"I endured regular abuse at my hospital job and I want compensation for PTSD" – which case won?

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Stacks Law Firm

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Nurse encounters abusive patients at work and suffers psychological injury.
Australia Litigation, Mediation & Arbitration

The Facts

Nurse encounters abusive patients at work and suffers psychological injury

A case in 2023 concerned a woman who worked as a nurse and made a claim for compensation for PTSD.

The woman worked in the emergency department of a hospital in northern NSW from 2011 to 31 January 2019.

Staff in the emergency department were regularly subject to abuse by patients.

Around 2015, the nurse had a particularly upsetting encounter with a patient, LF, who was verbally abusive, yelled profanities at her and threw a blood pressure monitor across the room.

On 31 January 2019, when the nurse arrived for her shift, she saw LF's name on the patient handover sheet. She began crying uncontrollably and suffered a panic attack for the first time.

She left work that day and has been unable to work since.

The nurse was diagnosed as suffering from post-traumatic stress disorder (PTSD).

Nurse seeks workers compensation for permanent impairment

The nurse brought proceedings in the Personal Injury Commission of NSW, seeking payment of permanent impairment compensation for PTSD, a psychological injury.

The question before the commission was whether the nurse had developed PTSD over time due the nature and conditions of her work.

CASE A

The case for Mr S

CASE B

The case for the lenders

  • I suffer from PTSD which developed over time due to the nature and conditions of my work between 2011 and 31 January 2019.
  • During the course of my employment, I was exposed to numerous traumatic incidents, including vitriolic outbursts and verbal and physical assaults by violent, drug-affected patients and mental health patients.
  • During almost every shift, patients would become angry, abusive, aggressive and violent, because without a doctor present, I was not able to prescribe the opiates and benzodiazepines they wanted. Going to work under such conditions caused me to become anxious and agitated.
  • One day I watched a highly agitated patient smash a glass door. I also saw other nurses being chased by highly agitated patients and having to lock themselves in the drug room to escape.
  • I complained to my manager about the disturbing incidents and lodged several incident reports.
  • My GP has testified that in 2013 I experienced irritable bowel syndrome, interrelated with stress, including work stress. I was referred for psychological treatment and prescribed antidepressant medication.
  • The incident with LF around 2015 caused me to feel extremely upset, agitated and fearful, both for my own safety and for the safety of the other patients in the waiting room.
  • In 2019, I had just started seeing my psychologist to address the impact of the various work-related events, when I was triggered by seeing LF's name on the patient handover sheet.
  • My psychological injury clearly developed over time due to the nature and conditions of my employment from 2011 to 31 January 2019. I am therefore entitled to compensation for PTSD.
  • The nurse's PTSD did not develop over time due to the nature and conditions of her employment between 2011 and 31 January 2019.
  • As the nurse's manager has testified, at times patients became verbally aggressive, but that was to be expected in an emergency department. Although the nurse lodged several incident reports, her manager has testified that she continued to work normally and never complained about experiencing work-related stress, notwithstanding that she had opportunities to do so.
  • There is no contemporaneous evidence of psychiatric symptomatology as a result of the alleged traumatic events since 2011. The treating evidence and independent medical evidence all support a finding that the only work-related events which were causative of the nurse's psychological condition were the events involving the patient LF in 2015 and the events on 31 January 2019. There is no evidence which establishes a causal connection between the nurse's emerging psychological symptoms and other incidents at work. As the nurse is alleging a psychological injury in the nature of a disease of gradual onset, this is insufficient to prove her case.
  • As our independent medical expert has testified, the nurse's employment was not the main contributing factor to her PTSD. Her personal life stressors were. The incident in January 2019 simply aggravated a pre-existing psychological condition. In August 2007, a date which predates the nurse's employment by four years, she was referred for psychological treatment. The referring doctor noted that the nurse described feeling increasingly teary and stressed for the past year. A mental health care plan stated that she had "generalised anxiety".
  • Since the nurse's PTSD did not develop over time due to the nature and conditions of her employment from 2011 to 31 January 2019, she is not entitled to compensation.


Chris Clarke
Nervous shock claims
Stacks Law Firm

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