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SINGAPORE: I still recall the force of the chair striking me before I hit the floor. It was decades ago, when I was a junior doctor. A caregiver attacked me just as I entered the ward. I fell to the ground, stunned, as my colleagues rushed to assist me.

Even now, the memory of the numbness, helplessness and embarrassment remains vivid. It was a moment that could have driven me away from medicine, but I stayed.

Why do we, as healthcare professionals, continue to serve, even when faced with such hostility? According to a tripartite workgroupā€™s survey, almost one in three healthcare professionals in Singapore witnesses or experiences abuse at least once a week.

While healthcare workers strive to provide the best possible care, abuse and harassment take a severe psychological and physical toll. Those subjected to threats or harassment often face heightened risks of burnout, depression and anxiety.

Abuse also worsens job dissatisfaction, absenteeism and turnover. In Singaporeā€™s ageing society, where demand for healthcare workers is only set to increase, abuse and harassment can jeopardise the much-needed inflow of manpower into our healthcare sector.

Yet, even in the face of such challenges, the dedication of our healthcare professionals remains unwavering. They continue to answer a calling that demands personal sacrifice, often in high-stress environments.

But this steadfast commitment should never be mistaken for an acceptance of mistreatment. There is, and never will be, an excuse to abuse those who dedicate themselves to healing others. It is our collective duty to ensure a safe and respectful environment for healthcare workers.

ENCOURAGING SIGNS

Consider the experience of a pharmacist, Ms Tan. In April, she encountered a patient who had become visibly frustrated with a long wait at the pharmacy.

When it was finally his turn, he became uncooperative and, upon being informed of the estimated collection time, erupted ā€“ accusing the hospital of being inefficient, turning his frustrations towards Ms Tan by raising his voice at her.

Throughout the encounter, Ms Tan held her ground with composure. She listened patiently, acknowledged his frustration, and calmly offered alternatives such as medication delivery. Though the patient eventually accepted the solution, his anger lingered.

But what struck Ms Tan was what happened after the confrontation. A second patient, who had quietly witnessed the exchange, walked up to the counter and gently asked her, ā€œAre you okay? Iā€™m sorry you had to go through that.ā€

That simple act of compassion meant the world to her. A check-in or thank you can lift a healthcare workerā€™s spirits and motivate them to keep going during tough times. 

To me, it also reflected something encouraging: that public understanding of appropriate behaviour in healthcare settings is growing. Besides increased awareness of the pressures healthcare frontliners face, it also shows that the public is willing to speak up in support.

SAFEGUARDING WORKERS FROM ABUSE AND HARASSMENT

It is leadershipā€™s responsibility to translate these experiences into meaningful, systemic change. For this reason, the Tripartite Framework for the Prevention of Abuse and Harassment was launched in 2023. It is deeply informed by my own and others' lived realities.

The framework provides healthcare institutions with a definition of abuse and harassment, as well as a set of standards for protecting their workers. To put the framework into action, we introduced the ā€œ3Rsā€ at Khoo Teck Puat Hospital and Yishun Community Hospital: Recognise the early signs of abusive behaviour; respond to de-escalate the situation; and report all cases of abuse and harassment.

Effective leadership involves proactively safeguarding those who provide care. While there are no simple solutions to achieving zero incidents of harassment and abuse, my message to all healthcare professionals, including junior staff and frontliners, is: Donā€™t ignore it. Speak up and use the support systems available to protect yourself and your colleagues.

A SHARED RESPONSIBILITY 

While policy and structural safeguards are important, meaningful change often begins with us. Small but sincere everyday actions can collectively send a powerful message.

Start with empathy and patience. Healthcare encounters can be emotionally charged for many reasons, but it's important to remember that staff are doing their best, often under intense pressure. A calm and understanding approach from both members of the public and healthcare professionals can help de-escalate difficult situations and create space for better communication.

Speak with respect, even when things donā€™t go as expected. Feedback is important and should always be heard ā€“ but channelling it through official platforms or constructive dialogue ensures your concerns are addressed without compromising someone elseā€™s dignity.

Recognise that healthcare professionals are human too. A kind word, a note of encouragement, or a simple ā€œthank youā€ can resonate deeply with someone who may be carrying more than they show.

If you witness unacceptable behaviour ā€“ whether itā€™s aggression, harassment or disrespect ā€“ donā€™t look away. Where it feels safe to do so, offer support or report the incident. Your voice can make a difference.

And finally, take a moment to reflect on what respectful behaviour in healthcare settings truly means. Awareness is the first step toward accountability and building a system that works better for everyone.

This is not just about shielding individuals from harm. Itā€™s about protecting the very spirit of care and compassion that binds our healthcare system together. It is a responsibility that requires each of us to do our part.

Prof Chua Hong Choon is Co-Chairman of the Tripartite Workgroup for Prevention of Abuse and Harassment in Healthcare, and Chief Executive Officer at Khoo Teck Puat Hospital & Yishun Community Hospital.