Rising Violence Against Healthcare Workers in Italy: The Need for Self-Defense Training

Italian healthcare is in enormous difficulty and the consequences often fall on those who work there. For this reason, as happened in Monza last October, the Policlinico Umberto I in Rome organized judo courses for doctors and nurses.

Attacks are now the order of the day, learning to defend oneself has become a necessity.

The “Self-defense course for healthcare workers” is coordinated by maestro Adolfo Bei and judo champion Michele Vannacci. 5 instructors and 18 students, including doctors and nurses, participate.
Even in this context the gender gap is evident: I am 15 of the 18 participants were women.

The course teaches how to block and knock an attacker to the ground with the help of colleagues, how to strike 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, how to defend oneself with kicks even when you fall. The aim is always defense, never attack. For this reason, the golden rule is to run away and ask for help as soon as possible.

“In the emergency room – a police officer tells La Repubblica – 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”.

The precedent in Monza

Far from being a problem only in the capital, attacks on doctors and nurses are now a sad reality throughout the country. Already last October, a similar solution was taken in Monza on the initiative of the Order of Surgeons and Dentists of Monza and Brianza, in agreement and in collaboration with the Police Headquarters.

The course doesn’t just teach defend yourself physically but also verbally. It is directed by Danilo Brignone, member of the Fiamme Oro of the State Police, Italian wrestling champion, black belt in judo, wrestling coach and mixed martial arts instructor. Chief commissioner Alessandro Barone supervises the works.

The first to seek a concrete solution to the increasingly dangerous and widespread violence was the president of the Order of Surgeons and Dentists of Monza and Brianza, Carlo Maria Teruzzi.
Announcing the initiative at the police station, Teruzzi also wrote a letter to all the doctors in the area, starting from two news events.

The murder of Barbara Capovani and the case in March 2024

The first case cited by the president was the fatal assault on Barbara Capovanithe psychiatrist killed just a year ago by her former patient Gianluca Paul Seung as she left the hospital in Pisa.
It seems absurd, but almost a year later (the attack on Capovani dates back to 21 April 2023), another attack occurred against a doctor from the same psychiatry department in Pisa. The woman was attacked on the night between 26 and 27 March, kicked and punched by a patient admitted to the psychiatry ward. The intervention of a police patrol averted the worst and the doctor was discharged with a seven-day prognosis.

In his letter, Teruzzi also cited the episode in which a doctor from the Milan Polyclinic was attacked by a patient followed by a CPS from Brianza, but the cases are multiplying as the health crisis worsens.

How many attacks are there on doctors and nurses?

The data speaks clearly. According to Inail, the attacks on doctors and nurses are 1,600 per year, more than 4 per day along the entire peninsula. Attacks that also affect night guards, who play an increasingly delicate role. In the letter, reported by Resto del Carlino, Teruzzi highlighted a worrying trend not only in the numbers but also in the perception of these acts: “Verbal aggression is almost no longer reported, despite being important reasons for stress which can even lead to abandoning the profession. Faced with this alarming picture, we must have the opportunity to defend ourselves, to prevent violence.”

The National Federation of Orders of Surgeons and Dentists (Fnomceo) notes that approximately 68% of healthcare workers during his life he was the victim of at least one episode of violence. Numbers which, however, are higher due to the omission of reports.

The Brianza initiative also highlights how women are particularly exposed to aggression: 80% of those joining the defense course come from women.

The latest Inail report

The most recent research on cases of violence against healthcare workers in Italy is the report of the National Institute for Insurance against Accidents at Work (Inail) relating to the year 2022. In just one year there were 2,243 cases of workplace accidents caused by violencethreats and similar incidents against healthcare workers, +14% compared to 2021. Of these, 1,584 cases involved women (+15%) e 659 men (+12%).

In the period 2020-2022, there were approximately 6,000 cases of violence in health and social care sector, with an incidence of 41% compared to all cases recorded in the same period in the Industry and Services sectors.

The report highlights that the 70% of the injured people were womenwhile from a demographic point of view the most affected age group is between 50 and 64 years old for both sexes. The situation is particularly delicate for nurses and OSS, the categories most affected by violence, with a total 60% of cases.

How widespread the phenomenon is along the peninsula

From the Inail report it emerges that attacks on health workers are more frequent in the North. In fact, almost one attack in three occurred in the North-West (17% in Lombardy and 8% in Piedmont) and 28% in the North-East (14% in Emilia Romagna and 9% in Veneto).
The South was more distant with 22% of cases (7% in Sicily and 5% in Puglia), while 19% of the attacks were recorded in Central Italy (9% in Tuscany and 6% in Lazio).

Types of aggression

Of the attacks recorded in the three-year period 2019-2022, approximately 59% resulted in a bruise22% a dislocation, sprain and distraction, 8% a fracture and 7% a wound.
The attackers they strike mainly in the head (13% face, 9% skull, 4% nose), followed by chest wall (9%), thoracic girdle (8%), wrist (7%), and spine/cervical (6%).

Those who are most frequently affected are operators in the psychiatric or emergency/urgency field. On average, the violence caused 22 days of sick leave and, in almost all cases, micro-permanent impairments.
Not just hospitals and emergency rooms: the third most attacked category is that ofprofessional educator which operates in different structures such as schools, socio-educational communities and prisons.

The role of the demographic crisis

Among the various causes of the Italian health crisis, the primary one being the lack of resources and personnel in public health, also includes the demographic crisis and the increase in life expectancy. From the first point of view, with fewer and fewer births, there are also fewer young people and, in perspective, fewer workers in every sector, including healthcare.

Furthermore, the birth rate decline risks compromising the welfare system because there are and will always be fewer workers and more pensioners. In this context the country’s tax revenue decreaseswhich is the pillar on which any public service is based.

Sources of supply, focus on IRAP

But what resources does Italian public health rely on? Basically on:

  • Toil;
  • Regional additional income tax;
  • Own revenues of the NHS (for example tickets);
  • On a residual basis, the state budget, whose intervention is increasingly necessary precisely to fill the gaps in tax revenue.

As explained in Pagellapolitica’s in-depth analysis in relation to 2017-2019, almost 1/5 of the NHS resources come from IRAP. And here, once again, the demographic crisis comes into play.
IRAP, in fact, stands for regional tax on productive activities. So, if production activities decrease, IRAP decreases. And in Italy there are fewer and fewer businesses.

As certified by Istat, in the second quarter of 2023 there was a decrease in new businesses of 3.7%. The statistics are confirmed in the eighth Confcommercio report on “cities and business demography” where we read that in 10 years (between 2012 and 2022) over 99 thousand retail businesses and 16 thousand trading companies have disappeared streetwalker.

Not only: the decline in businesses has been faster than the demographic crisis. In fact, despite the growing birth rate, between 2010 and 2022, commercial density went from 9 to 7.3 shops per thousand inhabitants (a drop of almost 20% in the last 10 years).

The decline in businesses is proportionally greater than the demographic decline also because it is not just how many people there are in a state that matters, but their age. An older population breeds less consumption and, at the same time, does not constitute a demand for work. The increase in the average age of the Italian population is the result of the decline in births combined with the increase in life expectancy. Another piece of the Italian health crisis.

Italy is increasingly older

An older population, in fact, requires more care and therefore ends up burdening the healthcare system more. A situation that sometimes backfires on the elderly themselves like a boomerang. The geriatricians raised the alarm by underlining how the elderly are often considered “too old and expensive” to receive the most advanced treatments, from which they would derive the greatest benefits, and to be included in clinical trials for the testing of drugs of which they are the first to use. 4 out of 10 elderly people are excluded from the best care due to their age. This stigma also shortens life by increasing the risk of mortality up to 4 times.

The latest Istat data on Italian demographic prospects do not show a reversal of the trend, on the contrary the demographic crisis continues slowly but steadily with the associated consequences on the present and future of the country.

Doctors and nurses who enroll in self-defense courses are perhaps the most clear and desolate emblem of the crisis of the national health system.

All aspects related to Public Health were discussed at the conference “Health and Healthcare, a shared challenge”, organized by Adnkronos on March 21st which you can learn more about here.
Because facing the challenges of the NHS now means is crucial to ease the tension on healthcare workers and guarantee free treatment to everyone, even to those who are not rich. Just as required by the Italian Constitution.

2024-04-10 15:29:54
#NHS #crisis #scary


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