Traps for the unwary

November 2010

Research

General practice as a fortress

Occupational violence and general practice receptionists

Volume 39, No.11, November 2010 Pages 854-856

Occupational violence and general practice receptionistsParker J Magin PhD, FRACGP, is Senior Lecturer, Discipline of General Practice, University of Newcastle, New South Wales

Terry Joyce RN, PhD, is a research academic, Discipline of General Practice, University of Newcastle, New South Wales.

Jon Adams PhD, MA, BA(Hons), is Professor of Public Health, Faculty of Nursing, Midwifery and Health, University of Technology Sydney, New South Wales.

Susan Goode BSc, is Program Coordinator, Primary Health Care Research Evaluation and Development Program, Discipline of General Practice, University of Newcastle, New South Wales

Georgina Cotter BA, GradCertApplSc(SocialStats), is Project Officer, Discipline of General Practice, University of Newcastle, New South Wales.

Background

Occupational violence is well documented among general practice receptionists, who are singularly vulnerable because they are placed in the general practice ‘frontline’. One response to this threat has been to physically isolate reception staff from waiting room patients by having a perspex shield at the reception desk and a locked door between waiting room and staff areas.

Methods

A qualitative study employing semistructured interviews, an inductive approach and a thematic analysis. The study explored the experiences and perceptions of three receptionists who work in a practice with a perspex and lockdown system, and 16 who work in practices without these.

Results

Receptionists were universally positive about the safety measures for reducing risk. But there was also a view that these safety measures potentially compromise the feeling of a practice being patient centred by alienating patients from staff and, paradoxically, increasing levels of patient violence and staff fearfulness.

Discussion

These safety measures, while viewed positively by receptionists, may have adverse effects on patient-staff relationships and exacerbate violence and increase staff fearfulness.

General practitioners and their staff are at risk of experiencing violence while they perform their everyday work.1,2 Over a 12 month period, 64% of GPs working in urban New South Wales experience violence at work – ranging from verbal abuse to physical assault.3 Studies of general practice receptionists have demonstrated a career prevalence of violence of 62% in receptionists from the Republic of Ireland,4 and a 68% 12 month prevalence in receptionists in England.5 As it does with GPs, occupational violence has marked effects on receptionists' wellbeing.6 While violence directed toward GPs is well recognised as a significant occupational health issue,7,8 the issue of violence should be conceptualised as a whole-of-practice problem.

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Correspondence afp@racgp.org.au

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