“You always have a deep down fear of being attacked by a patient, caregiver or anyone else who happens to be in the place where you work. But you think “okay, this won’t happen to me”, “this is all an exaggeration”, you try to convince yourself that everything is not so serious. But when you experience it, the illusions go away and you realize that you are really in danger,” emphasizes Stavros Kalpadakis, head physician at the Moira Health Center in Heraklion, Crete, and a recent victim of health sector violence. “. On January 8, he was attacked by a paramedic, who broke two ribs and a hip, and he was forced out of action for 2-3 months. As he notes, “this is the first time something serious happens. We receive verbal threats, but in the 16 years that I have been working at the Health Center, not once has anyone raised a hand against a doctor.”

Violence in healthcare facilities is a frequent occurrence affecting healthcare systems in recent years, which has led to 12 March being declared the European Day to End Violence against Doctors and Healthcare Workers. According to the World Health Organization, between 8% and 38% of healthcare workers, depending on the country, specialty, place of work and hours of work, have experienced physical violence at some point in their career. Referring to a meta-analysis of 253 international studies published shortly before the pandemic (2019), WHO reports that 62% of healthcare workers report experiencing some form of violence in the past year. The most common non-physical abuse is verbal (58%), followed by threats (33%) and sexual harassment (12%).

The “little girl” comes and goes in Greek hospitals. She is not a girl. She is a doctor,” Panhellenic Medical Association President Thanasis Heksadaktylos points out to K. Nurses, doctors, ambulance staff in general, paramedics and rescuers are most at risk of violence. A recent example, last October in Veria, when the patient hit the ambulance rescuer because he did not agree with the route taken by the ambulance.

The phenomenon has ups and downs and is directly related to the pressure that society as a whole is experiencing, as well as to the public perception at the moment. During the first wave of the pandemic in Greece, doctors were “heroes”, so cases of violence mainly concerned COVID-19 “deniers” or relatives of patients hospitalized in COVID clinics and not allowed to see their loved ones. those. “Society then considered us “holy monsters”. Then, little by little, the sanctuaries left, and in the eyes of some only “monsters” remained, – says in “K” Secretary General of the Panhellenic Medical Association, ophthalmologist Dimitris Varnavas. At this juncture, acute shortages of staff and dramatic increases in waiting times in emergency departments and conventional clinics are further fueling controversy and tension. As Takis Pantelis, a nurse at Triasio, points out in K, “The tension is very high. Citizens come in with worse conditions in terms of conditions of care and much more dissatisfied with what is happening outside in their lives.”

In Veria, a patient hit an ambulance rescuer because he did not agree with the route taken by the ambulance.

Mr. Kalpadakis still wonders why he was attacked. “It was the day of the vigil, Sunday, about 5 o’clock in the afternoon, when two young men came. One of the two told us that his friend had been drinking and was not feeling well. A 20-year-old patient with type 1 diabetes, he told us, had very low blood sugar, to the point where his life was in danger. We gave him serum glucose to raise his blood sugar a bit. Since the level was not rising in a satisfactory manner, we decided to give him additional serum sugar intravenously. Meanwhile, the attendant was terribly worried, constantly asking what we were doing with his friend. From what we learned afterwards, he probably thought we gave him a coronavirus vaccine. The commotion frightened the patient, dropped the serums, and ran to the exit of the Health Center. I quickly followed him as I knew his life was in danger. At this very moment, I feel a colossal push, an incredible push from behind. It seemed to me that I was literally flying, and I knew that I would fall hard. I hit. Unfortunately, I broke two ribs. Worst of all, and what kept me at home was that I broke my hip.”

Mr. Kalpadakis remains unemployed and on crutches. In 2-3 months he will return to work. It’s a Moira Health Center problem. “We have few doctors, it is difficult to find on-duty and morning polyclinics. Being absent creates a problem,” he notes. In 16 years as a General Practitioner at the Moira Health Center, this is the first time that any employee has been physically abused. As he points out, “We have verbal threats every day, such as ‘I’ll report you’, ‘I’ll tell your manager’, ‘I’ll call the police’, etc. We try to avoid confrontation because the emergency room is a very stressful environment where you have to keep your cool and do what is right for the patient. Many times you even pretend to be a fool because you see that the other person is beside himself.” In his case, the 7th Region of Health of Crete acted ex officio and filed a complaint promising to install cameras at the entrance and in the waiting area of ​​the Health Centre. “That’s something that can help, but you’re always subject to anger and irrationality.”

Unlike in the past, now the hospital authorities have begun to intervene, although the institutional structure is not clear to protect staff. “Two weeks ago we had a serious incident at the OB/GYN clinic in Triassio when a gypsy attacked the clinic staff. The hospital management sued, and Roma was arrested. In June last year, a relative of the patient hit the pediatrician in the emergency department. The administration was also taken over. “Our ‘regular’ visitor, who has repeatedly visited the hospital and injured at least three doctors over the past year, should appear about two months after the announcement from the hospital administration,” said Mr. Pantelis.

“I’ll bring you channels”, “See you”, “Shame on you”

Triasio is a hospital where violence often occurs. “One or two serious incidents per month and almost daily cases of verbal abuse. In general, verbal violence intensified. The tension is amazing. People get very angry because of the expectations,” says Mr. Pantelis and continues: “The most frequent phrases are: “I will bring the channels”, “We will talk”, “Shame on you”, “You are unacceptable”. We are saddened by this treatment, as anyone who is in the hospital can see how dire the situation is. In 2010, there were 101,000 health workers in the NHS system. We are now 73,000 serving the same needs as 101,000 people. People should understand that we are professionals, which is not enough. Those who struggle to get the job done. And we are the ones who will highlight the problems that need to be solved. You will never hear the Department of Health publicly say that there are eight-hour lines in the emergency room.”

Mr. Varnavas emphasizes that “at this stage, due to the fact that the staff has been cut off in hospitals and the number of appointments has increased dramatically, there are many protests among doctors and nurses, as well as in administrative services. Often they just come in as an emergency, the doctors tell them it’s not an emergency and that they should make an appointment, which causes protests because they’ll be waiting too long. These protests can lead to arguments and tensions.” In the event that the situation “gets out of control”, the disruption that will be caused by the violent incident will affect the entire operation of the hospital. “Such an episode, when the police are called, can last up to two hours. During this time, everything “freezes” in terms of the operation of the unit. And the question is in what mood and with what reserves the doctor or nurse who has been attacked will work until the end of the shift,” says Mr. Varnavas.

“Violence in health care is the history of several decades around the world. It’s not just Greek,” says Mr. Exadactylos. “There are countries where this phenomenon is very intense. In Pakistan, there are armed guards in medical institutions, and murders also occur in South American countries. Four years ago the NHS (National Health Service) of the United Kingdom had a big campaign on this particular topic. In Greece the problem has not been measured. According to Mr. Varnavas, one of the doctors’ requests is to have a recording protocol with a certain degree of violence in order to have an image in the coming years.

And, of course, measures must be taken to prevent violence. “For example, not having access to all areas of the hospital for relatives, even patients, if they do not need it,” points out Mr. Exadactylos, “security locks should be installed in places where doctors sleep, in changing rooms, in operating rooms and on hospital area. And we ask the state for protection. It is unreasonable to have only two women in the Health Center, where there are medicines with narcotic substances, all night.” According to him, “special penalties should be established for those who commit violence against medical workers. If someone slaps a doctor or two in a hospital, the treatment is the same as if someone slapped it on the street. Criminal treatment is different if the same incident happens to a police officer or a judge, and rightly so. The same should be true for us.” Mr. Varnavas adds that a structure needs to be put in place for the hospital to take legal action against the attacker, as well as legal support for the health worker who has been attacked.

The issue of violence against medical workers will also be discussed at the meeting of presidents of medical associations next Saturday, March 4th. The Panhellenic Medical Association is planning a special event to mark the European Day against Violence in Health on 10 March.