At the same time, hospitals are introducing new response measures to assist staff deal with violence and aggression, while the state government is pledging money for security upgrades to some regional hospitals.

Australian Nursing and Midwifery Federation industrial relations organiser for Bendigo Loretta Marchesi said incidents of patient violence towards healthcare workers was occurring across a range of sectors including aged-care, emergency and psychiatric services.

“There’s physical as well as psychological injuries from occupational violence and aggression,” she said.

In 2015, Bendigo Health introduced a “code grey” response for its employees to use when confronted with violence, trained some staff members in self-defence and dealt with a high number of patients under the influence of alcohol and drugs.

Ambulance drivers, too, found things tough. About 100 incidents in which a paramedic was physically assaulted were recorded across Victoria.

More preventive and security measures are needed to protect Bendigo’s healthcare workers from violent attacks at work, Ms Marchesi says.

Some of the incidents recorded had resulted in physical injuries, psychological scarring and time off work for employees.

In the past year, reports and some hospitals have highlighted the levels of occupational violence those in the health sector face. 

Many incidents involve patients under the influence of drugs and alcohol, while others are going unreported.

As far as the ANMF was concerned, Mr Marchesi said, violence was unacceptable and tighter security was needed to protect nurses.

“There needs to be a lot more security. A lot of outlying facilities don’t have 24-hour on-call security services to respond … so the only thing open to them is calling the police,” she said.

“Any worker should be able to have some kind of security response team.”

Preventing incidents from occurring in the first place was also essential, Ms Marchesi said.

“You have to have the preventative measures in place – you need to be doing something active,” she said. 

Good policies to prevent and respond to situations that escalated were vital, so was ensuring staff had a clear understanding of the behaviour of their patients and clients.

“It’s making sure the nurses are not left in vulnerable areas on their own.”

A number of incidents had occurred in Bendigo where staff had been injured, sometimes as a result of a patient being drug affected.

The impact a violent incident had on a worker was often influenced by how adequately their employer dealt with their situation, she said.

​“Each nurse has a passion for their area, many will still follow their area of interest (but) it may be more difficult at times to get casuals to certain areas where there are higher incidence of violence,” Ms Marchesi said.

A number of health services across the region had already implemented better polices and procedures to prevent violence, she added.

“We want to work with each of the health services to have the best safety possible for our nurses.”

Violence against healthcare workers – acknowledged as a largely hidden problem – became more visible to the public throughout 2015.

In May, a Victorian Auditor-General’s report shed light on the high levels of occupational violence and the “unnecessary and preventable risks” many healthcare workers face simply going about their job.

The extent of the problem is “unknown” because of significant under-reporting and insufficient data keeping that fails to provide a state-wide picture, the report added. 

At the same time as the report was being compiled and released, the issue reared its head in local media.

In March, the Advertiser reported on a rising incidence of violent and aggressive behaviour towards health workers and security staff at psychiatric treatment facility the Alexander Bayne Centre. 

Many patients were affected by alcohol and drugs such as ice, while physical injuries had resulted in nurses and security staff taking time off.

In May, it was reported that Bendigo Health had introduced a “code grey” response mechanism aimed at helping staff deal with aggressive behaviour. A project worker involved said at the time that healthcare workers were at higher risk than ever of being assaulted. To help counter that risk, some Bendigo Health staff were being given self-defence training.

In response to the problem, the state government this week announced the first round of a $20 million health service violence prevention fund.

Rochester and Elmore District Health Service will receive funds for CCTV cameras, safety glass and an access control system for a nurses’ station. Castlemaine Health will be given funding for lockable doors between an urgent care area and an acute ward’s nurses’ station, additional CCTV cameras and more.

Twenty-six hospitals across the state, 18 in rural areas, will share the funding, allocated on a needs basis after submissions from hospitals and health centres.

Minister for Health Jill Hennessy said violence was unacceptable.

“Our highly skilled frontline health care workers deserve to feel safe at work so they can do their job treating patients and saving lives,” she said.

Violence against healthcare workers also occurs on the road.

Ambulance Victoria acting Loddon group manager Tony Walsh said 328 reports of assault and aggression towards paramedics had been recorded in 2014/15.

About 100 involved paramedics being physically assaulted, 120 related to verbal abuse and threats and the rest related to “near misses” or instances where a weapon was produced. About 100 of all cases involved drugs or alcohol.

“Sadly, we believe these reports are just the tip of the iceberg,” Mr Walsh said. “No paramedic in the Bendigo area, or, in fact, anywhere in Victoria, comes to work expecting to be harmed.”

Ambulance Victoria has established an occupational violence working group that reviews the training paramedics receive.

“Paramedics use a range of methods to manage violent patients or deescalate confrontation, ranging from verbal skills to sedating patients to ensure the most appropriate treatment for these patients,” Mr Walsh said.