Doctors across India, Particularly Women, Feel Unsafe during Night Shifts: IMA Survey

The IMA survey was conducted to highlight the safety issue of healthcare workers in government and private hospitals. Responses from 3,885 individuals have been collected during the survey, which was done against the backdrop of rape and murder of a post graduate woman student at the RG Kar Medical College and Hospital in Kolkata.

New Delhi: A survey conducted by the Indian Medical Association (IMA) has revealed that doctors across the country, particularly women, feel unsafe during night shifts with maximum response coming from Kerala and Karnataka.

The survey was undertaken to evaluate safety concerns during night shifts among doctors. With 3,885 individual responses, it is the largest study from India on safety issues. And significantly, doctors from Kerala and Karnataka with more than 1000 and 700 responses top the list of States.

The survey was conducted amid a nationwide cry over the RG Kar medical college and hospital incident in Kolkata where a young female doctor during night duty at her workplace was raped and brutally killed. The incident prompted a nationwide protest and a service shutdown by doctors’ organizations advocating for improved workplace safety.

According to the survey, doctors across the country report feeling unsafe during night shifts. This survey identifies several modifiable risk factors contributing to violence in healthcare settings.

Respondents were from several states. 85 percent were under 35 years and 61 percent were interns or postgraduate trainees. Women constituted 63 percent, aligning with the gender ratio in some MBBS courses.

The survey has found that several doctors reported feeling unsafe (24.1 percent) or very unsafe (11.4 percent), totaling one-third of the respondents. The proportion of those feeling unsafe was higher among women.

“Duty room was not available to 45 percent of respondents during night shifts. Those with access to a duty room had a greater sense of safety. Duty rooms were often inadequate due to overcrowding, lack of privacy and missing locks, forcing doctors to find alternative rest areas. One-third of available duty rooms did not have an attached bathroom. In more than half the instances (53 percent), the duty room was located far from the ward/casualty area,” the survey highlighted.

The survey suggested enhancing safety including increasing the number of trained security personnel, installing CCTV cameras, ensuring proper lighting, implementing the Central Protection Act (CPA), restricting bystander numbers, installing alarm systems, and providing basic amenities such as secure duty rooms with locks.

The distribution of statewide responses reveals that the largest representation comes from Kerala with 1078 (27.7 percent) and Karnataka with 764 (21.1 percent).

More than a hundred individual responses each came from UP (4.4 percent), Andhra Pradesh (7.2 percent) Maharashtra (9.2 percent), and Tamil Nadu (11.1 percent). More than 50 responses each were obtained from Assam, Delhi, Odisha, Puducherry, Punjab, Telangana and West Bengal. More than 25 responses each came from Haryana, Madhya Pradesh, Chhattisgarh, Bihar and Gujarat.

According to the survey, government healthcare workers reported higher levels of insecurity, with 17.05 percent feeling “Very Unsafe” and 27.4 percent feeling “Unsafe”, totalling 44.5 percent.

In contrast, only 5.52 percent and 12.02 percent of private healthcare workers reported feeling “Very Unsafe” and “Unsafe,” respectively, totalling 17.5 percent.

Similarly, a larger percentage of private healthcare workers felt “Safe” (28.04 percent) compared to those in government institutions (8.71 percent). Additionally, 10.22 percent of private healthcare workers felt the “Safest,” whereas only 1.89 percent of government workers shared this level of confidence in their safety. Adding up, 38.3 percent felt safe in the private sector, while only 10.6 percent shared the same sense of safety in the government sector.

“There is substantial scope for improving security personnel and equipment in healthcare settings. Modifications to infrastructure are essential to ensure safe, clean, and accessible duty rooms, bathrooms, food, and drinking water. Adequate staffing, effective triaging, and crowd control in patient care areas are also necessary to ensure that doctors can provide the required attention to each patient without feeling threatened by their work environment,” the survey stated.

A 2017 study by the Indian Medical Association found that over 75 percent of doctors in the country have experienced workplace violence, while 62.8 percent are unable to see their patients without any fear of violence.

Another study reported that 69.5 percent of resident doctors’ encounter violence while at work. Exposure to violence is known to lead to fear, anxiety, depression, and post-traumatic stress disorder among doctors.