Cases of verbal, physical violence by visitors on the rise at three hospitals

BEING shouted at or roughed up by patients or next-of-kin is increasingly all in a day’s work for the staff at three hospitals here.

Senior principal radiographer Tan Chin Chong, 41, of the Singapore General Hospital (SGH) has had vulgarities hurled at him, has been grabbed by the collar, and has seen a colleague break down in tears in front of a patient’s aggressive husband.

He said: “Sometimes we don’t know what triggers their extreme anger and aggressiveness, but their behaviour which can cause hurt to others is unacceptable.”

The number of instances of verbal and physical abuse at SGH doubled from 18 in 2008 to 39 last year. At Changi General Hospital, another SingHealth facility, the figure jumped from seven cases in 2008 to 19 last year.

National University Hospital (NUH), which falls under the National University Health System, said it has had about 60 cases a year in the last three years, with “a slight increase” last year.

Two other hospitals have bucked the trend: Abuse cases dipped at the Alexandra Hospital (AH) from 57 in 2008 to 45 last year, largely as a result of measures taken to keep them down; Tan Tock Seng Hospital said the numbers have also fallen, but did not give figures.

Ms Isabel Yong, SingHealth’s director of Group Service Quality, said the actual numbers at SingHealth hospitals may be higher than cited because they exclude cases not reported to the hospitals’ security office or the police, and those in which hospital staff resolved the dispute on their own.

SingHealth explained that the climbing figures point to a rise in patients’ expectations amid an increase in patient load, resulting in “service gaps” which sometimes keep patients waiting longer.

NUH said the rise is likely the result of its staff reporting more cases of abuse, which they can do so voluntarily through the hospital’s online system.

Dr Chan Keen Loong, who heads AH’s seven-member Management of Violence Taskforce, said one move introduced in 2008 to tackle the problem was to send all new nurses for a class in self-defence. Frontline employees are also encouraged to sign up for in-house classes in the Japanese self-defence art of aikido.

This helped assistant nurse Nur HanisA. Rahim, 23. She was able to free her wrists from the vice-like grip of an agitated elderly patient without injuring him or herself. AH staff are also trained in-house to calm down violent patients and to call for backup from the Crisis Response Team of security officers and ward staff.

The taskforce also protects AH staff and patients by not admitting very violent individuals if they are checked and found free of physical problems.

Dr Chan explained that such patientsare likely to have first been picked up by the police for violent behaviour. When they are brought in, the hospital’s concern is whether they may have some medical problem that makes them violent.

Those who are admitted are put into two general wards – one for men and the other for women – together with patients with similar violent tendencies.

The SingHealth hospitals are also training their staff to handle abusive patients and visitors. Since January, 120 employees have attended workshops to learn how to manage aggression and violence.

And NUH has shown it will come down on those who do: In 2008, when an emergency room employee was slapped by a patient’s mother, it pressed charges and the woman was found guilty.