Fernanda, a nurse at the Policlinico Umberto I in Rome, punches and then kicks with all her strength. “Here we are exposed to the decadence of Italian healthcare” she snorts. “I had to ask patients who fitted the Holter to bring their own chest net. And they sometimes insulted us.”
Valentina, a midwife in the emergency room, practices by delivering forceful elbows to the ribs, then stops panting and says: “Recently a patient filled me with swear words and threatened me with her helmet. When I locked myself in a room she tried to break down the door. So I said enough and signed up for this self-defense course in the hospital.”
Elena, an internal medicine doctor, is next to her on the ground lying on her side and kicks. A few days ago in the ward you had dodged a vial of saline thrown by a patient. “I had gone to psychiatry for counseling. Once I too was barricaded in a room for an hour and a half, with an agitated patient outside.”
Laura, a nurse at the immunology day hospital, even had to swallow the insults of a patient who had the infusion needle stuck in his arm. She now carries out, as instructed, the neck hold and tackle of the attacker, played by one of the defense instructors enlisted by the hospital.
Welcome to the Umberto I Polyclinic in Rome. Here you are treated on the one hand – with the limited means you have – and on the other you learn to defend yourself from the now daily aggressions of patients and relatives. At the “Self-defense course for healthcare workers” coordinated by the master Adolf Bei and the judo champion Michele Vannacci 5 instructors and 18 students, including doctors and nurses, participate. As many as 15 are women. “The best defense is escape”, is the starting teaching, but often it is not enough.
The course teaches how to block and knock an attacker to the ground with the help of colleagues (the instructors act as guinea pigs), how to deliver blows with an open hand so as not to hurt oneself with closed fists, how to free oneself from a hold on the wrist or neck, to defend yourself with kicks even when you have fallen. And then always, as soon as possible, to run away and ask for help.
Healthcare in disarray
Seeing Claudio, a radiologist in the oncology department who didn’t even have time to take off his lab coat, in a fighting position, with a tag on his lapel, pens in his pocket and a few gray hairs, is however a metaphor of how our healthcare system is struggling tooth and nail so as not to succumb.
Not even Hippocrates, in his oath, could imagine that one day his heirs would have to study how to kick and punch to defend themselves from their patients.
“In the emergency room there are at least two or three altercations a day. Sometimes it comes to blows. Three days ago a patient pushed a doctor. Shortly before, a drunk man had woken up, discovered that his clothes had been cut off and had thrown a fit. Many calls come from pediatrics. Parents lose control more often than others,” says an officer from the police station of the Umberto I emergency department, which was recently expanded to deal with all the calls coming from inside the hospital.
The plague of violence against staff
“The violence that permeates society has also entered our walls” he adds Giuseppe La Torreepidemiologist, director of Occupational Medicine at La Sapienza University and Umberto I. It was he who organized this course: “We started a very careful monitoring of assaults in hospital and we realized how serious the phenomenon is, not only in our Polyclinic”.
Violence against healthcare workers is a plague throughout Italy. “But Umberto I is a special place” comments Anna, an emergency room nurse. “It covers a central area of Rome that goes from Termini station to Parioli”. And it doesn’t mean that stragglers who live next to the tracks are more difficult patients than those who come from high-class neighborhoods.
Violence without social class
“I remember a wealthy man who slapped a student one night in the emergency room. His alleged fault: not letting him see his son, drunk, who had had an accident. It struck me that the boy who had drunk too much and the student who was working for free were the same age.”
Elena, the internal medicine doctor, one day found herself dealing with an entire clan of criminals from Ostia who wanted to visit a relative. “At our request to come in a few, the grandfather started urinating in the ward,” she says.
Covid, in its worst days, had at least blunted the hostilities. “But he didn’t teach us anything. We definitely didn’t come out better, on the contrary” comments Andrea, an infectious disease specialist, with the good face of someone who attends the course but you can see that he would never harm anyone.
Insulted and embittered
The anger at the violence suffered then fades into bitterness and tiredness, due to decades of work in hospitals that work with the tank perpetually in reserve. “Ours is a universal healthcare system” reflects the infectious disease specialist. “It should treat everyone, but it no longer has the resources to do so and some feel left behind.”
Fernanda, 35 years of work behind her, has developed her technique: “I count to ten and wait for the anger to pass. Patients, now accustomed to the private sector, do not realize that the public sector is different. They feel like customers. And they demand. Whoever gave you your degree, you don’t want to work are the lightest insults we hear every day. And the most terrible thing is that we start to feel guilty when faced with things that don’t work. For 1600 euros a month maybe we don’t deserve it. But unfortunately no course can teach us the escape route from this.”
#Doctors #nurses #judo #lessons #Continuous #attacks #Healthcare #doesnt #work #patients
– 2024-04-06 05:17:12
