Hospital violence: medical workers, patients, public all to blame

By Pham Minh Triet   July 20, 2019 | 06:15 pm PT
“Do your job as a doctor! Why do you keep asking questions?” yelled a woman in my face, smashing my desk.
Pham Minh Triet

Pham Minh Triet

She was the angry mother of a child patient I had one night years ago at the emergency department of the Ho Chi Minh City Children's Hospital No. 1.

The child had high fever and her parents had given her some medicines at home before bringing her over.

So I had to ask about the medicines to ensure there is no overdose. But the irritated mother kept yelling, demanding swift diagnosis and treatment.

Another woman, possibly a relative of hers, stood by the entrance and videotaped our interaction.

It was irritating but I succeeded in calming down and getting the mother out of the room. Then I got the child’s grandmother and told her the poor child could not be given any more medicines as she had had a double dose at home. I instructed her to cool the child with wet cloth and promised to check after 30 minutes.

In the emergency department, we would identify which patients need priority attention to ensure proper allocation of manpower and save lives.

We have two shifts every night, one doctor would be in charge of one shift. From 10 p.m. to 7 a.m. every day, we would receive an average of 100-150 patients. Overcrowding is the norm.

One other time a man rushed into the department at 1 a.m. with a child and demanded immediate attention ignoring the 10 other children waiting for their turn.

A colleague of mine checked the child and told the upset man to join the queue since the child did not need emergency treatment.

He got mad and repeated his demand. Then he began to curse us, calling as cruel, heartless money-grubbers. He seemed ready to resort to violence before hospital guards came and stopped him.

Such experiences are common for doctors at Vietnamese public hospitals. The newspapers are full of these stories.

To my mind, there are three sides to this problem: medical workers, patients' families and the public.

I admit the medical sector has a lot of work to do to improve the attitude of health workers. For a long time now doctors and nurses have been criticized by the public for their poor attitude towards patients and their families. But it's not easy for them to carry heavy workload at a time when normal people get to sleep.

Several hospitals did train their personnel in communicating with patients, inviting psychologists for the purpose. However, the training outcomes were ineffective as most of those experts have never worked in a hospital, have not experienced a night shift with a big, anxious crowd.

I also think of other reasons that make patients and their families unhappy, including incompetent health workers, insufficient infrastructure, poor planning of hospital facilities, lack of instructions, and others.

As for patients, I find that most do not have basic knowledge of healthcare. During the time I worked at the pediatrics hospital I found that only 25 percent of the patients who came to the emergency department really needed hospitalization. Many of them obviously could wait until morning for normal checkups.

Most people brought their children to the emergency department because they did not know how to handle simple ailments at home.

But there were also others who were confident after looking up Google and refused to cooperate with doctors. Occasionally there would even be a person telling the doctor what to do.

Some patients would be under the illusion that doctors could cure every problem, even final-stage cancer. If a family member then died, they would blame the doctors and be ready to attack health workers.

A majority of Vietnamese cannot be bothered to queue up and await their turn at hospitals, and this even made many of them angry. It seems to me almost every patient wants to be the first to be checked, making hospitals chaotic as a result.

I also find these attitudes prevalent among the public. The ubiquity of social networks and people sharing negative news from the medical sector on them has nurtured hostility toward health workers among the public.

Not many people have enough knowledge to recognize the right and wrong in stories appearing on social media, yet they start sharing and make disparaging comments. In many cases, a mistake made by an individual medical worker meant calumny for the entire health sector.

Some patients come to hospitals carrying this bias and tend to make every situation worse than it is and blow up things if there is a problem.

A screenshot from camera footage of Hanois Saint Paul Hospital shows a doctor (L) being hit by a patients father as he was explaining the boys head wounds, April 13, 2018.

A screenshot from camera footage of Hanoi's Saint Paul Hospital shows a doctor (L) being hit by a patient's father as he was explaining the boy's head wounds, April 13, 2018.

On the other hand, the medical sector obviously needs to make improvements. I think that every hospital should put up signboards stating clearly the rules for communication and conduct for both health workers and patients.

Each hospital should ensure optimal allocation of manpower to provide proper service to patients even when it gets a large number of patients. Cameras and guards are also required in busy departments.

Staff members should be encouraged to report any instances of harassment from the patients or their families. They rarely report verbal abuse towards them, but having full reports of all kinds of abuse will help hospital managers and healthcare authorities understand the seriousness of the matter and prompt them to take measures.

Hospitals can make small adjustments to keep tempers in check: Setting up convenient waiting area where patients and their families have access to drinks, newspapers, televisions and be able to observe the medical staff at work, and making regular announcements in case of delays.

With the government cutting subsidies to the health sector, I believe every hospital will work hard to improve its service to attract patients to ensure revenue.

I wish patients understand that we doctors do not want to be bad or indifferent to them. Once we enrolled the university to be a doctor, we wanted the good for patients. It will be nice if we and you can be civil to each other.

*Pham Minh Triet is a practicing psychologist in Ho Chi Minh City. The opinions expresssed are his own.

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