SINGAPORE - "Were you even formally trained? Are you stupid or something?"
Words like these may not be vulgarities, but are just as hurtful to a healthcare worker when directed at them by a patient, said Ms Tong Yoke Tho, director of quality service management at Tan Tock Seng Hospital (TTSH).
Ms Tong was speaking to The Sunday Times about borderline abuse in TTSH and how such incidents can impact healthcare workers in the long run.
Dr Hoi Shu Yin, TTSH's chief nurse, said: "Borderline abuse may not be physical abuse or outright verbal abuse that includes racist remarks or expletives, but it tends to be an ongoing abuse that can cause healthcare workers to feel disrespected and distressed.
"Staff may not think that the incident warrants escalation, but we encourage staff to report it."
Exposure to such prolonged abuse can cause psychological trauma or lead the healthcare workers to feel emotionally drained, added Dr Hoi.
Ms Geeta Pattath Raghavan, assistant director of nursing at TTSH, noted that a number of foreign nurses make up the nursing workforce at TTSH, and that it is not uncommon for them to be subjected to racist remarks.
She said: "There have been occasions where patients tell these nurses, 'You are a foreigner. Go back to your own country.'
"Some have even questioned if the nurses were trained locally. Not only does this bring about emotional trauma, but they can sometimes get so demoralised that they cannot think about coming back to work."
She added that Covid-19-induced visitation limits at hospitals have also led to a handful of patients' families getting frustrated.
"I have had people tell a few of my nurse managers, 'Don't act like a god' when they were unable to get an extension of visitation hours. We try our best to accommodate when we can, but such rules are also for their safety," said Ms Geeta.
Healthcare workers at TTSH are trained to recognise an abusive situation and escalate it to their supervisors so that action is taken to keep patients and staff safe.
Ms Tong said: "There is also a staff support staff programme, where our healthcare workers are encouraged to look out for one another. And when an incident occurs, they know to step in and try to mediate the situation.
"They will also follow up and check on how their peers are doing, especially if they have been abused."
She reiterated that while such incidents do happen, most of the patients and their families have been very understanding.
Dr Hoi added: "The incidents we spoke about should not be generalised. Most of the people we care for have shown so much appreciation to us over the years. And we could not be more thankful for that.
"Regardless of what happens, our mission remains the same. We will always look after our patients and ensure they receive the best possible care."
Cases of healthcare workers harassed/abused in Singapore, according to the MOH:
2018: 1,080
2019: 1,200
2020: 1,300
Changi General Hospital:
2019: About 100
2020: About 200
January to September 2021: Close to 100
Singapore General Hospital:
2017: About 70
2020: About 170
January to October 2021: Close to 180
Ng Teng Fong General Hospital
From 2017 to 2020: About 38 cases per year
January to November 2021: 35
National University Hospital:
January to October 2021: 70 physical abuse cases, 120 verbal abuse cases
Tan Tock Seng Hospital and National Centre for Infectious Diseases:
2019: 218
2020: 158
January to October 2021: 244
Reasons for healthcare workers getting abused:
- Patients' refusal to comply with safety protocols
- Staff not meeting patients' unreasonable demands (for example, asking staff to buy carbonated drinks)
- Patients seeking preferential treatment, wanting to be attended to immediately when staff are caring for other patients
- Patients' frustrations while waiting to access healthcare services
- Patients' unexplained aggression without provocation
- Medical reasons such as dementia, delirium or psychiatric conditions
- Stress faced by patients due to family or financial matters
Sources: Singapore General Hospital, Changi General Hospital, Khoo Teck Puat Hospital, Tan Tock Seng Hospital