won’t let it happen again – even if it costs them their life.
Society often judges individuals based on visible markers such as gang affiliation. These judgements can influence how staff respond to patients, sometimes leading to disproportionate security measures or exclusion. It is vital to recognise that safety concerns arise across all populations and must be addressed with empathy and fairness.
So how do we keep these spaces safe for nurses and patients who understandably are becoming hoha or fed up with unacceptable waiting times; who after waiting too long become frustrated, infuriated only to lose the plot on the first workers they see – nurses?
It isn’t a quick fix, but one that will take years to achieve – building up the Māori health workforce and creating a systems mind-shift within Government and hospital hierarchy.
In a recent conversation with a member of Te Poari, it was highlighted that some hospitals hold regular meetings to address these safety concerns. Their research has demonstrated that simply increasing security measures is not an effective solution, and as a result, they do not advocate for heightened security. Instead, they emphasise that de-escalation strategies are key to resolving these issues including staffing.
Alarmingly, there has been a rise in assaults on nurses, particularly in aged care facilities, where patients suffering from dementia have, on occasion, seriously harmed staff. These incidents have led to many nurses being placed on ACC for extended periods, with some unable to return to work.
We must approach the discussion of these issues carefully. It is essential that all nurses feel safe at work, and the responsibility for ensuring this safety lays squarely with their employer.
Employers must provide safe environments for all nurses and healthcare workers. This includes not only delivering de-escalation training, but also establishing robust internal reporting systems that record, process, monitor and actively manage incidents.
Furthermore, embedding trauma-informed and culturally safe practices within both nursing education and ongoing professional development is an important aspect of kawa whakaruruhau and cultural safety. Let’s not substitute the problem, the root cause is inadequate staffing – address the issue.