The hospital is often a 'war front', a scene of aggression, provocations and violence, not just verbal. Tired of suffering, the doctors asked for help from the National Federation of Orders of Surgeons and Dentists (Fnomceo) which promptly responded with numerous prevention activities for the management of dangerous situations and with specific training courses, in person and remotely . The initiatives of the medical associations in the area are moving in the same direction, such as self-defense courses promoted by the president ofOmceo of Monza and BrianzaCarlo Maria Teruzzi, and by the president ofOmceo of Ragusa, Carlo Vitali. In short, from North to South the number of white coats interested in martial arts against violence in hospital is increasing, especially female doctors.
For three months (from October to December 2023) Teruzzi set up a super course in the gym of the Monza Police Headquarters, in via Montevecchia, to teach the most basic but effective self-defense techniques. Both verbal and physical. As many as 143 doctors, 80% women, followed the bi-weekly lessons (Tuesday and Friday, from 3pm to 6pm) by various teachers, including the assistant chief coordinator Danilo Bignone, absolute Italian wrestling champion, black belt in judo , fight coach and mixed martial arts instructor. Multi-decorated, he hit the headlines a few years ago when he got the better of a baby gang on board a train. “The course that we will propose again in the coming months – explains Salute Teruzzi to Adnkronos – was a success, also thanks to the support of the then Police Commissioner of Monza Marco Odorisio, now serving in the city of Padua. Word has spread about the lessons and many requests for the next courses have already arrived from the Orders of Nurses and Psychologists”. And given the escalation of attacks, 1,600 per year against healthcare workers, practically 4 per day (Inail data) “we will move forward in this direction – assures Teruzzi – because whoever attacks a doctor attacks himself. 68% of health workers have suffered at least one episode of violence during their professional lives. We can no longer pretend nothing happened.”
In the city of Ragusa, self-defense courses for doctors have also been extended to healthcare workers and will start in a few weeks. The “Let's feel safer” project is promoted by the president of the Omceo of Ragusa, Carlo Vitali, in collaboration with the provincial health authority and the municipality's health and community development department. “The course is aimed at 30 participants – says Vitali – and will start in a city gym on 23 February and end on 24 May 2024, every Friday from 7.30pm to 8.30pm”. The initiative was born from the “desire to try to provide answers to the serious phenomenon of violence against doctors and healthcare workers, not only in the emergency room but also in the care continuity centers (formerly medical guards) mainly during the night shift” In the gym “two judo and martial arts teachers are giving self-defense lessons. Doctors are enthusiastic about the idea. To book there is a number (3289029889), but I don't think we will be able to satisfy all requests”, he comments.
The doctor threatened. “For me, the relationship with the patients was everything. Instead, I received punches in the face, insults, swear words, they attacked me and threw me to the ground. Not satisfied, they also vandalized my car. I suffered as long as I could, but the threats then reached my family. At that point I reported everything to the police. Since then, I have resigned from a particular municipality and moved.” Rossana Vivona, general practitioner from the province of Monza and Brianza, is one of the 143 white coats who signed up for the super course promoted by the president of the Order of Surgeons and Dentists of Monza and Brianza, Carlo Maria Teruzzi, last October , in agreement and in collaboration with the Police Headquarters. The lessons ended in December 2023 but “the hope is that they will resume – hopes Vivona – because they are useful and now necessary. The teachers help you with defense tools, not only manual ones, to stop the attacker, but also include the so-called de-escalation – he says – a series of verbal instructions so that the attacker is calmed down by our words. If only I could have followed these lessons a few years ago, my story would certainly have taken a different turn.” Expert in NeuroRadioDiagnostics, having worked in a medical department and then working as a freelancer in neuroradiology for many years, Vivona then chose “basic medicine because I lacked contact with the patient, but compared to the past the patients have become aggressive, arrogant, provocative, verbally violent and more. It's no longer the medicine I was used to.”
There were those who asked for an unnecessary exemption”, who after having had their license withdrawn “due to drug use, asked for my help to get it back, unaware that they would have to follow an ad hoc path with the ASL. Then there was the patient who came to the office with the diagnosis obtained from Doctor Google, and demanded a prescription for a brain MRI for stomach pain. When I refused, the verbal and physical aggression immediately began: 'you're not a doctor, you ugly bitch… do what I say' or 'I'll have you disbarred by kicking your ass…' I can't say more, they are unrepeatable sentences”, she says, still shaken. Hence the need for the self-defence course and the thanks to the president of the Omceo of Monza and Brianza for the foresight in wanting to organize it. “Teruzzi has helped many doctors in the same conditions as me – confides the doctor – in particular us women. A fantastic initiative that teaches you some techniques to free yourself and make yourself safe from the attacker, as well as facing any situation also from a psychological point of view. I have learned that what often annoys patients is our gaze, which is too focused on the computer, but it is necessary if we want to open the medical record or write a prescription. However, it is good to know that this attitude can make us nervous. , so as to avoid accidents. I really hope that the initiative continues because the phenomenon of aggression – he underlines – has now reached alarming levels”.
The children's dentist, dealing with the parents. Not only in hospitals and emergency rooms, but also in doctors' offices, the lives of healthcare workers have become complex. Augusto Parolini, a dentist from Monza Brianza, who has his children among his patients, knows this well. “They are often not very cooperative – he tells Adnkronos Salute – they cry and keep their mouths shut, they throw tantrums. It is difficult to work in these conditions. The parents are often very apprehensive and raise their voices, pretend to be right and tell you that you don't know how to do your job. work. When I realized that the situation would sooner or later degenerate, I signed up for the self-defense course. I was among the first to take part in the lessons, which were very interesting because the teachers help you predict and defuse a possible argument or attack , not just verbal”.
Then he rattles off some examples: “Among the de-escalation techniques – highlights Parolini – the first is to get the other person to talk and vent, in order to release tension. At a later stage, we doctors intervene with the authority of our role, so as to bring the situation back to a civil and dialogue level. We were taught the distancing technique only after any physical involvement, as a defense reaction”. So, if necessary, “with the palm of our hand we hit our attacker's chest so as to re-establish the right distance. Then there are the techniques to avoid a blow and move the attacker from our view with our hands.” Parolini has no doubts: “I practiced martial arts many years ago, but I didn't know these teachings, which I found extremely useful. Meanwhile, you are aware that the situation can evolve and degenerate at any time, but you have the right tools to deal with any crisis”, he concludes.
We are not Karate Kid . “It is right that doctors, often victims of attacks by patients and family members, learn to defend themselves with de-escalation techniques, judo and martial arts courses. But this cannot be the only solution to the serious and worrying phenomenon of violence against doctors and healthcare workers. As the National Federation of Orders of Surgeons and Dentists, we have organized some Fad courses and will hold others, with the collaboration of the psychiatrist and criminologist Massimo Picozzi, which will involve all 468 thousand Italian doctors. Objective: to make patients understand that we are their allies, not enemies to be fought”, says Roberto Monaco, general secretary of Fnomceo. For Monaco, therefore, it is necessary to “establish a dialogue with citizens – he explains – because ultimately we are on the same boat, that of our national health system, with its strengths and weaknesses.”
Of course, “the discomfort is there” and “it should not be underestimated, but we cannot treat and save human lives during the day and do like the Karate Kid in the evening”, warns Monaco who adds: “Anything that can be used to safeguard the health of the doctor he will always see me in favour, but we must be careful not to use violence against violence. If anything, we need a paradigm shift: to make patients understand that there is a lack of resources, staff and organization in our hospitals but that in times of difficulty we do everything possible and impossible for their good”, he concludes.
(By Francesca Filippi)
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