By: Kip Teitsort
All across the country, speaking at conferences, or classes, asking for a show of hands, I get 80% or more of the audience to admit the fact they have been criminally assaulted on the job. When asked how many reported the assault to their supervisors, and/or law enforcement, the hands drop to where only 2-3% of the hands stay raised.
In my nearly 20 years of teaching healthcare staff our brand of mission-specific personal safety and protection, I found common reasons for this lack of reporting. The number one reason is lack of what is or is not to be considered a patient. That confusion has led to staff:
- Believing ” It’s part of the job…”
- Fear of ridicule by peers for not winning a fight, or considered a weak for reporting
- Witnessing a lack of administrative support
- Lack of arrest/prosecution
Ironically, the things staff fear about reporting, are the very things reporting will fix, and so much more. I have said hundreds of times, we are just as responsible for helping create this monster, and in the words of Fire Marshall Bill “Let me show you somethin’.”
During my travels, when wearing clothing bearing the DT4EMS logo, I have had people who obviously recognized the Star of Life, ask what DT4EMS was. When I would tell them, they would give me a look, similar to that of a dog hearing a high-pitched tone, and say “Who’d wanna beat up a ______ ?” The blank has been filled with nurse, EMT, Paramedic, Firefighter etc. The public at large has no clue how bad the epidemic is.
Nearly every podcast, newscast, newspaper, trade magazine, or social/mainstream media I have been interviewed by, asks what the most important thing I wanted the target audience to understand. My universal answer as, of late, has been getting people to recognize what is or is not to be considered a patient. I believe if we could get staff to recognize this, we could greatly reduce assaults in medicine overnight.
The lack of understanding patient versus aggressor has led to the belief it is “part of the job.” I agree, if staff was inadvertently touched, grabbed, slapped, pinched, punched, etc. by a true patient, that is part of the job. But, being threatened by, and/or actually assaulted/battered by a drunk or drugged individual, is not.
Fear of ridicule by peers: This one cuts me to the bone. I have talked to so many assaulted health care providers who share their shaming at the hands of peers for either not being capable of kicking someone’s ass, couple that with making them feel weak for even wanting to report it. Again, this is directly linked to who is or who is not a patient at a moment in time.
If an administrator doesn’t recognize the difference of patient versus and aggressor, they believe everyone staff comes in contact with is to be considered patient, and HIPAA prevents staff from talking to the police about an actual criminal assault. To make matters worse, it has hospital public information/media contact personnel unknowingly providing inaccurate information to reporters about the frequency of assaults on staff.
This brings me to the media. First, pretty much every reporter has appeared surprised when I share some of the above mentioned information with them . They say things like “I had no idea.”
Lack of Arrest and/or Prosecution: Much of “the hospital with them, or jail with me” issue could be resolved if law enforcement actually knew the dangers medical staff are presented with regarding actual criminal assaults. If staff are not reporting criminal assaults to the police, due to lack of patient versus attacker recognition, (and the problems of part of the job, fear of ridicule, etc. arising from that lack) they will continue to focus on their worry of an in-custody death, or obtaining the fit for confinement assessment, rather than the safety of the healthcare provider. Law enforcement is not purposely placing healthcare in harm’s way. Remember that we helped create this monster statement?
Check this out: Police and EMS/Fire and/or emergency department staff are dealing with an intoxicated individual for whatever reason… some form or restraint situation presents itself. On one side is the officer and staff the other. The officer uses some form of verbal commands along with physical skills. The healthcare provider, wanting to “help”, mimics what the officer does. The officer subconsciously thinks the healthcare provider must be trained similarly, or else how would they know how to do what law enforcement does to control a person… It becomes a vicious cycle repeated daily in medicine.
To muddy the waters a bit more… some law enforcement officers have taken the initiative to request a healthcare provider pursue charges on a suspect who just assaulted the provider. Usually this is because the officer is familiar with how many states have placed healthcare on the EXACT same law as assaulting police. Sometimes providers then, as I have been told by police, they don’t wish to pursue the criminal charge. It will only take a couple of times of this happening, and the officer will stop going out of his/her way to ask anymore providers.
Sometimes, the lack of contacting the police is staff expecting the employer to pursue charges. The employer is not the victim of the violent act, the staff member(s) involved are. Without a victim (in most cases) there isn’t a crime.
This takes us back to the media. Many times reporters get their stories due to scanner traffic, social media posts/tips, or visiting the local police agency and asking for dispatch logs.
When those cases of healthcare being assaulted, do have the provider contacting the police, pursuing charges, and the attacker is arrested, a court case usually follows. Having limited knowledge of “the system” and how it works, when a provider hears their case was resolved differently than the original charge (pleaded guilty to a lesser charge and received probation and such) the provider is frustrated. They feel they were slighted, and that essentially nothing happened to the person who attacked them. This leads t a rumor mill of “nothing will happen if I press charges, so it’s a waste of time..” Folks that is not true. It may not seem like it, but it does make a difference.
Here is what reporting the actual criminal assault does; it changes the culture. It makes the job safer for everyone that enters our profession in the generations that follow.
When an assault occurs and staff reports it to both their supervisor, and law enforcement, the following things are set in motion:
- Administration begins to recognize the scope of the problem- safety policies are enacted
- Victimized staff starts a healing process
- Police begin to see how frequent assaults occur in medicine = Less ” hospital with them or jail with me”.
- Police begin to show up on scenes without being dispatched
- Media coverage increases
- Public begins to recognize and acknowledge the epidemic and are shocked and appalled
- Changes in training for staff from the time they first enter training for their profession and refreshers
- Staff would disconnect from acts of aggression
- Stiffer penalties are given to attackers
- Peers in medicine would support a victimized peer ( as a firefighter would a burned firefighter, or police would an officer who was shot)
- Peer reviewed studies on violence in medicine would exist and have proper data
At DT4EMS, we do everything we can to share with staff how to prevent an assault from occurring. If one does occur, the pursuit of criminal charges is critical to not only supporting the victimized staff member, but changing the culture.