Prior to the escalation of violence itself identify sensitive triggers and promptly inform your senior doctors, before the matter slips out of hand. A key factor to aid this is in avoiding medical jargon, being well aware of how to break bad news, and prioritizing counselling in front of a nursing officer or a social worker familiar with the native languages and cultures. Remember the appropriate de-escalation technique can only be applied according to the category of violence and cannot be implemented when physical assault begins.
The idea of installing a panic room that has inlets and outlets with easy access to the staff and hidden away from the public glance, a panic button within all areas categorized by the hospital authorities to be ‘prone to violence’ that could have in- hospital announcements notified via apps or pagers available to all staff doesn’t seem to be a farfetched idea. The panic alarm can be outsourced to the local police station, considering most medical colleges have a police station within nearby premises.
Practice responsible counselling to patients
In addition to the numerous reasons for a mob attack, badmouthing your very own colleagues can be one of the primal reasons for an erratic encounter with the patients. Hence practicing good etiquette amongst colleagues is an important yet often neglected part of medical training and practice.
Regular drills and Workshops
Akin to fire drills, regular self-defense mock drills are important in establishing quick response behaviors amongst the hospital staff. Workshops involving violence assessment frameworks such as the popular popular STAMP approach which stands for Staring and eye contact, Tone and volume of voice, Anxiety, Mumbling and Pacing.
Awareness amongst Junior Doctors and Staff
A key factor in juniors being at the receiving end of violence apart from being first on call is that juniors often avoid active participation and generally shrug away responsibilities for numerous reasons most important being lack of awareness about the seriousness of such volatile situations.
Security guards have limitations, the current security employed in most hospitals do not have the basic equipment or training when the need arises. Deploying armed bouncers or central army personnel as seen in airports with screening detectors at entrances and exit points is not too impossible a task.
With the above suggestions and raising awareness that doctors are not against the general public rather a victim of the crumbling healthcare, one can hope for a peaceful co-existence between our doctors and the citizens of the world.
Author- Dr Deepthi N.S.