A young martial arts champion gets the honor of having the chance to train with the grand master (creator) of his system. The old master shakes the hand of the young champion, and just before their training match starts, the old master says “You can’t beat me”.
Shocked at the statement, the young champion thinks to himself “Did you just hear what he said?, This feeble man just said he was going to kick my butt!” As the match begins, try and try as he might, every move the young champion attempted on the master was countered and escaped. Not once did the master attempt to submit the younger stronger champion. The match concluded as the allotted time ran out. It was in that moment the young champion realized the most important lesson the old master could impart; Winning in self-defense does not mean you beat up your opponent. It is refusing to be beaten.
You see, many have an erroneous understanding of what winning in self-defense, combat and fighting truly are. This confusion not only comes from television and movies but from slick marketing tactics as well.
It is important to understand every system is great when used for what it was created for:
POLICE STYLE
Although police train “defensive tactics” that is actually a play on words. The average police officer trains in acts of aggression, the taking custody of someone. There is little, if any, training an officer receives that is strictly defensive in nature. This is due to the “win” or the end goal of a police officer’s use of force. The officer is working to effect an arrest. That is not defensive. For the most part officers have other tools on their belt for when empty hand techniques would not be appropriate or have failed. It is unlikely to see a person suspected of a crime raise their hands, fists clenched in an aggressive, fighting posture toward an officer and have that officer meet him equally to engage in a “fight” or attempt to take custody. The more likely scenario would be the officer gaining space and would choose a specific tool (Taser, Pepper Spray, Baton, Firearm) to effect the arrest. So police tactics/tools and techniques work well for the police.
He is the corruption part… With no training in the use of force, EMS/Fire and Emergency Department Staff have sometimes learned, “unofficially”, by watching how police officers handle a use of force encounter. As time has passed police officers in turn observe a healthcare provider using a similar “technique” that the officers themselves use and end up with a mistaken belief healthcare providers are trained similarly. We all know this is far from the truth.
The corruption is further compounded when a company allows healthcare providers believe that police style DT techniques designed for custody and control are self-defense and would be OK to use in medicine. If there were an empty hand technique that was so effective for “controlling” someone, why do officers have all the other tools on their belt? The next question is, if we establish a patient provider relationship (based on consent), and police style techniques use pain compliance, what patient would consent to pain?
MARTIAL ARTS
While many systems claim to be of self-defense in nature, they train that winning is accomplished by beating, submitting, destroying, or by being the “last man standing” type mentality. There are quite a few amazing martial arts/fighting systems. Each designed originally for winning in combat in their own culture, many have found new life as a sport or for participants to get fit. With the ever increasing popularity of Mixed Martial Arts (MMA) many amateur and professional fighters blend styles/systems to obtain a “win” in their respective sporting event.
The corruption here is when a a person/agency/martial arts system attempts to apply their “system” to the healthcare arena. While most systems have techniques that do in fact work well for stopping a criminal assault, the critical thinking skill required for the average healthcare provider is not usually addressed. This is not to say that a person who is in healthcare, AND trains regularly, in some form of martial arts is incapable of defending themselves on the job is far from the truth. As a matter of fact, those are the ones we see grasp the concepts taught in our EVE quicker than most, because the skills come easy to them because they already understand how their body moves. We simply educate them on when certain skills would be REASONABLE for use on the job for self-defense.
MILITARY STYLE
The US Army has the Modern Army Combatives Program. The U.S. Marine Corps has the Marine Corps Martial Arts Program (MCMAP). The Russians have Combat Sambo and Systema. The Israeli Defense Forces (IDF) have Kapap and Krav Maga. All have found their way around the world as credible systems for military forces.
SELF-DEFENSE (Workplace Violence (WPV) Prevention for MEDICAL STAFF
According o the Bureau of Labor statistics, injuries from assaults are THE leading cause of injury requiring days off from work in healthcare. It is not reasonable to attempt to offer a solution if one does not fully understand the problem, the dynamics involved SPECIFICALLY with the use of force in emergency medicine.
No one else on the planet- not a police officer, a woman leaving a big box store, or a person in a bar, besides those of us in medicine must differentiate ( in a split-second) patient or attacker. In choosing a system to train medical staff for self-defense, one must answer “what is the goal?” What should a “win” be considered in the healthcare setting?
The answer- Train in such a way staff focus on prevention of aggression by employing great customer service. Remove any perception (of all involved) of custody or control and have verbal skills to allow for venting on behalf of real patients.
The system must also allow for staff to win in 4 areas:
Mind- The provider’s personal mental state and preparedness, recognizing what is and what is not a patient, understanding what is reasonable and what may be considered excessive uses of force
Street– Skills that work more often than not for escape (not custody or beating someone up)
Media– We must win in both social media and mainstream media by appearing non-aggressive and professional
Courts– Both the legal and that of public opinion
You would not use a system designed for medical staff (of mitigation and escape) for a mixed martial arts fight. The crowd would “boo” immediately because one would have their hands up, backing away, trying to exit the area. The crowd came to witness a controlled “fight” in the sporting event.
The same can be said about using most MMA techniques in medicine. Can you imagine the fall-out and media storm if a healthcare provider beat a diabetic, septic or brain injured patient into submission? Providers have been arrested and convicted for assaulting patients. The problems are real.
I spent my adult researching various forms of martial arts. What I taught my martial arts students was different than what I would teach officers and those in emergency medicine. What I teach those in emergency medicine is very different than what I would teach my martial arts students or police officers. Why? Because every system is great when used for what it was created.
When faced with a violent encounter on the job, staff will respond. How they respond will be based upon their training or lack of it. Help them define their win.
