At the end of the day,

the goals are simple:

safety and security.

Jodi Rell

As a medical student I never imagined the level of security required in hospitals. It never occurred to me that there would ever be a need for security firms, police and surveillance cameras would ever be needed inside and outside hospitals. After all hospitals were there to help people not for the very same characters to abuse and threaten staff with violence. Yes, some patients were rude but threatening staff? No. Many staff now wear body cameras so that aggression can be recorded and the culprits identified.

In just a few weeks patients physically assaulted three of my colleagues

in the emergency department.

Susan Robinson

Consultant in emergency medicine, Cambridge

In my first year as a doctor I began to develop a little insight into the extent of the problem. That was back in 1989. Yes, I am that old. Our medical patients were seen in the accident and emergency unit. No problem there. The issue was in the waiting room. These patients did not have a serious injury or illness, they just wanted to be at the front of the queue. That blatantly was not possible. There were more urgent cases to attend to. The problem was particularly acute at weekends when alcohol was involved.

Alcohol is a cerebral depressant at all times. In the early stages it causes disinhibition. The state of merriness many of us will have observed and experienced. However, the more we get drunk, the underlying state of the mind maybe exposed. This results in possible violence. It does not happen in every case.

There are patients who develop delirium in hospitals. They may behave violently. That is not with intent. It is because of their situation. I recollect a patient in such a position in a high dependency neurosurgical unit. He was one of four patients. Like him, the other three also had tubes here and there. The guy was holding the door handle up. I was vigorously pushing down to try and gain access to prevent him from harming the other three patients. I hurt his hand. Before I could do anymore he opened the door and chased me down the corridor. He was stopped by the night porters. At the time the night porters doubled up as hospital security. I hate to think what the consequences might have been if he had caught me. 

Buggeration and Fuckery

Andy McDermott

In those early days of my career,