Code Violet: Codifying violence against healthcare providers

When the healer becomes a target of violence, everyone loses.

For nearly two-thirds of my professional life, I worked in a government healthcare system. Despite a few limitations, there was something invaluable about working there – a quiet and tacit understanding between the treating doctor and his patient. Patients understood that we were trying to do our best with whatever was available, and doctors knew that patients understood those limitations.

Patients and their families expressed appreciation spontaneously in many ways. Some thanked with folded hands and many wrote letters of appreciation. Even among the small minority of patients who wanted to express unhappiness, verbal abuse or violence was not their armament of choice. Most understood and acknowledged that the healthcare system had tried their best.

After more than two and a half decades of working in a government sector, I moved into the private sector. I had hoped to encounter changes in infrastructure, resources and outcomes. What was unanticipated was an introduction, rather late in professional life, to an entirely new vocabulary centred around an issue that scarcely featured in my earlier professional life – violence against healthcare workers.

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My Introduction to Code Violet

Within a week of joining a new, swanky, private hospital, I heard an announcement over the public-address system – “Code Violet, Emergency Department” – repeated three times. At that time I had no idea of the announcement’s meaning or its implications. On asking my OPD coordinator, I was enlightenment that this announcement was a way of alerting the entire hospital about an incident of violence or threatening behaviour against hospital staff. The aim was to mobilise the hospital’s security response.

A few days later, I was performing a lifesaving, emergency procedure on a sick, young man. He was accompanied to the hospital by a group of large and a seemingly aggressive attendants. Fortunately, the procedure was uneventful. During my interaction with them after the procedure, I noticed two tall and muscular men repeatedly flexing and extending their arms in the background. They obviously had no interest in the patient or his outcome. On completing the counselling session, I casually enquired from my staff about who these men were. I was astonished to learn that they were bouncers employed by the security department. Their laudable job description was preventing violence and vandalism. But were they required in a hospital?

Within two weeks in private healthcare, I had gained a sad realization. The healthcare environment was now different and had changed. One considers a hospital as a place where people come to seek remedy for their disease. Naturally, they are frightened and insecure about many issues – finances, outcomes, complications and so on. But things had now reached a stage where a hospital needed to employ personnel specially tasked with protecting these very caregivers!