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One of Australia's most dangerous workplaces: a shocking assault on nurse unit manager Debi Malcolm was one in a long sequence of violent events at Cumberland Hospital.

A SWOLLEN EYELID, BLURREDVISION and "a headache to end all headaches" still afflict NUM Debi Malcolm, 14 weeks after a patient assaulted her atYaralla psychiatric intensive care unit.

The physical symptoms are accompanied by nightmares and panic attacks that leave her struggling to breathe.

Debi is also frustrated and angry that authorities have allowed her unit at Cumberland Hospital to become one of Australia's most dangerous workplaces.

State governments crying poor have failed to act on several reports recommending that the ageing unit at Parramatta in Western Sydney be rebuilt. Yet they have found the money for new and upgraded mental health facilities in other Sydney local health districts.

"I'm angry big time," Debi said. "The authorities have known for years thatYaralla is unfit to serve as a psychiatric ICU. But Western Sydney is not a big priority for them. People out here don't seem to matter that much."

On the morning Debi was assaulted, patients were queuing for breakfast. Debi, who is secretary of the NSWNMA's Western Sydney Mental Health Managers' Branch, asked one man who had collected his meal to move out of the queue to allow others to be served.

"Who the f**k are you? You can't tell me what to do," he yelled, before jabbing a plastic knife into Debi's stomach.

"I grabbed the knife off him but he dropped the plate from his other hand and punched me several times in the head. Then he grabbed me by the hair and threw me to the ground.

"I hit the back of my head on the floor and must have briefly lost consciousness because I don't remember the next bit.

"My staff said he tried to strangle me. There were marks around my neck after they pulled him off me."

As three male nurses fought to restrain her attacker, Debi regained consciousness and phoned a "code black" to call for help from other wards.

The team arrived and helped to get the patient into a seclusion room. They restrained him on the bed while Debi put in another call to order medication--a combined sedative and anti-psychotic.

PAIN NEVER STOPS

After making sure her staff were OK Debi called the police and was driven to Parramatta station for an interview.

"I had a big headache and bruises were already coming up but I didn't feel too bad--perhaps it was the adrenaline. It wasn't until I got home and thought about what had happened that I just fell apart.

"The fall apparently caused my brain to hit the front of my skull so I have bleeding in the brain and blurred vision in the right eye, which means I'm only allowed to drive short distances."

Along with the nightmares and panic attacks Debi says she is sometimes gripped by "a sense of impending doom, like I think I'm going to die."

Debis assailant is now in jail. He is a repeat offender with numerous violence-related convictions. When he attacked Debi he had pending court hearings for assaults on two of her staff. One suffered a black eye and four loosened teeth.

Yaralla has a shocking safety record including 45 reported assaults causing injuries to nurses in the 34 months to August.

Broken limbs are not uncommon; one nurse suffered a broken leg that took more than two years to heal. A 2011 assault left another nurse with a brain hemorrhage and permanent hearing difficulties.

Debi has been assaulted three times in her six years at Yaralla. She suffered a broken nose when a patient attacked her during an on-site hearing of the mental health review tribunal: "The tribunal didn't even stop proceedings, they just went on hearing the evidence."

DESENSITISED

Authorities and nurses themselves have become "desensitised" to violence towards mental health staff, Debi says.

"There is a lot of under-reporting of violence towards nurses. We seem to accept a high level of violence, which is dehumanising and very dangerous.

"In 2009 the local health district applied for a rebuild but the director general of health said no funds were available for capital works.

"Yet while we are told there is no money for mental health in Western Sydney, they've built new units at Prince of Wales, Concord and Nepean and refurbished St George and Hornsby units.

Cumberland Hospital does not even have backup generators to supply power to Yaralla or other units when hit by a blackout.

"Nurses are expected to wander around in the dark with torches and lanterns to look after patients," Debi said. "If power is disrupted and food is spoiled, staff are expected to use their own money to buy food for patients.

"Their priorities are wrong. Western Sydney is the fastest growing part of the state and has the greatest need for mental health beds given the amount of ice and steroid abuse out here.

"Yaralla was built as a geriatric unit in the 1960s and cannot function properly as a mental health ICU. It lacks the facilities you need to look after very violent patients.

"When you've got 12 of the most disturbed and dangerous people you will ever meet in your life in one small area, it's a very volatile situation."

"We need a new unit and we need it in a hurry before someone gets seriously hurt or killed."
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Publication:The Lamp
Geographic Code:8AUST
Date:Dec 1, 2015
Words:881
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