Two security guards who forcibly removed a drunk and violent patient from Royal Prince Alfred Hospital's emergency ward have been sacked for misconduct, the latest in a string of security issues plaguing the NSW hospital system.
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One of the guards will take his dismissal to the Industrial Relations Commission on Wednesday, the day before Health Minister Jillian Skinner is expected to meet with the Health Services Union to discuss violence in hospitals.
Ms Skinner agreed to meet with officials following the near-fatal shooting of a police officer and a security guard in Nepean Hospital's emergency department last week.
Michael De Guzman, a patient believed to be affected by the drug ice, allegedly grabbed Senior Constable Luke Warburton's gun during a struggle on the ground and fired two shots, hitting the officer and the security guard, Barry Jennings, in their legs.
Doctors, nurses, security guards and emergency workers have since spoken out about a crisis NSW hospitals, with violence increasing alongside skyrocketing use of crystal methamphetamine, or ice.
The number of ice-related presentations to 59 public hospital emergency departments in NSW increased more than seven-fold between 2009 and 2014, according to a NSW Health background paper released in September.
However, security guards say they don't have legal powers to detain or restrain violent patients.
A security incident report viewed by Fairfax Media shows that on May 11, 2015, two guards at RPA took a patient by both arms and escorted him out of the Camperdown hospital's emergency department after he had been repeatedly abusive.
Fairfax Media understands the patient had attended RPA several times in the preceding days and was about to be issued with a barring notice for aggression, abuse and threats.
The incident report, written on the day of the incident by one of the now-dismissed guards, said security had been called to the emergency department because the man had tail-gated staff into a ward and was being aggressive.
He threatened to kill the guards, saying "you's are all c--ts, I am gonna kill all of you's," and attempted to punch one, according to the report.
However, when the guards restrained him and forced him outside, he fell back and hit the pavement, causing his head to bleed.
A spokeswoman for Sydney Local Health District confirmed that two guards were "terminated for misconduct following their inappropriate interaction with a member of the public".
"NSW Health has a strong policy position that violence against any staff member or patient is not tolerated. There are comprehensive policies on the management of security and violence issues in the workplace," she said.
She said RPA had about three incidents per week out of more than 7000 patients who came through the hospital.
The HSU, which will represent the guard in the IRC, said the case is another example of security officers being expected to keep hospitals safe but being hamstrung by laws that confine them to "observing and reporting" only.
"Security officers are consistently operating in a grey zone to manage difficult patients but ... then facing the threat of their job being on the line," said HSU secretary Gerard Hayes.
Ms Skinner has declined to comment on hospital safety before Thursday's meeting.