Thursday, 11 April 2013

Policies in place to protect health-care staff from abuse: MOH

WE AGREE that any abuse of health-care workers, whether verbal or physical, should not be tolerated ("Protect health-care workers from abuse" by Dr Zhang Weisheng, last Thursday; and "Abuse of health-care workers on the rise", last Saturday).

Our public hospitals serve large numbers of patients daily and we are grateful that the vast majority are appreciative of the hard work and good care provided by our health-care workers.

Unfortunately, there are occasions when our health-care workers have to face abusive behaviour from the public.

Our public health-care institutions have in place policies to protect their staff from abuse.

Staff who face abuse can seek assistance from their supervisors, who will step in to manage the situation.

Our hospitals will also not hesitate to activate security or press charges against individuals who resort to physical abuse.

Our health-care workers should be treated with respect. They come to work every day with the mission to care for patients as if they were their own loved ones.

Care and understanding work both ways and we hope the public is able to honour that.

Bey Mui Leng (Ms)
Director, Corporate Communications
Ministry of Health

Cecilia Pang (Ms)
Director, Corporate Communications

Protect health-care workers from abuse

LAST Saturday afternoon, my fiancee, who is a staff nurse at Khoo Teck Puat Hospital's cardiac intensive care unit, told a patient's family member not to use his mobile phone within the ICU as it could interfere with the medical equipment.

Though she was polite throughout the encounter, she was subjected to a verbal tirade, including finger pointing, that was vicious enough to reduce her to tears.

Senior nursing staff were called in and, at the end of the incident, not only was there no apology from the family member, but my fiancee was also informed about his feedback and told to understand his situation.

This notion of "the customer is always right" is unacceptable.

I understand that a patient's family has to endure extreme stress and anxiety, but it does not justify verbal abuse of health-care staff.

Health-care workers have the patients' best interests at heart, and this may occasionally be at odds with what is seen as "good" customer service.

As a doctor who has worked in both hospital and primary care settings, I have found that incidents of verbal abuse are not uncommon.

This is most often directed at nursing and auxiliary staff, although doctors are also not spared.

Abusive individuals are usually coaxed rather than warned, thus perpetuating the impression that they can get their way through such deplorable behaviour.

Firmer action needs to be taken against them.

It is essential for public health-care institutions to show unwavering support to all staff who have been verbally abused.

Can the hospital and the Ministry of Health elaborate on what concrete measures are in place to protect staff from abuse? What forms of redress are available to them?

Public health-care staff should not have to suffer in silence.

Zhang Weisheng (Dr)
ST Forum, 4 Apr 2013

Time for the Ugly S'porean to grow up

IN VIEW of the increasing incidents of abusive behaviour towards health-care workers ("Protect health-care workers from abuse" by Dr Zhang Weisheng, last Thursday; and "Abuse of health-care workers on the rise", last Saturday), it is time to examine why economic progress has brought with it the emergence of the "Ugly Singaporean".

Part of the reason is that many of our children are now brought up by maids, and they lack the strong cultural milieu to cultivate codes of good conduct.

Once they grow up, they treat nurses the way they treat their maids - because they know of no other way.

When I was growing up, I was immersed in the culture and traditions of my grandparents, who made me read San Zhi Jing (Three-Character Classic), which taught Confucian morality.

My uncles and aunts told me stories from the Chinese classics of great men and heroes with outstanding conduct.

These have influenced my thinking and conduct in later life.

Now, some affluent, Westernised Singaporeans throw litter, abuse nurses and are road bullies.

Fortunately, they are a minority, but nevertheless, the trend cannot be ignored.

Singaporeans must learn to be self-disciplined and civic-minded, and respect other people, regardless of their social standing.

The other problem is that we have been brought up expecting the Government to take care of everything.

Hence, the solution to littering is to increase fines, use closed-circuit television cameras and increase policing. But what happened to self-discipline?

It is time for Singaporeans to grow up.

George Wong Seow Choon (Dr)
ST Forum, 9 Apr 2013

Don't blame Western values for bad behaviour

IN HIS letter, Dr George Wong Seow Choon extolled Eastern values and criticised "affluent, Westernised" Singaporeans for littering and abusing nurses ("Time for the Ugly S'porean to grow up"; Tuesday). His message seemed to be that "East is good, West is bad".

It puzzles me how some Singaporeans continue to blame the West for supposedly bringing decadent values here.

I lived in Australia for a number of years. Many residential areas I visited in Australia and England are spotlessly clean. Also, none of my many Western friends is abusive to anyone.

Traditional Chinese culture is marked by a rigid social hierarchy and inequality. Wives were expected to serve their husbands and in-laws, and servants were owned by their masters and called xia ren (lowly people). The local magistrate was like a parent who took care of everything, which is what some Singaporeans want of our Government, as Dr Wong correctly pointed out.

Western values like democracy, egalitarianism, minority rights and environmental friendliness are values largely alien to traditional Chinese culture. Singaporeans who do treat people such as maids and nurses as equals probably learnt from these values.

Contrary to what Dr Wong implies, there is a great deal we can learn from the West.

Wong Jock Onn (Dr)
ST Forum, 12 Apr 2013

Say 'no' to abusive treatment of front-line staff

FRONT-LINE staff who provide vital services to the public should not be subjected to uncivil and even abusive treatment ("Abuse of health-care workers on the rise"; last Saturday).

Prime Minister Lee Hsien Loong, in his 2011 National Day Rally speech, noted a growing trend of such unacceptable behaviour towards front-line staff, especially after the general election that year ("Govt staff can't say 'yes' to everything"; Aug 15, 2011).

Very often, when people complain and ask to see the management, the supervisory staff who are attending to them tend to take the easy way out by apologising to them and giving in to their demands, in front of the front-line staff who turned them down in the first place.

By doing so, the supervisory staff are sending a signal to customers that complaints do indeed lead to their desired outcomes.

The customers are not censured for being difficult or even unreasonable, and the front-line staff's authority is undermined.

Supervisory staff find themselves in a difficult position if they cannot pacify demanding customers. In this age of social media, the customers can easily write to the top management and media about their perceived mistreatment, and supervisory staff risk jeopardising their performance targets, which may include customer satisfaction.

The top management of organisations need to come out strongly in support of their staff, by being firm - yet polite - with unreasonable customers.

With such support, staff will have the confidence and morale to perform their work effectively.

In England, there are signs that say front-line staff, such as bank cashiers, will not attend to abusive customers. Unions also champion the cause of having a working environment that does not tolerate abuse. The public are educated about the need to respect front-line staff and do not vent their frustrations on them.

Obviously, we have a long way to go to become a truly gracious society, especially when social norms are made and remade with globalisation. However, there are concrete steps that we, as a society, can take to say "no" to abusive behaviour directed at our front-line workers.

Tam Chen Hee (Dr)
ST Forum, 12 Apr 2013

Abuse of health-care workers on the rise
Nurses bear brunt of ugly behaviour from patients and their families
By Salma Khalik, The Straits Times, 6 Apr 2013

SEVERAL times a day, every day, a health-care worker at a public hospital here is scolded, abused with vulgarities, or even physically threatened by a patient, his family or friends.

Although hospitals do not track every incident, only the more uncontrolled and violent ones, they told The Straits Times they are seeing more cases of abuse.

"SGH (Singapore General Hospital) has almost one million patient encounters a year," said Ms Isabel Yong, who is in charge of service quality at the hospital. "And we have seen an increasing trend in the number of demanding or abusive patients or next of kin."

Although other health-care staff experience their share of demanding patients, nurses often bear the brunt of ugly behaviour.

National University Hospital (NUH) staff nurse Norazlina Hassan said that when patients or their families use vulgarities and rude gestures, it could reduce a nurse to tears and affect her work for the rest of the shift.

Staff at hospitals The Straits Times spoke to related various incidents of patients and visitors getting abusive.

And sometimes it does not take much to set them off.

Patients who ask to see a doctor sometimes get impatient and vent their anger on the nurses.

Some get upset over not getting the food they want. Others treat nurses as their maids.

Visitors, meanwhile, vent their frustrations when told visiting hours are over, or when they feel their relatives are not getting treated as well as they should be.

There have also been cases of hospital and polyclinic staff being slapped or punched.

Most hospitals train their staff on how to deal with such people. They also learn from experience.

NUH staff nurse Jonelyn Tanalgo said that when she thinks a patient will be aggressive, she would get a colleague to accompany her. They are less likely to get violent when there is more than one person around, she explained.

A spokesman for Changi General Hospital said it has even installed "panic buttons" at its work stations so staff can call for security should they have problems.

When all else fails, or when the behaviour gets violent or too abusive, police reports are made.

Some of the more serious cases end up in court, where people have been fined and even jailed for such abuse. An NUH spokesman said a patient's mother slapped a female member of staff whom she thought was flirting with her husband when, in fact, she was merely updating on his child's illness. The woman was taken to court and found guilty.

But often, the staff involved do not want to escalate the matter.

Ms Norazlina takes it all in her stride because, she said, they generally get more compliments than complaints.

A Health Ministry spokesman said it does not condone abusive behaviour towards health-care workers. She said: "While it is understandable that patients and their families may face stress and anxiety, our health-care staff are doing their best to provide the best care possible, and should be treated with respect."

Tempers and unreasonable demands

Singapore General Hospital
- A patient wanted bananas every day. When he did not get them, he turned abusive and threatened to storm the hospital kitchens.
- Unhappy with a 10-minute wait at the laboratory, another patient demanded a written apology. When this was given, he was not happy with the wording and wanted another apology.

National University Hospital
- A patient who was on a therapeutic diet insisted on having mutton rendang. When he did not get his way, he swept the entire tray of food off the table. He then went to the hospital's foodcourt to buy his own meal.
- Staff nurse Jonelyn Tanalgo recalled being verbally abused by a patient, who was supposed to be undergoing a procedure ordered by the doctor but wanted to leave to smoke. When she told him that the hospital was a smoke-free zone, matters got worse.

Changi General Hospital
- Some patients and their visitors treat nurses like maids, asking them to pick up tissue paper they had thrown on the floor, a spokesman said. They would also order nurses to pick up delivery food such as pizzas, and become upset when they get "no" for an answer.

Khoo Teck Puat Hospital
- A patient had her blouse buttoned up wrongly. Her son was so furious that he not only scolded the nurses in abusive language but also wrote in to complain.
- A family of 10 arrived after visiting hours, rang the bell incessantly and banged on the doors till they were admitted. Meanwhile, their children ran around the ward helping themselves to masks and gloves and opening the cupboards of other patients - leading to complaints.


No comments:

Post a Comment