Say no to violence in hospitals!

Finding the cause

On June 1, at Nghe An General Hospital, a female medical staff member was punched in the face by a patient's family member in the emergency room. When she was attacked, the female staff member was assisting the patient. Immediately after, the police arrested the subject.assaultThis is worryingly not an isolated incident. In just over the past month, there have been a series of assaults on employeesmedicaloccurred at many public health facilities across the country.

More importantly, when the incident of the attack on the medical staff was reported by the press and posted on social networks, it received many different reactions from readers and social network users. Besides the angry opinions about the hooliganism of the patient's family, there were opinions justifying the violence with emotions such as "there is no smoke without fire", "what must people do to be upset", "the fault lies with the victim". Such justifications not only hurt the hearts of medical staff but also make many people question whether social ethics and civilization are deteriorating?

Looking for the question of why there are assaults on medical staff, and what justifications are there for such hooliganism? A medical doctor - specialist 2 in Nghe An (asked to remain anonymous) explained: Objectively, first, the trust of some people in medical staff has decreased, especially after a series of violations in the medical sector were exposed, many medical staff were arrested in the Viet A case related to the Covid-19 test kit. Second, a few medical staff in the past have had actions and words that are not in accordance with medical ethics. One bad apple spoils the whole pot.

Third, the emotions of the patient’s family members when in a medical facility are already pushed to the edge of “ready to cross the threshold”. In this state, they will be highly stimulated when they think someone has inappropriate gestures, actions, or words. Not to mention that there are family members who bring the patient in under the influence of stimulants such as alcohol or beer.

Subjectively, firstly, up to now, medical staff have been trained a lot in schools, agencies, and work units. However, the vast majority of these subjects and training classes only teach purely technical skills. Subjects and training classes specializing in soft skills such as patient psychology, patient family psychology, staff behavior, etc. are very few. Medical staff and employees mostly acquire these skills through self-study. And those staff with such a self-study spirit have mostly become leaders, with less direct contact with patients.

Second, the work pressure in the medical environment (especially the public medical environment), especially in the Emergency Department, is extremely stressful. For example, the Emergency Department of Nghe An General Hospital receives 200-250 patients every day. The medical staff here work with a spirit of urgency and efficiency. Invisibly, the normally polite words have become reduced and become a "heartless" request and command. In public medical facilities, the recruitment and use of human resources is very "economical", the medical staff here have to work at high intensity, for a long time, so they are "stressed". In circumstances that negatively affect their mental and physical health, medical staff may unintentionally have words and actions that do not please patients and their families.

Third, many medical facilities today do not perform hospital security well; security equipment is very limited. The security team (contracted with a security company) has many people who are "intermediate" workers, not professionally trained; many are elderly, have poor health... so when a situation occurs, this force can only stand by and watch, showing helplessness. For example, in the recent incident at Nghe An General Hospital, when a patient's family member raised their voice and was about to attack medical staff, the security guard at the Emergency Department calmly sat watching his phone.

In addition, many public hospitals today, in order to "save" human resources and expenses, have not yet formed a social work department. One of the important functions of this department is: Reception, guidance, information provision, introduction of the hospital's medical examination and treatment services to patients right from the time they enter the examination department or examination room... The social work department plays the role of "reducing pressure" for patients and their families. In reality, in hospitals that have this department, there are very few incidents of assault on medical staff.

Whose responsibility is it?

Obviously, the victims are not entirely at fault for incidents of assault or unsympathetic attitudes towards staff. Whose responsibility is this? - First of all, it is those who attacked medical staff. They are attacking the very people who are trying to protect the lives of their loved ones, the people who protect public health. Medical staff are on duty to save people without support tools, without the ability to defend themselves in a stressful and risky environment. It is necessary to consider the act of attacking medical staff as an act of attacking people on duty in order to have strong and strict sanctions.

Particularly for those who are attacking medical staff on social networks, they need to be alert and clearly distinguish right from wrong in each case and each individual; they should not equate inappropriate words and actions of a certain staff with the general perception of the medical industry. Harsh and unfair words and phrases towards medical staff in general not only hurt and scare those who are on duty to save people, but also cause people to have unfriendly reflexes when meeting medical staff; at the same time, they encourage violence in the medical environment. This will cause violence to escalate, spread, and become routine in society... gradually sweeping away all the most basic moral values ​​in society.

Next, it is the responsibility of the medical facilities themselves. Medical facilities have not done a good job of protecting themselves. Specifically, medical facilities have not done a good job of arranging and using human resources; have not done a good job of hospital security; have not done a good job of fostering, training and educating medical staff... It should be added that nearly 15 years ago, the Nghe An Health sector launched the movement "Innovation in style and service attitude of medical staff towards patient satisfaction" (including improving medical ethics, communication skills and service spirit of medical staff). Health sector leaders continuously disseminate and require medical facilities to implement the movement well. Reality is requiring facilities to promote the implementation of this movement.

Ultimately, it is the responsibility of every medical officer and staff. Every medical officer and staff needs to raise awareness of self-improvement, improve medical ethics, communication skills and service spirit. Along with that, every medical officer and staff must also learn how to behave appropriately in the social network environment. A word or sentence that is not appropriate to the context or situation can cause others to misjudge; the victim becomes the target of attack.

Returning to the case of a female medical staff at Nghe An General Hospital being attacked by a patient's family member, the leaders of Nghe An Health sector took appropriate, accurate and timely actions. Immediately after the incident, Director of Nghe An Department of Health Le Thi Hoai Chung requested the authorities to strictly handle the perpetrator; at the same time, requested medical examination and treatment facilities to review, consolidate and implement measures to ensure security and order according to regulations; proactively develop plans to prevent and respond to situations of disturbance and assault on medical staff; urgently review, install and maintain security camera systems and increase security personnel in key areas such as the Emergency Department, Examination Department, etc.

The Director of the Department of Health also requested that medical examination and treatment facilities must be public, increase consultation and explanation of rules and regulations in medical examination and treatment, the number of patients' relatives allowed to enter when taking their loved ones for examination and treatment; and professionalism in the behavior of medical staff and hospital workers.

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The leaders of the health sector have requested units to continue to thoroughly educate medical staff and employees on good medical ethics, good behavior and full explanation to the patient's family. They hope that the patient's family will share the working environment and nature of the work, creating all conditions for medical staff to perform their duties in the best way.

Director of Nghe An Department of Health Le Thi Hoai Chung

The good news is that right after the direction of the Director of Nghe An Department of Health, many medical facilities in the province have arranged training courses on medical ethics, communication skills and codes of conduct. This is one of the timely and necessary actions to help medical staff protect themselves and protect the trust of the white blouse./.