First aid to deal with ‘gypsy’

Ho Chi Minh CityA 41-year-old male patient was hospitalized due to a traffic accident, was being taken by a nurse for blood testing, when a person burst into the emergency room and shouted, “Are you guys like that?”

The incident happened at Gia Dinh People’s Hospital recently, recorded by the emergency room camera. The person who broke into the emergency room repeatedly uttered obscene words, scolded the doctors and nurses for letting their family members “wait for a few hours without visiting”, asking to appoint someone to watch and take care of patients 24/24. .

Meanwhile, according to the medical staff participating in the duty that day, the time from the time this patient was admitted to the hospital until the completion of the medication, blood test, film, transfer of the shoulder cast and the appointment of a specialist doctor. orthopedic examination, only 24 minutes.

Realizing that the person entering had a tendency to assault, the crew rang the Code Gray alarm, the security team was there immediately. However, this person despite the intervention still proceeded to assault the medical staff. When the police entered the hospital to work, everyone knew that this was the patient’s sister-in-law.

On the same day, just a moment after the incident, a group of about a dozen people burst into the emergency room shouting “you guys send people here, what are you doing to hide the patient”. When the doctors asked, they learned that the person being found was a male patient who entered the emergency room 18 hours ago because of drunkenness and vomiting. After checking, the doctor said that this patient had voluntarily left the hospital after injecting the drug and asked them to “report the police to work, access the camera”. This group of people still threatens and prevents the emergency team from treating other patients.

At that time, doctors were urgently handling 5 cases of acute stroke, one patient stopped breathing. “This commotion has affected the stroke patient’s golden time for emergency care,” the doctor on emergency duty that day shared.

At the end of July, also at this hospital’s emergency department, a doctor was strangled by a family member of a pediatric patient because he thought he was slow to rescue his daughter. Meanwhile, the girl had a fishbone choke, went to the hospital to check her vitals normally, no difficulty breathing, no crying, the medical staff told her to wait for about 10 minutes for the ENT doctor to come and pick up the bone. .

Not only at Gia Dinh People’s Hospital, according to doctors, being abused by a patient’s relative This is a situation that emergency department medical staff face in many hospitals every day. This is the most dangerous department in the hospital, due to the characteristics of receiving patients for initial treatment, it comes into direct contact with many objects and many unexpected situations.

Dr. Dieu Ha Lam, Head of Emergency Department, Le Van Thinh Hospital, who has more than 20 years of experience in the emergency field, said that doctors and nurses here often suffer from verbal abuse, “almost every day.” any have”. Some medical staff are also subjected to physical abuse; A patient’s family suddenly burst into the emergency room with a knife and chased the doctor, threatening to kill him. “Many doctors, after being abused, change careers or apply for another department, not doing emergency work anymore,” said Dr. Lam. He did not say how many doctors changed jobs after being abused.

Nearly 30 years of working in emergency medicine, Dr. Vu Hiep Phat, Head of Emergency Department, Children’s Hospital 2, admits that doctors and nurses are scolded “as much as usual”, the situation of being beaten is rarer. . “About 85% of patients who go to the emergency room are very cooperative with doctors and nurses, while some people raise their voices unreasonably, if their requirements are not met, they will get angry and call everywhere. Many people are very ‘aggressive’, the doctor has not had time to say anything and has rushed into the hands and feet,” said Dr. Phat.

According to a survey of the Ministry of Health, in recent years, there is not a month without cases of violence against doctors, from mild to severe, at hospitals and medical facilities across the country. The situation of theft, stork, drunk people, drug use, insanity… disorder in the hospital is also quite common. From 2010 to 2017, the whole country recorded 26 cases of serious disturbances in hospitals. The Ministry of Health recorded that most of the cases of violence against doctors occurred at provincial health facilities, 70% of the victims were doctors, 15% were nurses, even some doctors were injured for life. network.

This is also happening globally. According to the World Health Organization, violence against doctors is mainly caused by patients and their family members. In the US, 80% of nurses surveyed in 2014 reported being abused in the form of punches, kicks, scratches, bites, spitting, threats and harassment. According to the Indian Medical Association, over the past year, there have been about 400 cases of violence against doctors and this is just the “tip of the iceberg”.

Crowded patients at the Emergency Department, People’s Hospital 115. Photo: Hospital provides

Deputy Director of Ho Chi Minh City Department of Health Nguyen Anh Dung said that the emergency department is the “head of the storm” of the hospital, so in the process of receiving and treating will face many difficulties and pressures. The city’s health sector has tried to reform administrative procedures, building many channels to listen to the opinions and contributions of people, patients as well as medical staff to improve service quality in facilities. health care, especially public institutions.

“People entering the hospital need to keep a safe treatment environment, trust the doctor so that the medical staff can work safely and the patient can take care of their health,” Dung shared.

Causes of violence then it was explained by the patient’s family that he did not understand the emergency procedure, was impatient for his loved one’s condition, felt that the doctor was slow, not active, did not work well… relatives, relatives using alcohol, drugs, or thugs hospitalized.

On the side of medical staff, leaders of hospitals noted that some people were not skillful when communicating with patients; handle situations or explain poorly in the context of an overloaded hospital, a harsh working environment, stress and time pressure.

“Violence is also related to cultural issues. Violent behavior has become a habit of some Vietnamese, for example, when going out on the street, just hitting a car can lead to stabbing each other,” said Dr. Phat shared.

Whatever the reason, Dr. Lam believes that hitting others is wrong. He said: “If patients or relatives are not satisfied with the behavior of doctors and nurses, they can call the hotline, ask hospital leaders to intervene, report to the police for handling, or even sue in court,” he added. “It is unacceptable when not satisfied, cursing, insulting dignity, threatening, hurting other people’s bodies, affecting the treatment of patients in need of emergency.”

Over the years, hospitals Implement many solutions to reduce violence medical staff, but the condition has not improved significantly. Doctor, Doctor Nguyen Hoang Hai, Director of Gia Dinh People’s Hospital, said that four years ago the institute has implemented Procedures for emergency response to security incidents – Code Gray. The list of phone numbers of relevant employees is entered into the software, when there is an insecurity situation, the doctor presses the alarm button, the automatic system will directly call the security force, and at the same time Please contact the local police. This process has so far been replicated in many other medical facilities, helping to promptly handle cases of disorder, use of threatening weapons, and assaulting doctors.

In addition to this system application, Le Van Thinh Hospital also has a solution to group emergency levels by color on the patient’s bracelet, explaining to family members. In which, the red circle is a critical patient, needing emergency treatment within 5 minutes; yellow indicates medium level, processed in 5-30 minutes; white and blue rings may delay, final processing. Relatives have their own waiting area, looking at the bracelet is able to know the patient’s status.

“When having to go to the hospital, everyone always has the mentality of wanting to be treated first and treated quickly; but emergency doctors must prioritize the patient’s condition, not like buying goods, no one comes first. will be done first,” said Dr. Lam.

In addition, now in many hospitals, doctors and nurses learn martial arts for self-defense, in addition to health training to perform well in their professional work of saving lives. Most hospitals have equipped audio and video camera systems to help protect doctors and nurses when they need to retrieve the incident.

Doctor Nguyen Minh Tien, deputy director of the City Children’s Hospital, said that the institute’s leaders regularly remind and share experiences with doctors and nurses on how to communicate, how to behave with patients, to understand the mood of family members to promptly respond to needs, minimizing the risk of conflict. “Communication skills are very important, doctors and nurses must limit the time the patient’s family members wait for news of their loved ones, such as how long it takes to notify the patient’s information so that the family members are not impatient. “, said Doctor Tien.

According to Dr. Tien, if family members cause trouble, medical staff should try to be soft, calm the situation, keep a safe distance, and use an emergency alarm program for support. City Children’s Hospital deploys Code White security system, to quickly gather support team when needed. Code White team including leaders, psychologists, security guards, customer care team… will be present at the scene of the conflict to help reassure, soothe and reconcile insiders.

Emergency doctor was strangled by a patient's family member

The camera recorded the scene of a doctor at Gia Dinh People’s Hospital being attacked by a family member of a child on the night of July 27.

Meanwhile, Doctors want patients to understand more about their work, the hard work of the doctor. They believe that the hospital setting up the alarm system and strengthening the security force is just a solution to deal with the situation. The root problem is to improve trust among patients, relatives and medical staff, in the spirit of mutual respect and sharing.

According to Dr. Lam, doctors and nurses who are at fault with patients will be disciplined with appropriate forms; but also need to have sanctions against relatives and patients who attack medical staff. In fact, patients who do not have money to go to the hospital can still receive emergency treatment, even if doctors are beaten and scolded, they still have to continue their work of saving lives. Someone abused a medical staff but was not handled except for an apology, while a passenger on an airplane if he hit a flight attendant could be banned from flying, the person who pulled out a gun threatened the driver that he could go to jail. .

“Medical doctors don’t need an apology. If something happens, even if you apologize, the doctor will be beaten and scolded, affecting your mental, physical, and honor”, Dr. Lam said and suggested pictures. sanctions such as reducing health insurance benefits or suspending insurance in the next medical examination and treatment, heavy fines, notification to the locality or working agency…

“The law needs to stipulate appropriate deterrent and handling measures for those who attack doctors and nurses, because it is an act against public officials,” the doctor suggested.

Many countries have adopted measures to protect health workers such as recruiting more security staff, monitoring cameras, limiting the number of visitors to patients, allowing medical staff to bring guns into hospitals to self-destruct. In 2020, China enacted a new law to ensure the safety of medical staff, prohibiting individuals and organizations from threatening or harming the safety and dignity of medical staff. Violators will be administratively sanctioned and detained. In the United States, acts of assault causing bodily harm to health care workers can be punished by imprisonment or a fine, depending on the seriousness of the violation.

Le Phuong


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