Security of health care workers, and particularly staff in emergency rooms, is the responsibility of both the hospital and the state said experts at a symposium on Violence in Health Care Settings at Aga Khan University (AKU). Health care workers need training in how to communicate and provide attentive care to anxious patients and their families as well as to recognise that violence in the workplace is not acceptable and should be reported.
Violence in hospitals is on the rise in Karachi, with health workers exposed to assault, physical and verbal threats and hospital property open to vandalism. According to a survey of over 380 doctors and emergency room staff at four tertiary care hospitals in Karachi, over 70 per cent had been verbally abused and 20 per cent physically assaulted within the last year. According to Dr Muhammad Baqir, Assistant Professor, Department of Emergency Medicine, AKU, who conducted the survey, almost 43 per cent of the people who had faced threatening behaviour or physical abuse, reported that weapons were used. It also found that physicians with less work experience were more likely to face workplace violence because, usually, they are the patient’s first point of contact. Dr Baqir pointed out that to reduce the chance of such behaviour, hospital staff must be trained in recognising the signals of impeding violence, resolving conflict and managing assaults.
According to Dr Aasim Ahmad, Dean and Chief Nephrologist, The Kidney Centre Post Graduate Training Institute and Chair, Bioethics Group, AKU, a lack of accountability, unfair policies and the inability to properly tend to the needs of both staff and patients also leads to violent incidents. The Pakistan Medical Association (PMA) has recently demanded that policies be put in place to control such violence. Physical attacks on doctors while they are working should be considered interference in the workplace and attackers should be fined or imprisoned. The PMA has also suggested that the security and protection of health care workers is the responsibility of the organisation where they work and that they should be fully compensated if they are injured in any such attack.
The importance of the rule of law was stressed by Hina Jilani, Advocate, Supreme Court of Pakistan and Director, AGHS Legal Aid Cell. Discussing the legal implications of violence, Jilani said that it is the state’s responsibility to ensure its citizens’ right to health and ensure the protection of health care providers. Moreover, physicians cannot be automatically charged with murder if a patient in their care were to die; instead, laws are to be interpreted in cases of medical negligence or error, an area where health professionals and legal community need to collaborate, she stressed.
Dr Murad Moosa Khan, Chair, Department of Psychiatry, AKU, touched on the root causes of violence in society which he believes are the unfair social conditions of daily life. Dr Tufail Bawa, Medical Director, Patel Hospital, Dr Shahab Shaukat, Instructor, Department of Emergency Medicine, AKU, Dr Summaiya Syed Tariq, Medico Legal Expert, Civil Hospital, Dr Seemin Jamali, Joint Executive Director and In-Charge, Emergency Department, Jinnah Postgraduate Medical Centre, Khairunnissa Hooda, Nursing Manager, Critical Care, AKU and Dr Sardar Sarmad, Head, Emergency Department, Liaquat National Hospital also spoke at the event.
The symposium will be followed by a workshop on March 27, 2010 to create a network of key stakeholders who can continue to work on this issue.