The “1st Clinical Communication Symposium: Violence in Healthcare and Communication in Healthcare” was organized by the Üsküdar Üniversitesi Faculty of Health Sciences. Speaking at the symposium, Üsküdar Üniversitesi Founding Rector, Psychiatrist Prof. Dr. Nevzat Tarhan, emphasized that a subject not monitored with statistics cannot be managed. Tarhan pointed out that clinical communication acts as a violence-preventing buffer, fostering trust and reducing anxiety. In this context, experts in their fields met with participants in the organized sessions.
The opening speeches of the symposium, held at the NP Sağlık Yerleşkesi İbni Sina Auditorium, were delivered by Üsküdar Üniversitesi Founding Rector, Psychiatrist Prof. Dr. Nevzat Tarhan, Faculty of Health Sciences Dean Prof. Dr. Arif Aktuğ Ertekin, and Faculty of Medicine Dean Prof. Dr. Haydar Sur.
Faculty academics and students also attended the symposium.
Prof. Dr. Nevzat Tarhan: “If we do not monitor a subject with statistics, we cannot manage it”
Delivering the opening speech of the symposium, Prof. Dr. Nevzat Tarhan presented on “Effective Methods in Clinical Communication”. Tarhan stated: “Globally, there are World Health Organization figures on violence in healthcare. According to World Health Organization data, 62% of healthcare professionals have been exposed to violence at least once in their professional lives. The most common types of this violence were reported as verbal abuse, threats at 33%, and sexual harassment at 13%. Between 8% and 32% of healthcare professionals experience physical violence during their careers. This rate is quite high among young and inexperienced employees. In a sectoral comparison, healthcare professionals are seen to be 5 times more at risk of exposure to violence than employees in other sectors. 73% of all workplace violence is in the healthcare sector. I received new records from the World Health Organization. 73% is a large number. White Code data for Turkey in 202 year has not been shared. White Code data for 2021 was shared for the first 6 months. There are 9035 applications in the White Code system for employees. 78% legal aid was provided. An average of 2 White Code notifications were made daily. Of the 450 violence in healthcare cases identified in 2021, 43% of the victims were nurses and 48% were doctors and other healthcare professionals. In the 2023 data, White Code dates were shared, data collected every 16 months. If we do not monitor a subject with statistics, we cannot manage it. The most important thing here is data, accurate data analysis, and providing training and different analyses based on that data.”
They were declared heroes during the Covid period, now they are forgotten
Tarhan underlined that satisfaction is high when there is healthy communication; “Depression, anxiety, and insomnia lead to psychological problems in healthcare professionals. During the Covid-19 pandemic, 27% of employees experienced depression and anxiety, and 33% experienced insomnia. In other words, healthcare professionals were declared heroes during the Covid period, now they are forgotten. Violence reduces the quality of healthcare services and jeopardizes patient safety. When there is violence, the quality of healthcare services decreases, and patient safety is endangered. It leads to an increase in medical errors. Therefore, it also harms the patient. That is why it is necessary to question the populist policies here. What is clinical communication? 20% of the bilateral communication between the patient and the healthcare professional is verbal communication, and 80% is nonverbal communication. Its components are listening, empathy, open communication, body language. The relationship between clinical communication and patient satisfaction is very significant. In other words, if there is healthy communication, satisfaction is high. Clinical communication fosters trust, reduces anxiety, and prevents misunderstandings. It reduces the reactions of patient relatives and acts as a violence-preventing buffer. There are case examples. As a result of an empathetic explanation about the waiting process in the emergency department, the anger of patient relatives is calmed. This is related to mirror neurons in the brain. It is not an abstract thing. Our mirror neurons completely communicate with the mirror neurons of the other party. If there are emotions felt by the brain such as anger, hatred, fear, love, those emotions activate the mirror neurons in the other party's brain.” he said.
“Correct communication requires investment”
Tarhan stated that as value judgments increase, compassion and social capital in communication also increase; “There are communication errors that trigger violence. Such as snapping and not making eye contact, performing procedures without explanation, and not listening to the patient. Correct communication requires investment. Because this is social capital. Communication is social capital. We approach it with financial capital methods. In financial capital, it is necessary to provide optimal benefit. Here, input modulation and output modulation are performed to achieve optimal benefit, not maximal benefit. You expand the pool. In social capital, expanding the pool means developing relationships. If social capital is broad, that much effective power emerges. Investing is finding the reward of a good generation. Like a shoemaker making the best shoe he designed. Competent people also perform their skills best. That is, they develop their social skills in the best way. And these are the proofs for it. These are stated as communication values, meaning human values. The neurobiological equivalents of these values, described by Gardner in 1982, have been found. Kolberg's rational brain: to be logical, to analyze logically, to solve, the ability to calculate. Only emotions, actions, intuitions, artistic, aesthetic tastes. We see that these are communication values more related to the right brain. So, if we act only with the left brain, approaching cleverly, sharply, with an engineer's logic, we cannot communicate. We need to appeal with our right brain. That is the emotional brain. There is wisdom there. There are 6 virtues: Courage, humanity, justice, temperance, transcendence, meaning being able to overcome oneself, and wisdom. There are also 24 values. We will increase these values in our brain. The more we increase these value judgments, the more our communication compassion increases, and our social capital increases. This happens through education, it is not innate.” he said.
Prof. Dr. Arif Aktuğ Ertekin: “Violence exists not only in healthcare, but everywhere”
Üsküdar Üniversitesi Faculty of Health Sciences Dean Prof. Dr. Arif Aktuğ Ertekin evaluated the issue of violence in healthcare. Ertekin said; “Violence exists not only in healthcare, but everywhere. It exists in our religion, in politics, in education, on the road, on the street. Violence is everywhere you greet someone. In an environment where violence is so widespread, I think it is not very easy to cleanse certain professional groups from violence. Many good things have been done in the field of health in the last 20 years, but have great things been done regarding violence? No. People's expectations are very different. Increasing people's expectations is a good thing in the field of health, but it is very important to create realities here that are grounded and compatible with reality. While we do the healthcare side of the job, some issues occur beyond us. Unfortunately, we are not the decision-makers here.”
Prof. Dr. Haydar Sur: “It will be on our agenda every year”
Üsküdar Üniversitesi Faculty of Medicine Dean Prof. Dr. Haydar Sur, stating that violence falls within the responsibility of everyone interested in social psychology; “In an environment like Turkey, where violence constantly corrodes itself and the morality of society in daily life, it automatically falls within the responsibility of everyone interested in social psychology. Since there is violence in healthcare, and since we are healthcare professionals, it also enters our agenda. Many activities related to this have been carried out for a long time. A new one will be held every year, and different aspects of the issue will be discussed on our agenda every year. We hope this will continue until this country gets rid of the issue of violence.” he said.
‘A Growing Problem in Healthcare Services: Violence’ was discussed
The first session, titled “A Growing Problem in Healthcare Services: Violence”, was chaired by Üsküdar Üniversitesi Rector's Advisor Prof. Dr. Mehmet Zelka. In this context:
-Marmara Üniversitesi faculty member Prof. Dr. Gürkan Sert presented on “Refusal to provide patient care in cases of violence in healthcare (legislation and medical ethics),”
-Üsküdar Üniversitesi Faculty of Medicine, Department of Mental Health and Diseases faculty member Prof. Dr. Cemal Onur Noyan presented on “Anatomy of White Code: 5W 1H,”
-Üsküdar Üniversitesi Faculty of Communication, Head of Public Relations and Publicity Department Assoc. Prof. Dr. Özge Uğurlu presented on “Crisis Management in Combating Violence in Healthcare Institutions: Risk or Solution?).”
After a question and answer session, the first session concluded.
“What Needs to Be Done to Prevent Violence in Healthcare” was discussed
In the second session of the event, titled “What Needs to Be Done to Prevent Violence in Healthcare”, the session was chaired by Kocaeli Üniversitesi faculty member Prof. Dr. Ayşe Günsel. In this context:
- Üsküdar Üniversitesi Faculty of Medicine Dean Prof. Dr. Haydar Sur presented on “The Issue of Violence in Healthcare Services,”
- ISSCA Board Member Mehmet Salih Yıldırım presented on “Communication in Healthcare: The Cleveland Clinic Model,”
- Üsküdar Üniversitesi Dr. Lecturer Gamze Kağan presented on “The Importance of Communication Skills in Violence in Healthcare Services.”
The symposium concluded with the presentation of certificates of appreciation and a group photo.