Violence in the workplace

BMJ 2002; 324 doi: https://doi.org/10.1136/bmj.324.7340.788 (Published 30 March 2002) Cite this as: BMJ 2002;324:788

Delirium should be considered

  1. Siobhan MacHale, consultant liaison psychiatrist (ravelrig@fsmail.net)
  1. Department of Psychological Medicine, Royal Infirmary of Edinburgh, Edinburgh EH3 9YW
  2. Falkirk and District Royal Infirmary, Falkirk FK1 5QE
  3. Norvic Clinic, Norwich NR7 0HT

    EDITOR—The account of an assault on a nurse in the course of her work is distressing, and familiar to NHS staff.1 The clinical picture is of an agitated patient trying to leave the ward at night, within a day of admission with diabetic ketoacidosis. He was deemed unfit to be discharged, to the extent that the police were called to ensure his return to medical care. There may have been several causes for the violent outburst, for which the patient may rightly be held culpable. I was concerned, however, that all three commentaries failed to raise the possibility of delirium being relevant to the outburst.2

    I encourage staff to press criminal charges when they are assaulted at work, as they would when out on the street or in their homes. But appropriate medical advice also needs to be available to police and staff if a patient is not legally responsible for his or her actions due to …

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