The spate of physical violence in our society has increased tremendously, daily; the media is inundated with the news of all forms of assaults. It seems as if people have not taken lessons from all this reportage as it keeps rising astronomically. Unfortunately, this ugly trend has not spared healthcare workers and this is a dangerous position that must be discouraged.
The World Health Organization (WHO) defines workplace violence as, “Incidents where staff are abused, threatened, or assaulted in circumstances related to their work, including commuting to and from work, involving an explicit or implicit challenge to their safety, well-being, or health.” WHO considers both physical and psychological harm, including attacks, verbal abuse, bullying, and both sexual and racial harassment, to be workplace violence.
In a study conducted by the New England Journal of Medicine, there are 4 types of violence that can occur in the workplace. The first type is by perpetrators who have no association with the workplace or employee. In the second type, the assailant is a customer or a patient of the workplace or employee. The second type of violence, usually committed by the patient, their families, or their friends, is most prevalent against healthcare workers. A third type is when the attacker is a current or former employee of the workplace. The fourth type occurs when the perpetrator has a personal relationship with the employee but not with the workplace.
Also, in an article published by BMC Health Services Research, titled, “Manifestations of verbal and physical violence towards doctors: a comparison between hospital and community doctors” by Tamar Nevo et al, doctors often are a target for workplace violence. About a quarter of emergency room doctors reported that they were the victims of physical abuse over the previous year. In a study conducted at Michigan University, 89% of the violent incidents were by patients, 9% by family members, and 2% by friends of the patient.
The primary reasons for violence directed at the medical staff are long waiting times, dissatisfaction with treatment, a hurtful comment by a staff member, or the influence of drugs and alcohol on the attacker.
According to the U.S. Department of Labor, 12% of the injuries sustained by registered nurses are from violent acts. These injuries can be deadly. Last year in Nigeria, the National President of Nigerian Association of Resident Doctors (NARD), Dr. Aliyu Sokomba, Secretary-General, Dr. Bilqis Muhammed, and Publicity and Social Secretary, Dr. Egbogu Stanley, the association condemned the recent attack on members who were performing their legitimate duties in Maitama District Hospital, Abuja and Nnamdi Azikiwe University Teaching Hospital, Nnewi.
The recent happening at the Lagos State University Teaching Hospital (LASUTH) wherein the relative of a patient, who was presented with a gunshot injury, assaulted the staff has brought the discourse to the fore again. In the process of trying to resuscitate the patient, the relative attacked 3 nurses and a doctor in the line of work. In fact, one of the nurses had a deep cut on the head, while one was almost stripped naked. However, the security personnel of the hospital later got him apprehended and arrested.
With the significant rise in the population of Lagos, both in numbers and in age, the waiting time to see a doctor gets longer in both the emergency room and the wards. These frequent acts of violence against employees can have on their morale over time. “Emergency care is one of the specialties that do have a high burnout rate. How many other places do you go to work, and it’s commonplace and almost accepted that people are going to swear and scream at you? Eighty percent of the emergency physicians say that patients threaten them or threaten to return to the emergency department to harm them. The cumulative effect of both kinds of violence does wear and it creates burnout. I think it’s contributing to nurses leaving the profession.
Although the hospital has put up “zero tolerance” signs, patients and their relatives do not adhere to this instruction. With the various ways of escalating the pain of patients and their relatives to the hospital management, people still find it easier to be violent rather than engage with the management team. Every day across the country, people are verbally and physically abusing staff.
The apprehended relative of the patient has been taken to court and the law would take its due course. All hands are on deck waiting for the verdict. It is wise to state that everyone needs to be calm even in the face of utmost provocation and seek other methods of dispute resolution rather than resorting to violence.
According to the Chief Medical Director of the hospital, Professor Adetokunbo Fabamwo, with the level of innovative solutions that LASUTH is bringing to Lagosians through its dedicated healthcare workers, it can only be done in an atmosphere free of chaos and agitation. Violence against healthcare workers is unacceptable. It harms the psychological and physical well-being of the staff but also affects their job motivation.
“The management of the hospital, under any circumstances, would not tolerate any assault against her staff going forward. The hospital provides for checks and balances within the hospital which are available to treat situations if they occur, and the hospital on several occasions appealed to aggrieved members of the public to seek redress through various channels.
The hospital is committed to providing quality healthcare services to our patients and their relatives and we urge everyone to cooperate with our staff to facilitate their care,” he added.
As a responsible workplace, LASUTH has continued to investigate workplace violence incidents, risks, or hazards; provide training and education to employees who may be exposed to workplace violence hazards and risks; meet record-keeping requirements; and prohibit acts of discrimination or retaliation against employees for reporting workplace violence incidents, threats, or concerns.
It has become expedient, therefore, for policymakers, hospital managers, and supervisors should work collaboratively to minimize workplace violence and ensure the safety and psychophysical stability of all healthcare workers in Lagos and the nation at large.