We all have a right to be treated with dignity and respect

Navina Evans profile picture

08 May 2019

Navina Evans
Chief executive
East London NHS Foundation Trust


Around a year ago I was the consultant psychiatrist on call for the last time in my career. I carried out an assessment of a patient who was very unwell. A young support worker accompanied me during this assessment. All was fine but suddenly and unexpectedly, the patient spat in his face. It was shocking and upsetting. My support worker colleague continued to do his duty with dignity. When we completed the assessment my colleague went into the adjoining room where he started scrubbing his face vigorously with a paper towel, clearly upset though trying hard not to show it.

This incident brought back a strong recollection for me. It was of one occasion from many years ago when I was spat at. What happened to my support worker colleague transported me back to that time, and the associated emotions came flooding back. I have been thinking about this ever since, wondering what I should do or say now in my role as chief executive.

Then I received another reminder. A few weeks ago, my staff mentor, contacted me to express hurt and anger because she had experienced a situation where someone spat at her. She said that she is a ‘strong’ woman, but what happened was so degrading that it nearly broke her.

Spitting is a gut-wrenching assault. It is horrible for all involved. The person who spits at us must feel utterly desperate and completely disempowered.

Navina Evans    Chief executive

Spitting is a gut-wrenching assault. It is horrible for all involved. The person who spits at us must feel utterly desperate and completely disempowered. They are reduced to spitting as the only means of expression at that moment in time. For the care giver, who is trying their best to help, usually under very difficult and challenging circumstances, this is the ultimate rejection, the ultimate attack. We rarely talk about this, it is far too uncomfortable. But sadly, this is something that happens far too often to our colleagues.

I ask myself what can be done. We can, of course, improve policies, processes and reporting. We can ask for greater help from the police, we can support sanctions and prosecution.

Navina Evans    Chief executive

I have found it very difficult to write about this. I ask myself what can be done. We can, of course, improve policies, processes and reporting. We can ask for greater help from the police, we can support sanctions and prosecution. We must do more to prevent these situations and always take the appropriate action.

We can do more to deal with the sadness and humiliation involved. I have recently slowly started to open up conversations about this, it always feels awkward. What I have heard from colleagues has made me conclude that there is so much more to be done to look after one another in these situations.

Navina Evans    Chief executive

Is there something else we need to be better at doing? I think we must find a solution. When these things happen, we can do more to deal with the sadness and humiliation involved. I have recently slowly started to open up conversations about this, it always feels awkward. What I have heard from colleagues has made me conclude that there is so much more to be done to look after one another in these situations. We can attend to the need to be cared for, which exists in all of us from time to time. It is important to feel that it is all right to be really upset and it is definitely all right to have others give you comfort.

We all have a right to be treated with dignity and respect. We all also have a right to expect that those with whom we work closely will take care of us when the unimaginable happens.

This blog also featured on the East London NHS Foundation Trust's website.

About the author

Navina Evans profile picture

Navina Evans
Chief executive

Navina has over twenty years’ clinical experience in psychiatry, medicine and paediatrics, and came to East London in 1997 as a consultant psychiatrist. In 2011 Navina took on the role of deputy chief executive and director of operations at the East London NHS Foundation Trust (ELFT), and was appointed as chief executive in August 2016.

Prior to 2011, Navina worked as the clinical director for Child and Adolescent Mental Health Services (CAMHS) at ELFT, where she led on ensuring effective delivery in terms of quality, performance and effectiveness and had lead responsibility for partnerships and integrated care.

Follow Navina on Twitter @NavinaEvans

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