Emergency nurses call for more security, counselling, after strangulation attack

January 10, 2025

Staff at Middlemore Hospital’s emergency department (ED) have asked for more security, after a nurse was punched then strangled to unconsciousness by a patient on Monday this week.

It took five colleagues — including a nurse with rugby skills — to get the man off and subdue him before hospital security and police arrived a short time later, staff told Kaitiaki.

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A 23-year-old has been arrested and will face charges of assault and impeding breathing in the Manukau District Court on January 14, Police have confirmed.

The nurse, a male, is now recovering in hospital with lacerations, but — like his colleagues — was highly traumatised and upset, a nurse colleague said.

‘I don’t know why security didn’t turn up . . . sometimes it will take a while because they are covering all the  hospital.’

The nurse was one of three nurses on duty in the emergency department (ED)’s short-stay unit on Monday afternoon and was about to change the patient’s dressing when the man put his hands around his neck and began squeezing and shouting.

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The patient was not flagged as dangerous or a mental health patient and acted “without any provocation”, said the nurse colleague, who is also an NZNO delegate.

Another staff member said the man had been earlier dropped off at ED by police.

While there is usually a security presence in the ED, guards were elsewhere at the time — something staff had since raised with management, the nurse colleague said.

“I don’t know why security didn’t turn up . . . sometimes it will take a while because they are covering all the  hospital.”

Staff were “afraid, traumatised and emotional” and had requested strengthened security, with guards present in ED at all times. They had been given a week off work but so far neither the victim nor colleagues had been offered much-needed counselling, he said.

The Middlemore assault comes shortly after the stabbing of another nurse on December 28 in Rotorua, during an after-hours callout by Te Whatu Ora Lakes’ acute mental health response team.

Violence ‘unacceptable’

Te Whatu Ora national chief clinical officer Richard Sullivan said to hear of multiple incidents of violence against its staff recently was “saddening” and he promised Te Whatu Ora would beef up security and support for staff.

Richard Sullivan

“No level of violence is acceptable and we await the outcome of the police investigations underway into these incidents.”

Welfare checks were ongoing with all staff involved, he said.

Sullivan said staff health and safety was “top priority” across Aotearoa New Zealand.

“We continue to work closely with our staff and hospital security to ensure additional security and support is available for staff.”

Sullivan said Middlemore Hospital was one of eight high-priority EDs which were given $31 million extra security funding in the Budget. Those security measures — including extra training and 44 more staff — remained in place, he said.

The package also included $408,000 for “surge capacity” in all 33 EDs around the country, to allow extra security to rapidly respond to EDs in a major incident.

Minister of Health Shane Reti said violence against health workers was “unacceptable”.

Shane Reti

“Staff and patients deserve to feel safe in our hospitals and as they go about their work, which is why the Government prioritised funding for extra security in eight high-risk EDs and surge capacity across the country for busy periods.”

Also included in the Budget was new training and support for ED security teams, clinical staff and behavioural incident leads, focusing on de-escalation and safe restraint, Reti said.  This was now ready to go, with the first programme starting on January 13 and all eight high-priority EDs to be fully trained by May this year.

The high-priority EDs are in Dunedin, Christchurch, Wellington, Waikato, Waitematā, Middlemore, Waitakere and North Shore Hospitals.

Police are also investigating reports of a gun being fired in the Middlemore Hospital carpark last weekend. Nobody was injured and police say enquiries are continuing.

Aggression ‘constant’

Another Auckland nurse, who spoke to Kaitiaki on condition of anonymity, said she had been regularly abused and threatened over the years in her ED triage role.

She also said violence and aggression had noticeably worsened in recent years, due to rising poverty and addiction. Frontline nurses and health-care workers bore the brunt and needed more protection and support.

“It’s just constant, all the time.”

‘There needs to be a change in management attitude and an understanding about the risk.’

After a particularly scary incident in 2023, where a man threatened to rip her head off, spat on her and threw things at her, she called police. They arrested the man, who was imprisoned for threatening to kill.

She said security guards were not always in ED due to the size of Middlemore Hospital, which has 1000 beds as well as up to 250 ED patients. “There’s not enough of them — they spend the majority of time in ED but also respond to calls throughout the hospital.”

Management needed to take staff safety much more seriously, she said.

“There needs to be a change in management attitude and an understanding about the risk.”

The senior nurse said she had been given no support or time off after the incident and simply continued working. She has since been diagnosed with complex post-traumatic stress disorder and needed ongoing counselling.

Kerri Nuku

Calling for more protection, NZNO — Tōpūtanga Tapuhi Kaitiaki o Aotearoa kaiwhakahaere Kerri Nuku said nurses were increasingly facing volatile situations as hardship grew.

“Whānau are struggling with the stress of the rising cost of living and this leads to increasing levels of frustration which play out during home visits or long wait times at EDs.”

She acknowledged the security boost, but said recruitment had been “too slow” by Te Whatu Ora.