What is Code Violet? Tamil Nadu resident doctors issue advisory on safety after Kolkata horror

NEW DELHI: Tamil Nadu Resident Doctors’ Association (TNRDA) has urged all medical colleges to create awareness about ‘Code Violet’ to establish a clear and effective response to incidents of violence or threats. The advisory was issued in light of brutal rape and murder of a PG trainee doctor at RG Kar Medical College and Hospital. The policy was framed to safeguard all staff, including medical, administrative, and support personnel as well as patients and visitors within the healthcare facility.

Resident doctors from several states across the country staged protests and closed the OPD and other services demanding justice for the Kolkata doctor. However, the junior doctors, nurses, and others in West Bengal continued their casework for the 15th consecutive day today.

All India Institute of Medical Science (AIIMS), Dr Ram Manohar Lohia Hospital (RML), Lok Nayak Hospital (LNJP), and Maulana Azad Medical College ended their strike that commenced on August 12. The Federation of Resident Doctors Association ( FORDA ), a major body of RDAs across the country, also announced its decision to call off strike and resume duty after the Supreme Court’s appeal on Thursday.

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What is Code Violet?

Code Violet refers to an emergency situation where there is an immediate threat or act of violence within the healthcare facility. “The healthcare facility is committed to maintaining a safe environment. Any acts of violence, whether physical or verbal will not be tolerated. The facility will take immediate and appropriate action to manage and mitigate such incidents. If safe, close doors to contain the situation and prevent others from entering the area,” the TNRDA said.

The advisory also issued a detailed procedure to be followed by staff, security personnel, and the college administration during emergency situation. The staff on duty have been asked to take necessary steps in expediting evacuation of non-involved patients, visitors, and others to a safe and secure area. It also advised them to use “calm and firm tone” to direct people by emphasizing their safety.

Advisory for safety of doctors

The visitor’s time should be specified and restricted and no one should be allowed without an attendant pass. It also asked to give restricted access to certain areas and map dark spots in the campus and ensure adequate lighting in the premises of college, particularly in the duty areas of the lady health care staff, parking lots, entryways etc.

“Adequate number of well secured duty rooms with basic amenities should be provided for female health professionals. Deployment of lady health professionals at night should be preferably done in more than one number. They should be escorted in premises while on duty and proper arrangement of secured transport should be made for them for any movement at night,” it demanded.

Pressing for regular safety dialogue with staff, the TNRDA said: “Posters depicting legal liability and consequences of Assault and vandalism against medical professionals should be displayed at prominent places in hospital premises,” it added.

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Advisory for staff

Further, the advisory asked the staff to “avoid physically confronting the aggressor unless trained and it is necessary to protect others”. The officials are also responsible to provide updates if the situation changes and keep the communication lines open for security personnel and administration.

The doctors demanded the security personnel to arrive at the spot as quickly as possible by assessing the risks of the situation, and taking a note of potential weapon usage.

“Identify the aggressor(s) and attempt to de-escalate verbally by maintaining a calm demeanor, using clear and non-threatening language,” it said. The guidelines for physical intervention is given below.

• If verbal de-escalation fails, use approved physical restraint techniques.
• Ensure the safety of all parties, applying the minimum force necessary to control the situation.
• If the situation involves weapons or severe threat, request assistance from law enforcement.
• Ensure a seamless handover of the situation to the authorities if necessary.

Medical colleges have been asked to monitor the situation from a designated safe area. It further appealed to the administration to assign a staff member to document the incident in real-time, noting actions taken, timings, and any injuries.

Post-incident actions

The medicos have proposed to document, provide support, review the incident, and implement preventive measures. Additionally, it suggested providing regular training sessions to all staff on appropriate skills to handle emergency and violent situations. The training sessions will include role-playing exercises to simulate real-life scenarios.

It also recommended conducting Code Violet drills at least twice a year to test the effectiveness of the guidelines. The mock drill has to be reviewed, evaluated and feedback should be gathered from participants for improving the procedure, the doctors said.