Lessons to be learned after doctor suicide: shocks await the entire system

Offers rotation of not only top managers but also middle managers

The former Minister of Health, current member of the Seimas Aurelijus Veryga, had to face the problem of mobbing in hospitals a few years ago. During his tenure, in 2019, a doctor at the Vilnius Republic University Hospital committed suicide.

According to A. Veryga, psychological harassment is not only a problem unique to the health sector. According to the interviewee, this is like a certain “heritage” of ours: many managers do not have a proper understanding of how to treat employees, what communication should be.

“In a bad way, we have inherited several problems that do not change that fast. We imagine a good director as a good director, a good organizer. And if it is a person of high emotional intelligence, who knows how to communicate, knows how to realize when there is a difficulty or problem, usually those questions are not even asked, “said the former minister.

Mobing, according to A. Veryga, is not the only problem that doctors face emotionally difficult situations. Another problem is their persecution or fear of being persecuted, which led to the introduction of a no-fault damage model in the last period.

“I have heard from many doctors how they treat you when something goes wrong. It is said that the doctor will “tighten up” after the courts, that everything possible will be done to stop the doctor from working here. Our understanding that we need to learn from mistakes, not learn from the courts, forgive, is also a threat.

Doctors find themselves as if they are on opposite sides and this greatly worsens the general condition. And another aspect when it comes to suicide: we probably shouldn’t put the whole problem on mobbing alone, apparently there have been more events in human life that have taken place. If the suicide did not happen spontaneously, that decision was made over a period of time, of course, that decision does not solve the situation at all, but the person usually tries to send a signal to the community. Do we as a society recognize such signals, do we not laugh when we hear them, or are we able to offer help? ”The interlocutor mentioned several problems.

Manifestations of psychological harassment, according to a member of the Seimas, can be found in almost all health institutions. However, the level at which this happens is different: middle managers are often invisible. Currently, the Seimas is considering amendments regarding the competitions for the terms of the heads of divisions and divisions; in A. Veryga’s opinion, they should be held every 5 years.

The interlocutor emphasizes that harassment is not only a problem in the health sector: “Medical suicides cause a lot of resonance, but if a saleswoman or employee in another field commits suicide, many times we do not hear those stories.”

According to A. Veryga, the Ministry of Health also received complaints about the toxic environment in the workplace during his tenure. As a result, several new tools were tried: an anonymous line was established, the SAM team at that time went to the most problematic institutions and tried to establish a dialogue. A working group was also created with psychologists who were thinking of new tools.

With the onset of the coronavirus pandemic, this work came to a halt and, according to the interviewee himself, it went to the third or fourth plan.

“But again, you have to understand that if the minister orders ‘no more harassment’, nothing will work. Often people misunderstand that they are harassing employees. Some don’t even see the problem in that.

Also, not all bullying complaints are actually bullying or, say, firing an employee involves some form of bullying. After all, it cannot be the case that a manager no longer has the right to fire any employee or impose a penalty. We need to find a balance, of course, the manager has to do everything in a civilized way, ethically, there are many subtle nuances. Suicide is not the answer in any case, “said A. Veryga.

According to the interviewee, the emotional environment of the institution is highly dependent on the behavior and attitude of the manager. Therefore, it is possible that the time rotation helps to solve the problems of bullying.

“It was and is very difficult for doctors during the pandemic. And bullying, as such, will return in full force after the end of the pandemic, because the emotional state will not really improve after the pandemic”, A. Veryga shared his thoughts.

The biggest problem is the fear of speaking.

Antanas Matulas, chairman of the Seimas Health Affairs Committee, said that a meeting on harassment in institutions will be held at the end of May, which will be attended by members of the Medical Union.

As one of the reasons why it is not possible to address these issues, A. Matulas mentioned the fear and desire of employees to remain anonymous.

“Mobbing can also occur because of the Soviet legacy, but we see that in institutions run by people young enough, those things also happen. This is due to complex causes and people’s fears. There are many complaints, but sadly everyone refuses to speak about it in writing, to testify. Our task is to inspire the public, give assurances to doctors that we will protect them.

In addition, the employee himself must learn to defend himself. I have worked as a director of a medical institution and I can say that both the doctor and the nurse will be harmed as much as they allow themselves. When I started running in the hospital early in my career, I personally saw a sister slapping a doctor on the back who held her indecently. For how many years I worked, everyone knew that this nurse knew her worth and was worthy. Unfortunately, there were other cases. But of course we must take that issue seriously. I know that the Minister of Health is going to Šiauliai to find out the situation, ”said A. Matulas.

He also agreed that the heads of the institution play a crucial role in such situations. Now, according to the interlocutor, there is a tendency for no one to be afraid to complain to the president, the prime minister, the Seimas or the mayor of the city, but in very rare cases they dare to speak out loud about the evils of their place of work. This practice must change.

However, according to A. Matulas, there are also a number of cases in which statements about psychological harassment do not come true.

“Recently, we have seen that the problems of mobbing are especially difficult to solve in institutions subordinate to the ministry, because the functions are confusing. It is clear that all previous ministries have paid very little attention to this issue.

You can accept what kind of changes you want, there have been attempts to hire only managers of impeccable reputations, but what about that? One day a person wins a contest with an impeccable reputation, the next day a complaint is received that he is hiring his own people. There are fixes and I think that’s enough, but the mobbing is probably more driven by other factors, the fear of naming problems in public. Amendments to the laws will probably not solve these problems, “said A. Matulas.

Highlights the need for managerial rotation

Jurgita Sejonienė, a member of the Seimas, a member of the Health Affairs Committee, also agrees that there are many legal acts that regulate labor relations. According to her, it is currently proposed that the concept of mobbing be included in the labor code. However, it is difficult to answer why the current legislation is not working and what needs to be done to make it work.

“What is most needed is to change the procedure and conditions of management competitions. Mobbing in the workplace depends mainly on the manager. Managers must be prepared to recognize the problem and not use psychological harassment themselves to know how deal with it.

There should be regular evaluations by independent experts at the workplace itself, and there should be an opportunity for employees to report a problem safely and anonymously. Minister Veryga also formed a working group, as well as a detailed comprehensive plan to ensure the emotional environment in health institutions. The pandemic had stopped working, but now the activity is resuming, I myself asked this group to participate in its activities. I very much hope that we will achieve a breakthrough, “said the interlocutor.

J. Sejonienė emphasizes the problems of managers and affirms that changes must start from them. Another problem is the proof of the bullying itself as fact.

After all, even with sufficient legal regulation, it is very difficult to obtain proof that mobbing takes place in an institution. The interviewee asks rhetorically: how to gather evidence that the manager applies psychological pressure, creates an unfavorable emotional environment or insults the employee?

“As for the heads of institutions, a bill for the rotation of heads has already been presented. The mandates must be limited and the person must be motivated to grow and improve. It seems to me that more frequent competitions and clearer tender conditions will pay off.

Mobbing is a problem in almost all, if not all, health centers. This phenomenon is constant, so ingrained that employees don’t even always realize they are experiencing it. He is afraid to speak about it in public and that fear is justified, ”said J. Sejonienė.