Things Only Those Working in Emergency Medicine Will Understand (but are usually afraid to talk about)…


If there is one thing I have found travelling the country speaking to and training with Firefighters (who run medical calls), EMTs, Medics and ED nurses is this… WE ARE THE SAME. We are wired the same. If you think I am wrong ask yourself this question… “Is an ED nurse different ( in personality) than a floor nurse”?

By Kip Teitsort, Founder DT4EMS

(Cooperative, inter-agency communication and training can solve a lot of these issues)

1) As an EMT, Paramedic or an emergency department nurse… We are public servants. But we are not supposed to be subservient. You ask for our help, we will give it to you. But we operate on consent not custody. If you don’t want our help you can leave. If you don’t want our help and we (or the courts) think you need it, our brothers and sisters in blue can take custody and then we will provide care.

2) In the Pre-Hospital setting those who became an EMT or Paramedic to solely become an EMT or Medic didn’t want to be a fireman or a police officer. They wanted to deliver emergency medicine period. Some agencies have done things like Forcing a fireman to become a paramedic (to obtain a promotion) which means you may have a person who attended Paramedic school “just to pass”. Is that the one you want working on your loved ones? This does not mean that a firefighter WANTING to be a medic (also) is wrong. That is a beautiful thing.

3) We are the same. Urban, suburban, industrial or flight etc. Why is it if an EMSer or an ED nurse works for Service “A” and thinks Service “B” is the biggest crap-hole on the planet, decides to quit and leave Service “A” to work for Service “B” that Service “A” is now said crap-hole?

4) We feel forgotten. Everyone loves a fireman and most still respect the profession of a police officer. When it comes to emergency medicine side of things, we are seen as the step-child of public service. This feeling of being forgotten tends to make us eat our young. It causes us to bicker amongst other agencies and “compete” for the public to recognize us as special too.

5) Most entered the medical profession wearing rose colored glasses. We thought people would FB_Post_medic_assaultbe glad to see us because we arrived , or when they came to the ED to “save lives”. Nobody told us we would be spit on, kicked, punched, pushed, stabbed, shot or even killed by the people we were called upon to help. Watch These Videos! 




6) We are not cops! We don’t want to force the public to do anything they don’t want to do. We Restraint_Trainingare only wanting to help. We don’t get hundreds of hours of training on how to “restrain” someone. I address this in Soft Restraints = Hard Times for Medical Staff



7) When a cop says to a person….. “You can either go to the hospital with them or to jail with us”…… they just made us look like a cop in the eyes of the drunk or drugged individual. Medical staff works off of consent. We are not trained to take “custody” of anyone. The moment the person does not want us to take them to or remain in the hospital the dynamics change. Many healthcare providers have been injured on the job trying to restrain a person the cop just handed off to them. Many officers are simply unaware of the hazard this poses to the provider. I know this because I have 17 years of LEO experience and had to argue with supervisors over this in the past. (Read my argument about this statement here)


8) Just because a person is drunk or high does not automatically mean they require an ambulance or a night in the ED. Many healthcare providers have a mistaken belief that any intoxication means a person is unable to refuse medical treatment. If that was the case, why is there not an ambulance staged in front of every bar in every city in the country all the while a triage nurse is next to the guy checking ID’s?     Check Out: DRUNK IS NOT SICK Drunk is not sick


9) An ambulance is not the same as a taxi. Calling for an ambulance for a non-emergency call, then having family members follow the ambulance to the hospital in a caravan is just….not cool. To make matters worse, EMS transports the person to the ED because the “patient” requested said transport… this is turn hacks off the ED staff who have to now deal with the person who is not actually having a true medical emergency. This now causes family (ED and EMS) to argue over something neither had any real control over.

Examples of non-emergency types of calls: A cough for three days and you decided to call at 3 AM of Day 4, Ingrown toenail, chronic low back pain etc. This system abuse leads to burn-out. Again, not talking about a person who truly needs an ambulance. This is about the system abuser.


10) Many in emergency medicine become jaded. It not because they don’t care, I believe it happens because the actually care so much. They become jaded because of the abuse, not only of the “system” but the actual criminal abuse that occurs both mentally and physically. However, the jaded attitude can be corrected with one good save, at least until the system and actual criminal abuse starts again.


11) Voluntary intoxication is not a blank check to commit crimes like assaulting EMS. 

12) Many states have enacted laws to protect EMS providers, Firefighters and nurses on the job from assaults. Just remember penalty is NOT protection, but it proves there is a problem. If criminal assaults on healthcare were not an issue…why is there a law?Slap, punch, kick or spit on a cop when you are drunk anTopThreeReasonsd see what happens.


13) EMS, and ED staff are committed to selflessly helping those in need. This makes them a proud bunch. There is a distinct feeling of pride belonging to this group that provides a truly selfless act of putting others before us. We are not asking for a ticker-tape parade, but a simple act of appreciation from supervisors, other agencies and the public goes a long way. Since the words of “thank you” are so rarely heard from a patient or patient’s family member, when it happens…… It is like the Heavens opened up for the recipient. You can visibly see a change in a provider’s body language that lasts for days.






14) Medical staff are forced to ignore the elephant in the room. They are made to believe violenceElephant in the room directed at them is just part of their job. One day people will openly accept the existence of the giant elephant in the room and fix it!






And here is my story, the reason DT4EMS exists : Ambulance Car-Jacked… My story of being assaulted on the job  IMG_4135



Before you go, watch this : Saving Yours, While You Save Others. It may very well change what you think about how we have been trained in medicine regarding violence as just part of the job.