Disclaimer: The aim of this article is not to decide whether it is the Patients, Doctors, Media or the “Gormint” who is responsible for the rising cases of violence against doctors in India. Rather, we hope to provide a guide that can be followed, to prevent and deal with such instances of violence against doctors.
There was a time when doctors were considered next to “God” and treated with utmost respect. However, with the turn of events in our country today, doctors are being rounded up and beaten just like the ‘palindrome of god.’
Our super-powers of quick judgment,skills and empathy, help us deal with our patients on a day to day basis. But, we do need to add one to the list – self-defense.
There have been plenty of episodes of doctors facing violence, and not even one of the knee-jerk strikes has led to any change in the scenario. As medics, we are already the smart ones among humans.
It’s high time that we are smart enough to save ourselves and avoid the ICU bed because the conditions are not likely to be any different.
[The Ultimate Survival Guide for Violence Against Doctors]
You are not God!
Remember that time the patient in the ward told you,
“Beta aap toh humare liye bhagwan jaise ho (Son, you are like God for us)”
All of us have heard this compliment at some point during our lives as medical students/ doctors. Felt good, didn’t it? Now consider, the same patient gets their son gasping to the Emergency Department. You try your best to resuscitate the boy. Alas! That life could not be saved. However, you were “like God” right? You did accept it, remember? That, right there, is breaking the trust that the relatives had in you. This broken trust is often vented out as anger leading to the catastrophic set of events that ensue.
We need to establish this from the very start. We are as human as the patient, and we will try our best as a fellow human being to save the patient’s life.
So the next time, somebody calls you God-like, hasten to remind them that you are just another highly qualified human doing their job.
The harbinger of bad news
Majority of instances of violence against doctors happen at the time a patient is declared dead. You will have to do this at some point in your career. Declaring death is a difficult job, because it entails proper counseling and explaining to relatives scientific things at a time when they have just lost their loved ones. Here’s how you can go about it:
Inform Security
Always, always inform the security before you declare a patient dead. I know those malnourished a-muscular men are not worthy of being called security, but they’re your best bet. After all, Captain America was just Steve before becoming Captain America. Don’t doubt their strength, they already do.
Chose the right setting
Do NOT declare deaths in the ward. Take the relatives to a quiet place (like a side room). Make them comfortable. Provide them with a glass of water.
Call the Senior
Do not rush into a situation that you are not confident of handling. If you are not sure about how it is done, there is no shame in calling a senior doctor to help you. It is wise to observe how others do it a few times before you go ahead and break bad news independently.
Learn to say NO
You are the doctor, and you have the right to reject treatment to a patient when you know the relatives are potential troublemakers. I know it’s moral obligation to help people as doctors, but you can only do that as long as you are alive.
*This may not always be possible. For example, in any set up, you may be required to provide emergency medical care to every patient*
Someone more qualified? Refer.
Since medicine is evolving at such a rapid pace, it is impossible to know everything. If the facility has a more qualified specialist (example a cardiologist), immediately refer the patient. Don’t attempt to treat something you are not trained to.
Mob Control
Avoid having multiple relatives. This is not your job and you can’t do much about it. It is the job of the ‘security’ and the ‘hospital administration,’ but you can remind them time and again because laaton ke bhoot baaton se nahi maante.
Look for STAMP
Violence against doctors is now a well researched field. It is often easy to predict when a patient or their relatives can turn violent. Look for these useful indicators:
- Staring or lack of eye contact
- Tone and volume of voice
- Anxiety levels of the patient
- Mumbling
- Pacing
If you notice the signs mentioned above in a person, be on high alert. Immediately keep the security on standby and get your seniors to help you handle the case further. Stay Alert!
Communicate, communicate, communicate
Be empathetic, explain everything about the procedure that you intend to do. Take a written informed consent. The condition of the patient, the prognosis, the risks involved- talk out everything! This can be the most important part not only in saving yourself but also in satisfying the family because, in the end, everyone has morals or some societal values, however uneducated or ignorant they may be. You need to appeal to that sense and leave them with the confidence, that you did your best for the patient.
Create your own alarm systems
Tired of asking the hospital administration to install alarm systems?
Be the change you want to see.
Create an SOS WhatsApp group with all the residents. No good mornings, no recipes, no adult jokes. This group is STRICTLY for emergencies. If you notice the situation getting out of hand in any part of the hospital, quickly drop a text stating your location. Our sheer numbers are enough to stare down any mob.
Play Kung Fu Doctor
Learn self-defence, karate, Kung-Fu, kushti, kickboxing- doesn’t matter if you’re thin or fat. If a panda can become a Kung-Fu master, so can you. If all the above measures fail, and you find yourself in a situation where you think violence is imminent, follow your gut! If you think you can block a few blows and land some, go for it! It’s self-defense. However, if you are surrounded by a mob, there is no way you can overpower so many people. In that case, run! Always make sure you have an exit planned in case things go south.
So that was our Ultimate Guide for Surviving Violence against doctors. Have suggestions you would like to add? Comment below.
-Dr. Saad Ahmed and Dr. Rohit Nathani
(The Indian Medical Student Team)
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