Medical resignation wave has been staged in many countries
Recently, the United States San Le Android Vascular Surgery Hospital closed the emergency department.
"The hospital has COVID-19 epidemic prevention regulations, and visits are not allowed. The hospital refuses a visitor to enter on this grounds. He is excited and threatens to bring a gun to the hospital." The nurse of the hospital, Mawata Kamala, said that earlier, another patient suddenly lost control of his emotions and swears, spitting at the medical staff. "He kept waving his fists and threatened to shoot in my face. Considering safety issues, the hospital decided to suspend emergency services."
AP reported that Kamala's situation was not an isolated case.
International Committee of the Red Cross (ICRC) summarized global data showing that after the COVID-19 pandemic, violence and attacks against medical staff have increased significantly. In the first six months after the pandemic was announced, more than 40 countries reported 611 physical or verbal attacks and threats against medical care.
"Medical care has been subject to violence and threats," Mawata Kamala told "Caiser Health News", "But the COVID-19 pandemic has magnified the contradiction."
In April 2021, a 62-year-old woman in India died of COVID-19. His son clashed with staff at the Apollo Hospital in Delhi, India. /Indian Express
Medical care is attacked everywhere
At the beginning of the epidemic, people around the world held commemorative activities almost every day to express their respect for front-line medical staff.
Emergency doctor Stu Coffman, Dallas, Texas, USA, has felt this enthusiasm. "In March 2020, every night at 8 o'clock, people will stand on the balcony, porch or window, applaud, beat pots and pans, make various sounds, and cheer for medical care." This event is called Solidarityat8, and millions of users from many countries said they had participated on the social media " Twitter ".
Twitter user @Mitzi Weinman posted a post recording himself and her husband participating in Solidarityat8 and cheering for "medical care". /Twitter
Later, the situation changed. The public vented the inconvenience and negative emotions caused by the epidemic on medical care.
Cox Medical Center in Branson, Missouri, said that in 2019-2020, the hospital reported 123 incidents of patient attacks on health care workers, three times that of the previous year. The situation of related incidents causing medical injuries has also increased from 17 in the previous year to 78.
"Patients and families seem to be getting more and more irritable." Ashley Blevins, a nurse at Cox Medical Center, said that aggressive behaviors include spitting, speaking dirty words, and pushing hands. After frequent negative events in
, the hospital's recruitment was also affected. “The first question we are interviewing now is, ‘Can you keep me safe?’” Ashley Blevins said.
htmlIn June, Brazil released a survey of 1,166 health care workers. 47.6% of the respondents admitted that they had suffered violent attacks during the COVID-19 pandemic, with the frequency and extent of the epidemic being higher than before the outbreak.
In Taiwan, China, the new crown epidemic broke out in May this year. After June, patients took knife attacks on medical staff and violently attacked medical staff in many medical institutions in New Taipei and Taipei, and other places, and destroyed hospital facilities. Chen Yufeng, chairman of the Taiwan Nursing Association, said that some patients deliberately coughed and spitted at the nurses and shouted, "I want to die together."
According to statistics, from January to September this year, Taiwan, China reported 14 medical violence cases, which exceeded (12) in 2020. In order to protect medical personnel, many places have joined hands with the police to form a "joint medical and riot prevention team".However, the National Taiwan University Hospital Enterprise Trade Union pointed out that in a violent incident, the security personnel of the joint defense team responsible for the safety of the hospital told the violent medical staff: "You were beaten to death, and our (resident police force) will not report the case for you."
Picture sourced from The Guardian
0 Complex reasons caused violence to medical staff
In April 2021, JAMA Network issued a statement saying that in the past 10 years, taking the United States as an example, the number of violent incidents of medical staff has been increasing. According to U.S. Bureau of Labor Statistics data, from 6.4 injuries per 10,000 full-time employees in 2011, it increased to 10.7 per 10,000 full-time workers in 2018.
"During the pandemic, various situations seem to be fueling violence against medical staff," the article said.
Image is from JAMA Network
Global Health Yearbook released Pakistan study, trying to find the cause of this phenomenon. The study used 29 violent incidents reported from April 7 to August 7, 2020 as a sample, and the analysis pointed out that the "most common" perpetrators were relatives of COVID-19 patients. The most common causes of conflict are "distrust medical care", "believe in conspiracy theories", "patients are rejected due to limited hospital space", "hospital epidemic prevention strategies" and "new coronavirus patients die".
The US study also had similar results. At the end of 2020, the country's Nurses Alliance interviewed more than 15,000 registered nurses. About 20% said that frequent workplace violence may be related to the shortage of staff, changes in patient structure and limited visitation caused by COVID-19.
"During the pandemic, nurses took on a lot of extra responsibilities. They included feeding patients, drawing blood, and cleaning the rooms. These tasks were originally done by the patient's family and other hospital staff. But now, nurses must take them over to minimize the number of visitors and avoid cross-infection." said Jane Caldwell, a nurse at the Research Medical Center in Kansas, Missouri., who has a significant increase in workload, the number of patients each nurse needs to care for has not decreased.
"We have almost no time to communicate with our families and patients and listen to their concerns." said Jane Caldwell.
The Associated Press reported that some anti-intellectual views are prevalent, which has also caused medical workers to be blamed and attacked.
Katie Bobbitt, a spokesman for a hospital in Codaran, Idaho, said that some families of COVID-19 patients denied the existence of the epidemic and claimed that their relatives died because of poor treatment by medical staff. This caused several nurses in the hospital to dare to leave the hospital in their work clothes to avoid being attacked.
Ashley Coggins, a doctor at St. Peters Regional Health Medical Center in Helena, Montana, said she asked patients as usual if they had been vaccinated or were willing to receive the COVID-19 vaccine. "He cursed and said that vaccines were a conspiracy."
There are also some hospitals who refuse to treat unvaccinated people and do not wear masks, which has caused inconvenience in medical treatment and has also caused strong dissatisfaction among the public. But these epidemic prevention regulations are not only for patients. , New York State, Northwell Medical Center, the largest medical institution in New York, announced on October 4 local time that with the implementation of the vaccine mandatory order, the agency has fired 1,400 employees who refused to receive the vaccine.
"Sometimes, medical care is treated violently just because they are medical care." Paul Sanese, senior executive of Virtua Health in New Jersey and president of the International Association for Healthcare and Safety, pointed out that medical practitioners are more likely to be "victims of serious attacks" than other industries. In 2018, 73% of non-fatal injuries caused by workplace violence in the United States occurred in medical practitioners.
COVID-19 has worsened this "professional discrimination". A survey by the University of Rochester Medical Center in New York, USA found that medical staff are twice as likely to be harassed, bullied or hurt due to COVID-19 than others. In a qualitative analysis of the study, a Southeast Asian nurse cried and complained that she was banned from entering the supermarket. “They said I was a ‘rat with the virus’."
Picture source from U.S. News
Violence makes medical staff feel cold and resigned
" There is no magic medicine to solve problems such as violence in medical staff. It is multi-factor. "Terry Kovarenko, professor of emergency medicine at South Carolina Medical University in the United States, said that the first step in the response strategy should be to encourage medical staff to report actively. Later, by analyzing data on the time, location, causes of violence, etc., a plan can be formulated to avoid recurrence of similar incidents.
Terry Kovarenko has conducted randomized controlled clinical trials on violent incidents in medical institutions. One of the results shows that most violent incidents occur after 8 pm. Limiting visit time can significantly reduce the incidence and severity of attacks. In addition, the findings also illustrate the importance of "consistent behavior". "If a nurse allows five visitors to visit, while another nurse only allows two visitors, it will lead to conflict. "
Second, training medical staff to identify violence is also a key skill. "The best way to reduce attacks is to avoid them completely. Raising your voice and aggressive tone, accelerating your pace and suddenly approaching your body are all red flags. "Terry Covarenko said.
"Caiser Health News" said that medical institutions have recognized the dangers of violence in the workplace. The Kansas Research Medical Center, Missouri, has expanded its security team and added video surveillance devices to require clinical and security to receive self-defense training together.
According to NBC, Cox Medicine The center plans to equip 400 medical staff and medical technology working in emergency rooms and wards with positioning emergency call buttons before the end of the year. When they are attacked by patients in the hospital, press the button and the security personnel will set off for rescue immediately. The hospital also bought a dog, led by security personnel every day, patrolling the hospital to play a "deterrent" role.
Paul Sanese said that major hospitals should restrict "entry and exit" Quantity, ensure that every visitor is in and out of the channel with security and camera.
In order to protect the rights and interests of medical care, Taiwan, China has also revised the "Implementation of the Subsidy for Injury or Death in the Prevention and Control of Class V infectious Diseases". The Measures state that during the fight against the epidemic, medical staff or emergency medical rescue personnel suffer medical violence while performing prevention and control work, and the injured can receive a maximum subsidy of approximately RMB 229,000; those who are violently disabled will be subject to serious courses. The amount can receive a subsidy of approximately RMB 600,000-2.29 million, and the maximum death subsidy is approximately RMB 2.29 million.
, but these cannot eliminate the concerns of medical care. According to the People's Daily Overseas Network, data from the Taiwan Nursing Association shows that from February to May this year, a total of 795 registered nursing staff were lost in the local area. Cai Biru, a "legislator" of the People's Party who was once a medical staff at the National Taiwan University Hospital, posted a message on social media: "Heartful! The wave of medical staff resignation has still erupted! "
The latest data from the U.S. Department of Labor shows that in September alone, the working population of the U.S. health care industry decreased by 18,000. From the beginning of 2020 to the present, the U.S. health care industry has lost 500,000, of which about 400,000 come from the nursing field.
According to a survey by Morning Consulting, in the past year, the proportion of medical staff resigning in the United States has reached 18%. Even those who stick to their posts want to resign, because of excessive workload, overwork, low wages and lack of security. This has formed a vicious cycle. The more people resign, the greater the pressure left, and the higher the willingness to resign.
Source:
[1].'Are You Going to Keep Me Safe?' Hospital Workers Sound Alarm on Rising Violence. KHN
[2].Delhi: Anger spills into violence at Apollo hospital. Indian Express
[3]. Violence and discrimination were encountered during the epidemic, and Taiwan medical staff resigned. People's Daily Overseas Network
[4].Navigating Attacks Against Health Care Workers in the COVID-19 Era. JAMA. 2021;325(18):1822-1824. doi:10.1001/jama.2021.2701
[5].Violence against Healthcare Workers during the COVID-19 Pandemic: A Review of Incidents from a Lower-Middle-Income Country. Annals of Global Health. 87(1), p.41. doi.org/10.5334/aogh.3203
Source: Medical community
Author: Yan Xiaoliu
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