ima-survey-reveals-gaps-in-safety-for-healthcare-workers

A recent survey conducted by the Indian Medical Association (IMA) has highlighted alarming safety and infrastructure concerns faced by doctors during night shifts across India.

 

Nearly one-third of doctors surveyed reported feeling unsafe, with inadequate safety measures reported in both government and private hospitals.

 

The survey, which covered 3,885 doctors from 22 states and Union Territories, revealed that 45% of respondents did not have access to a duty room, a basic requirement for rest and safety during night shifts.

Nationwide protests prompt survey

The survey follows nationwide protests by doctors’ organisations demanding better workplace safety after the rape and murder of a 31-year-old trainee doctor at Kolkata’s R.G. Kar Hospital during her night duty.

 

The shocking incident has sparked a conversation about the safety of medical professionals, particularly during night shifts.

 

The survey was conducted by the Kerala unit of the IMA and has been accepted for publication in the IMA’s Kerala Medical Journal in October.

 

It focused on the safety perceptions of doctors during night shifts, the availability of duty rooms, and access to basic facilities like bathrooms.

One-third feel unsafe

The survey revealed that 24.1% of doctors reported feeling "unsafe," while another 11.4% felt "very unsafe," accounting for nearly one-third of respondents. Women doctors were more likely to feel unsafe, with 36.7% reporting a sense of insecurity compared to 32.5% of male doctors.

 

The findings also showed that duty rooms, which are crucial for doctors to rest during night shifts, were unavailable to 45% of the respondents.

 

Even when duty rooms were available, they were often inadequate due to overcrowding, lack of privacy, and missing locks, forcing doctors to find alternative places to rest. In 53% of cases, the duty rooms were located far from the ward or casualty area, further compromising safety.

Safety concerns higher in government hospitals

The sense of insecurity was more pronounced among doctors working in government hospitals. According to the survey, 17.05% of government healthcare workers reported feeling "very unsafe," and 27.4% felt "unsafe," totalling 44.5%. In contrast, only 5.52% of private healthcare workers reported feeling "very unsafe," and 12.02% felt "unsafe," totalling 17.5%.

 

Furthermore, a higher percentage of doctors in private hospitals felt "safe" (28.04%) compared to their counterparts in government institutions (8.71%). Only 1.89% of government doctors felt the "safest," compared to 10.22% in private hospitals.

 

Overall, 38.3% felt safe in the private sector, while just 10.6% shared the same sentiment in government hospitals.

Infrastructure deficiencies

The report calls for urgent modifications to infrastructure to ensure safe, clean, and accessible duty rooms, bathrooms, food, and drinking water for doctors working night shifts.

 

It also stresses the need for adequate staffing, effective triaging (sorting and allocation of treatment to patients), and crowd control in patient care areas to enable doctors to focus on patients without feeling threatened.

 

"Each healthcare establishment must take up the responsibility of providing a safe, comfortable, and secure working environment for doctors and other staff," said Dr Rajeev Jayadevan, chairman of the IMA Kerala research cell and lead author of the report.

 

He further added, "They can do this by providing safe and secure duty rooms, adequately trained professional security according to the size of the institution, reducing the number of bystanders, and introducing triaging so that doctors can see patients in peaceful conditions."

Rising violence against healthcare workers

The survey also touches on the rising violence against healthcare workers in India. According to a 2017 study by the IMA, over 75% of doctors have experienced workplace violence, with 62.8% unable to see patients without fear of violence.

 

Another study cited in the new report states that 69.5% of resident doctors encounter violence while at work. Such exposure to violence has been linked to fear, anxiety, depression, and post-traumatic stress disorder among doctors.

 

The report also highlights that the percentage of women choosing MBBS as a career is increasing, especially in states like Kerala, where it has crossed 67%. "Providing safe conditions for women who do night shifts at work is a priority, whether they are doctors or other professionals," Jayadevan maintained.

Suggested measures to enhance safety

To address these safety concerns, the report suggests several measures. It notes that many hospitals employ low-wage security personnel to cut costs, but these guards are often perceived as weak and incapable of providing adequate security.

 

"Doctors have expressed a preference for ex-servicemen as security guards and able-bodied men in their 30s to 40s as bouncers in high-risk areas such as casualty and ICU lobbies, where skirmishes are common," the report notes.

 

Some women doctors have also indicated the need for female security personnel and the establishment of a police check post on hospital campuses.

 

The report highlights that "healthcare violence is a condition that has many contributory reasons—and each one of them has to be addressed systematically for any meaningful change to occur in the future."

Government response

In response to the rising concerns about the safety of healthcare workers, the Union Health Ministry, following a directive from the Supreme Court to constitute a national task force, has recommended several measures to states for enhancing security in hospitals. These measures include:

• Displaying state laws for healthcare workers’ protection and relevant sections of the Bharatiya Nyaya Sanhita in conspicuous places, along with details of penalties.
• Constituting 'Hospital Security Committees' and 'Violence Prevention Committees' involving senior doctors and administrative officers.
• Regulating access for the general public and patient relatives to key areas of the hospital and enforcing a strict visitor pass policy for patient attendants.
• Making provisions for the safe movement of resident doctors and nurses within different blocks, hostel buildings, and other areas of the hospital during night duties.
• Ensuring proper lighting inside all areas of residential blocks, hostel blocks, and other hospital premises.
• Conducting routine security patrols in all hospital premises during the night.
• Setting up 24x7 manned security control rooms in hospitals.