Darwin ED nurses report daily violence threats and slow duress alarm response; NT Health rejects security review

A nurse inside the emergency department at Royal Darwin Hospital has told their union they fear that a colleague is going to be stabbed. That warning, relayed by Heidi Crisp, secretary of the Australian Nursing and Midwifery Federation, sits at the centre of a dispute over safety in one of the Northern Territory's busiest hospital departments.

Crisp says nurses in the department "feel unsafe every day". By her account they face threats of violence daily, along with actual assaults serious enough to need several people to step in, and some of those incidents have left nurses traumatised. The union member she quoted said they were not the only one with extreme concerns.

The union also says help does not always come quickly. According to Crisp, nurses report that police are often unable to attend incidents at the hospital, or cannot get there fast. The hospital's private security guards are sometimes slow to answer when nurses press the duress alarms. She said it can take 15 minutes for security to respond, and that the nurse team leader may not even know an alarm has gone off. The union wants team leaders alerted in real time every time one is pressed.

NT Health chief executive Chris Hosking rejected calls for a review of the department's security arrangements. He told the ABC the department takes staff safety seriously and denied a systemic problem with slow response times, calling any such cases "isolated occurrences". He said NT Health is already strengthening arrangements, including personal duress alarms that nurses can carry on their person, which he noted was something the union had sought. Team leaders, he said, will now be told in real time when alarms are triggered. NT Police said they could not comment on the claims of slow response without details of specific incidents.

The union has also taken its concerns to NT WorkSafe. The regulator confirmed it had received a safety concern from the federation describing several incidents at the emergency department that it had not previously been told about, and said it has begun an inquiry into them.

The second strand of the dispute is crowding. Crisp said the department often runs at 150 per cent capacity, when ideally it would sit near 90 per cent so it could absorb a surge of patients. She called 150 per cent unmanageable and said it puts patients at risk. She also said one nurse can be left watching 30 patients in the waiting room, which she described as an impossible task.

Hosking agreed the hospital is running at or close to capacity, because there are not enough beds for the number of patients. He was less willing to call it unsafe. A nurse watching 30 people in the waiting area, he said, is unusual and must have been a peak day. He pointed to new capacity on the way: 32 new beds, and a 24-bed mental health ward due later this year, added to the hospital's existing 400 beds.

Health Department data shows the strain building over time. Over six years, fewer patients in the territory's emergency departments have been treated and discharged within the four-hour limit the NT government sets for itself. In 2018-19, 67 per cent left within four hours of arriving. The figure is now 54 per cent. Hosking said Darwin is not so different from other emergency departments around the country, all of which are struggling to meet those targets, and said triage works: someone with chest pain is seen quickly, while someone with a sprained ankle may wait a good while.

What happens next turns on the WorkSafe inquiry, on whether the personal duress alarms and real-time alerts change response times, and on whether the new beds open on schedule. The security review the union wanted has been ruled out.