Nelson Hospital’s clinical director of the Emergency Department, Andrew Munro, says the behaviour of people under the influence can be unnerving for staff. Photo: Sara Hollyman.

Alcohol-fuelled violence ‘unacceptable’

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Frontline workers say alcohol continues to be a key driver of violence in Nelson and stress that our attitude towards booze needs to change.

For the next few weeks Nelson Weekly is looking at the relationship between alcohol and violence through the eyes of those who deal with it every day as part of their jobs – our hospitals, police and the court system.

This week we speak to the Nelson Hospital’s Andrew Munro, who has been clinical director of the Emergency Department for the past five years. The ED now sees around 300 patients a year who are accompanied by police – a number that has seen a six per cent rise over the past 12 months.

He describes a typical Friday night as busy, noisy, congested, frustrating, high turnover, high risk, stressful, smelly, and again frustrating.

Outbursts of alcohol-fuelled violence can range from verbal threats and abuse through to physical acts of violence on staff, again something that has seen an increase over the past few years.

“We have perfect conditions for that, especially in a crowded ED,” he says. “You can imagine we see people at their worst, they’re experiencing sometimes the worst things of their lives and some of them have limited ability to cope so often express it in terms of physical and verbal threats, to the point some of our nurses have been struck.”

Andrew says sometimes people just need to “take a look at themselves”.

He says Nelson’s attitude towards alcohol needs to change.

“Yes, this is a public space but it’s not a place where you should feel comfortable talking to us or at us like some people do, racial slurs and abuse, verbal violence. It’s quite unpleasant, some of it’s horrible, some of the language that comes out is incredible.”

Each year around 1000 patients present to ED with injuries or illnesses in which alcohol has been a contributing factor. This number has also been steadily increasing.

Andrew says police are also spending a lot of time in ED with agitated patients and often acting as a first defense against outbursts of violence against staff.

“We do feel sad that they’re not able to do their core duty in the rest of the community but it’s great to have them here. The nurses feel so much safer when they are around.”

Andrew says there’s a pattern of behaviour where patients are preloading with alcohol before heading into town.

“And in the wee hours of the morning something happens or they collapse and they’re brought here by a good Samaritan, a police officer, or they come here by ambulance having been a victim of violence.”

Andrew worries that this all becomes normal and acceptable but says even worse is that ‘oh, I was drunk’ has become an excuse for violent behaviour.

“A lot of it is around a cultural shift and ultimately, when is it going to be unacceptable to behave like this?”

He says dealing with the aftermath has a demoralising effect on hospital staff.

“These are professionals that are used to dealing with this all the time but it has an emotional toll, burnout toll, and an empathy toll. Your bucket’s only so full of empathy, if you don’t do anything to restore that then you’re at risk of just accepting the issue and becoming part of the problem yourself.”

WE SAY:

The dangerous relationship between alcohol and violence could not be starker on Bridge St after dark. It’s when intoxication meets bravado and the results can be especially dangerous.

Friday and Saturday nights have long been the hospital’s and police’s busiest nights with excessive drinking continuing to be a major driver of crime and violence. Bridge St after dark is a pretty good canary future issues down the line.

If you speak to medical specialists, they will say that a pattern of injury known as a ‘boxer’s fracture’ in the hand, caused by fighting, is a pretty good indication that the patient will be back with more severe injuries. In this way, a combination of poor impulse control mixed with alcohol can prove deadly.

So, it’s important to shine a light on this issue, no matter how ugly. As the hospital’s Andrew Munro laments – we don’t want this to be business as usual. We want to strive to be better. So, over the next few weeks we will explore this problem and raise some potential solutions.

We also want to hear from you and your own experience with violence and alcohol, especially if you have been a victim. Email editorial@nelsonweekly.co.nz with your story.