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While emergency room doctors and nurses dedicate themselves to saving lives, they face a very real risk of violence. Patients who are drunk or mentally unstable along with criminals and gang members all pose a threat.
Limited budgets for police and security sometimes leaves hospital workers with no choice but to defend themselves, an unfortunate situation that affects quality of care.
Practicing medicine for 24 years, Hong Shi-chi is the director of an emergency room operated by Taipei City Hospital. He worries about how difficult it has become to recruit good doctors to work in emergency rooms.
Hong Shi-chi
Taipei City Hospital ER Director
“Doctors have to save people, including gangsters. Even if you know that he is a murderer, you have to save him. I often joke that even if a criminal had shot someone and he was sent to me, I have to save him, even if he decides to commit another crime when he recovers. This is my responsibility as a doctor.”
Sometimes drunk disputes or people chasing enemies can lead to an outbreak in emergency rooms. About 90 percent of ER doctors and nurses have experienced violence, and 40 percent have been hurt.
Hong Shi-chi
Taipei City Hospital ER Director
Even I have been hit. An ambulance delivered a drunk person and nearly halfway through the exam, he suddenly jumped up and punched me from behind. There was nothing I could do.
This has led the Department of Health to take special measures, such as adding direct lines to the police as well as stationing police or security guards in the hospital. Anti-violence posters are also posted in the emergency room.
Yang Han-chuan
Taiwan Hospital Association
There are only a few things that hospitals can do to protect themselves. We can’t really support a large staff of security guards at most hospitals. Instead, they only have a direct line to the police in their emergency room. Sometimes the response may be slow.
Security in an emergency room can be easily shattered with a single violent outbreak. Since it’s difficult for the Department of Health or hospitals to improve this situation, medical staff are often responsible for their own protection.
Huang Ji-ren
Chang Gung Hospital ER
We have found someone to teach Jiu-Jitsu. This is something we don’t want to have to engage in with patients, but when we are subjected to violence, we need to know how to protect ourselves.
Yen Zui-Shen
Taiwan ER Association
Traditional surveillance cameras only provide images with no sound. Some doctors wear a pen to record sound.
Hong Shi-chi
Taipei Hospital ER Director
I have told my students that one of the best ways to protect themselves is by being a little more attentive. If you see a patient whose mood has begun to turn angry, you have to pay attention. You shouldn’t be foolish and engage him in a debate because you don’t know where he can find a knife and stab you.
Violence at emergency rooms is frequently caused by alcohol or those with mental illnesses. Medical reform groups say there is a shortage of emergency room care. With more critically ill patients clogging up emergency rooms, the situation could worsen.
Hong Shi-chi
Taipei Hospital ER Director
There was a 40-year-old man who came with a small finger wound that was probably less than 2 centimeters in size. When he came in, his wife was shouting that there were no doctors to attend to him. Luckily, I was here attending to someone. I came out and told his wife to take a look at one person who had five or six knife wounds, some were 5 or 6, even more than 10 centimeters long. I told the wife that her husband’s case wasn’t so serious.
Yen Zui-shen
Taiwan ER Association
When we are treating people, we divide patients into five different levels of care. It doesn’t matter if you were the first one to arrive. We assign priority based upon the patient’s type of injury.
Chiu Yi-chun
Health Reform Foundation
There’s lots of pressure and we have a shortage of manpower, making doctor-patient communications very poor. It leads to many instances of hospital violence, sometimes due to people waiting in line for too long. This is because of a lack of medical personnel and the resentment of medical staff.
In fact, some medical reform groups are urging the legislature to pass laws requiring doctors to wear protective clothing to prevent such violent attacks.
Chiu Yi-chun
Health Reform Foundation
The Council of Labor Affairs in 2007 developed regulations for the medical profession to prevent violence at hospitals. In the end, it did not pass. Also the Department of Health likes to say that its evaluation of hospitals includes violence prevention regulations. But these regulations are not a part of the required evaluation for small and medium-sized hospitals with under 49 beds. And from what we hear from the ER medical association, much of the violence takes place at small and medium-sized hospitals
Emergency room doctors hope to make violence at ER rooms a major offense to curb this growing trend.
Hong Shi-chi
Taipei Hospital ER Director
If a crazy person hits a doctor, don’t you think we should have better laws to protect us? This doesn’t just protect doctors but also the safety of patients. If I am working on a patient and I become injured, or killed or hurt, don’t you think this would affect our ability to treat patients? Prosecutors did give someone a three month suspended sentence or a fine, but do you think this is really a deterrent? Basically, making it a major criminal case or an indictable offense would be a better deterrent.
While doctors work hard to save people, many of them feel that both the law and authorities are not doing enough to give them a safe working environment.
Questions:
Limited budgets for police and security sometimes leaves hospital workers with no choice but to defend themselves, an unfortunate situation that affects quality of care.
Practicing medicine for 24 years, Hong Shi-chi is the director of an emergency room operated by Taipei City Hospital. He worries about how difficult it has become to recruit good doctors to work in emergency rooms.
Hong Shi-chi
Taipei City Hospital ER Director
“Doctors have to save people, including gangsters. Even if you know that he is a murderer, you have to save him. I often joke that even if a criminal had shot someone and he was sent to me, I have to save him, even if he decides to commit another crime when he recovers. This is my responsibility as a doctor.”
Sometimes drunk disputes or people chasing enemies can lead to an outbreak in emergency rooms. About 90 percent of ER doctors and nurses have experienced violence, and 40 percent have been hurt.
Hong Shi-chi
Taipei City Hospital ER Director
Even I have been hit. An ambulance delivered a drunk person and nearly halfway through the exam, he suddenly jumped up and punched me from behind. There was nothing I could do.
This has led the Department of Health to take special measures, such as adding direct lines to the police as well as stationing police or security guards in the hospital. Anti-violence posters are also posted in the emergency room.
Yang Han-chuan
Taiwan Hospital Association
There are only a few things that hospitals can do to protect themselves. We can’t really support a large staff of security guards at most hospitals. Instead, they only have a direct line to the police in their emergency room. Sometimes the response may be slow.
Security in an emergency room can be easily shattered with a single violent outbreak. Since it’s difficult for the Department of Health or hospitals to improve this situation, medical staff are often responsible for their own protection.
Huang Ji-ren
Chang Gung Hospital ER
We have found someone to teach Jiu-Jitsu. This is something we don’t want to have to engage in with patients, but when we are subjected to violence, we need to know how to protect ourselves.
Yen Zui-Shen
Taiwan ER Association
Traditional surveillance cameras only provide images with no sound. Some doctors wear a pen to record sound.
Hong Shi-chi
Taipei Hospital ER Director
I have told my students that one of the best ways to protect themselves is by being a little more attentive. If you see a patient whose mood has begun to turn angry, you have to pay attention. You shouldn’t be foolish and engage him in a debate because you don’t know where he can find a knife and stab you.
Violence at emergency rooms is frequently caused by alcohol or those with mental illnesses. Medical reform groups say there is a shortage of emergency room care. With more critically ill patients clogging up emergency rooms, the situation could worsen.
Hong Shi-chi
Taipei Hospital ER Director
There was a 40-year-old man who came with a small finger wound that was probably less than 2 centimeters in size. When he came in, his wife was shouting that there were no doctors to attend to him. Luckily, I was here attending to someone. I came out and told his wife to take a look at one person who had five or six knife wounds, some were 5 or 6, even more than 10 centimeters long. I told the wife that her husband’s case wasn’t so serious.
Yen Zui-shen
Taiwan ER Association
When we are treating people, we divide patients into five different levels of care. It doesn’t matter if you were the first one to arrive. We assign priority based upon the patient’s type of injury.
Chiu Yi-chun
Health Reform Foundation
There’s lots of pressure and we have a shortage of manpower, making doctor-patient communications very poor. It leads to many instances of hospital violence, sometimes due to people waiting in line for too long. This is because of a lack of medical personnel and the resentment of medical staff.
In fact, some medical reform groups are urging the legislature to pass laws requiring doctors to wear protective clothing to prevent such violent attacks.
Chiu Yi-chun
Health Reform Foundation
The Council of Labor Affairs in 2007 developed regulations for the medical profession to prevent violence at hospitals. In the end, it did not pass. Also the Department of Health likes to say that its evaluation of hospitals includes violence prevention regulations. But these regulations are not a part of the required evaluation for small and medium-sized hospitals with under 49 beds. And from what we hear from the ER medical association, much of the violence takes place at small and medium-sized hospitals
Emergency room doctors hope to make violence at ER rooms a major offense to curb this growing trend.
Hong Shi-chi
Taipei Hospital ER Director
If a crazy person hits a doctor, don’t you think we should have better laws to protect us? This doesn’t just protect doctors but also the safety of patients. If I am working on a patient and I become injured, or killed or hurt, don’t you think this would affect our ability to treat patients? Prosecutors did give someone a three month suspended sentence or a fine, but do you think this is really a deterrent? Basically, making it a major criminal case or an indictable offense would be a better deterrent.
While doctors work hard to save people, many of them feel that both the law and authorities are not doing enough to give them a safe working environment.
Questions:
1. What are doctors and nurses at hospitals at risk of?
2. What's the unfortunate situation that affects quality care at hospitals?
3. What are the few things hospitals can do to protect themselves?
4. What makes doctor-patient communications very poor?
5. What kind of person makes an excellent doctor?
6. What do you think are the worst aspects of being a doctor?
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