Hospital security guard's well-being and repeated exposure to personal threats in the workplace: a qualitative study in an Australian hospital

• DOI: https://doi.org/10.1108/IJWHM-01-2022-0013
• Published date: 29 August 2022
• Date: 29 August 2022
• Pages: 728-744
• Subject Matter: Health & social care,Healthcare management,HR & organizational behaviour,Human resource policy,Employee welfare
• Author: Janie Alison Brown,Elaine Watson,Tamra Rogers

Hospital security guard’s

well-being and repeated

exposure to personal threats

in the workplace: a qualitative

study in an Australian hospital

Janie Alison Brown

Curtin School of Nursing, Curtin University, Perth, Australia and

St John of God Midland Public and Private Hospitals, Midland, Australia, and

Elaine Watson and Tamra Rogers

St John of God Midland Public and Private Hospitals, Midland, Australia

Abstract

Purpose –This study aimed to understand the effect of repeated exposure to personal threats on hospital

security guards’well-being.

Design/methodology/approach –A single site, qualitative study using a convenience sampling approach

to recruit hospital security guards who attend code black (staff, patient or visitor exposed to a personal

threat) calls.

Findings –Five interviews were held with eight hospital security guards. Seven of the eight participants were

male. Seven were Caucasian. All had extensive experience in the industry. Six consistent themes emerged from

the data covering well-being, copingand support; concerns about physical safety; compassion and compassion

fatigue; effective communication is crucial; role/s; and training and equipment.

Researchlimitations/implications –This study used a convenient sampling approach to recruit security

guards from one acute hospital in Australia, limiting the applicability of the findings to other contexts.

Although the majority of hospital security guards were interviewed, the format of interviews varied

between one-to-one interviews and focus groups, based on the availability of guards to participate and

attend.

Practical implications –We recommend that the role of the hospital security guard in Code black situations

is documented in policy and practice documents, and articulated in multidisciplinary aggression management

training. There should be clear statements on the importance of strong communication and clinical leadership

in code black situations. Hospital security guards should attend Mental Health First Aid training, which

teaches on and off the job coping strategies. There is a need for debriefing and consideration should be given to

supporting “time-out”. Hospital security guards require education on infection control and the risks associated

with blood and body fluids.

Originality/value –Hospital security guards play an important role in the safety of patients and staff in

code black situations. When they are well supported, they experience high levels of job satisfaction and are

able to maintain their compassion towards people who are aggressive and violent towards them. However,

repeated exposure to code black situations has the potential to erode the well-being of hospital security

guards.

Keywords Occupational violence, Well-being, Security guard, Hospital, Qualitative, Interview,

Personal threat, Critical incident

Paper type Research paper

Introduction and background

It is wellknown that workplacestress can resultin negative psychologicalconsequences forthe

individual (Harnois et al., 2000). More minor consequences may include sleep disturbance

(Magnavitaet al., 2019)and social anxiety,while more majorsequela includedepression,anxiety,

burnout and post-traumatic stress disorder (Leino et al., 2011a;Rudkjoebing et al., 2020).

IJWHM

15,6

728

The current issue and full text archive of this journal is available on Emerald Insight at:

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Received 30 January 2022

Revised 13 April 2022

21 June 2022

Accepted 9 August 2022

InternationalJournal of Workplace

Health Management

Vol. 15 No. 6, 2022

pp. 728-744

© Emerald Publishing Limited

1753-8351

DOI 10.1108/IJWHM-01-2022-0013

Individuals canadopt positive copingstrategiesto manage these psychologicalconsequencesof

their work that help them to maintain their resilience and cope with workplace demands.

Workplace stress can also have physical consequences for individuals resulting in chronic

conditions such as metabolic syndrome, diabetes, hypertension and cardiovascular disease

(Jovanovi

cet al., 2021). Where individuals experience negative psychological or physical

consequences as a result of their work, they are more likely to have reduced job satisfaction

resulting in underperformance, increased sick leave and high turnover (Chung et al., 2017).

For this reason, organisations often put a variety of employee well-being initiatives in

place, including Employee Assistance Programs, wellness initiatives and flexible rostering

practices (rostering to meet the needs of the individual, while meeting the needs of the

organisation).

Many professionals working in hospitals experience high levels of workplace stress that

may negatively affect their well-being. Work-related stress is prevalent in emergency service

and security professions, including police (Leino et al., 2011a) and armed forces (Browneus,

2014), as well first responders such as paramedics (Reardon et al., 2020) and firefighters

(Antony et al., 2020). Workplace stress is also seen in prison officers (Kinman et al., 2016) and

security guards (Saleem et al., 2017;Talas et al., 2020).

In the case of security guards (officers), a number of workplace characteristics are known

to contribute to high levels of occupational risk, both psychological and physical. Workplace

conditions that may contribute to guards’stress include shift work, job insecurity, poor pay,

extreme environmental temperatures, confined or small spaces, and stationary seated or

standing positions (Jovanovic et al., 2020;Nalla and Cobbina, 2016). The nature of this work

has been shown to put security guards at the greatest risk of work-related injuries and death

among all occupations in Australia (Ferguson et al., 2011). However guards do experience job

satisfaction, associated with the thrill of the work and anticipation of the unknown on any

given shift (Nalla and Cobbina, 2016). Although being a first responder may induce a

sensation of excitement, many situations guards respond to may involve violence and threats

to their personal safety (Leino et al., 2011b) and can contribute to reduced well-being (Talas

et al., 2020;Vanheule et al., 2008).

In hospitals, the focus of research to date has been on clinicians including medical doctors

(Clough et al., 2017), nurses (Cooper et al., 2021;Delgado et al., 2017) and allied health

professionals (Cleary et al., 2018). It is not known exactly how repeated exposure to personal

threat situations, also referred to as “code black”, in Australian hospitals, effects responding

security guards’well-being or what their post-code needs are. A code black call is made where

there is a personal threat to the safety of staff, patients or others, when immediate medical

assistance is required, de-escalation attempts have failed, there is an immediate threat to

personal safety and/or weapons of any sort are involved (reference). Theoretically, this study

positions the workplace well-being of the individual centrally. We acknowledge that when an

individual’s well-being is compromised as a result of their work, a number of factors are

effected, including performance and productivity, job satisfaction, absenteeism and intention

to remain in the organisation (Taris and Schaufeli, 2015). Further, we accept that poor

workplace well-being manifests outside the organisation for the individual and their wider

family and community (Edwards and Rothbard, 2005). For the purposes of this study,

we define workplace well-being as the experience of good health, both physical and

emotional, that comes from a satisfaction with work-life balance and is manifest in a positive

attitude towards work. Well-being is maintained when there is a manageable workload and

time is taken for breaks from daily work, as well as through utilisation of annual leave for

holidays. At an organisational level well-being in staff is apparent through a positive culture

and morale and may also been measured through decreased sickness and decreased clinical

incidents.

Hospital

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