Ever Have Someone Say to You “I Could Never Do Your Job” ?

A High Stress Event

Train to reduce the effects

Violence in medicine is real.

Have you ever had someone tell you ” There is no way I could do what you do” when discussing a medical emergency? Yet, seasoned emergency medical professionals, regardless of EMT, Medic or ER Nurse handle emergent events like others flip a burger.

Do you remember how you felt in school when you wondered how well you would handle a true dire medical emergency when you were finally on the job? And notice now you have handled emergencies, you do so, in many instances, like a well oiled machine?

How is it we can take a person from the street and in a couple of years have them “handle” a myriad of life or death challenges when it comes to patient care? The answer is simple. A systematic approach to training for the High Stress Event.

In school you were taught emergency medicine similar to how a person is taught to type. First learning to type you had to obtain a base, a reference point if you will, a place for your fingers to start. In medicine that would be the equivalent of learning basic human anatomy. The next phase in learning to type was to begin to form words. In medicine we began to learn about different problems a person may experience trauma or medical.

As your learning in typing progressed you learned to form sentences, the medical equivalent may be viewed as learning treatments to specific medical or trauma incidents. As your training in typing progressed your sentences now became paragraphs and your typing speed was faster. In medicine the parallel may be now your we’re seeing patients with multiple problems and discerning which needed treatment first.

I draw that parallel to point out that many events we see in medicine are high stress events. Training for these high stress events (like a cardiac arrest (adult or pedi), high speed vehicle crashes, the CVA patient or the respiratory distress where the patient is begging for help as you see the fear in their eyes) is what we all agree allows us to perform (make appropriate treatment decisions) where others not in our profession would freeze or run away.

We can all agree that the training for these high stress events is what allows us to make appropriate decisions when faced with challenges, many of which require us to make life or death decisions when it comes to our patients. So riddle me this, if so many studies, surveys and anecdotal stories prove that violence directed at medical professionals is a problem, and not a single study says violence is not an issue…. why is there a lack of training for the high stress event (assault on staff) not given more national attention. We train for everyone else’s safety but not our own.

Learning to use force, in the middle of a use-of-force incident, is simply dangerous.


However, the training for the high stress event of assault on staff must be trained similar to typing. The provider must be given groundwork similar to the home key reference point (learning the difference between a patient and an attacker) and built into typing words (what an assault is and is not). Slowly progress the provider into what is REASONABLE in their use of force and choice of “techniques” for self-defense (Assault Response Guidelines/Force Options) so they can form their own sentences-using the parallel with typing.



This systematic training approach will keep providers from:

Without a systematic approach to training staff to deal with the high stress event like assault, they will never be able to make good decisions under stress.


When there is no formal training on a subject, people rely on what they have learned based upon their own past training and experience. Think about it… what if you or your staff member was a former military member, an amateur or professional MMA fighter, a former bouncer in a bar? The previous training or experience obtained was great for what it was designed for. But what if some of their skills were used inappropriately while on the job in medicine- with no recognition of the difference between a patient an an attacker?

Also read JADED
and Too Much Wrong Medicine.

We have to change the culture. We need to make this better, safer for all those who follow us.