Jaded: Is That What is Expected in Emergency Medicine Today?

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

Remember sitting around the fire station and hearing other firefighters laugh and joke about a fellow firefighter being badly burned on the job?
What about sitting in the ambulance base and hearing EMSer’s laughing and joking about a provider being run over at a crash scene?
What about nurses sitting in the ED laughing about other nurses having back surgery after injuring their back from catching a falling patient??

Yeah, me neither. Don’t you find it ironic that people will make jokes about staff injured from violence on the job? That is why there is such a problem within our culture when it comes to how to deal with violence. We have become jaded. What makes it worse, is how some now believe how they should use force on the job because of how they have been treated.

Injuries from Violence on the job is a recognized hazard, but it does not get the same attention as other hazards we face.

In my travels I have met thousands in EMS/Fire and nursing. Not one provider has ever stated they got into emergency medicine to fight or to beat someone up. However, the internet is riddled with comments on how those in emergency medicine would handle various self-defense or use-of-force situations.

If I were to have created a social experiment, it could not have turned out any better than the comments listed on this Facebook image:

Click Image to enlarge

Read the definition of “reasonable” and let me know if what many have said would be considered “reasonable”.

READ THEM FOR YOURSELF and because some people actually “do” what they post on social media, heard at the station or the break room wait until you watch some of these.

This picture was the first in a series where DT4EMS’ Kip Teitsort and EMS1 work together on a series based on the DT4EMS Course Escaping Violent Encounters.

It is possible many commented on the picture without ever viewing the video. <— Watch the video

If there were any doubt about how many providers in emergency medicine perceive their role and the confusion that exists regarding what level of force may be considered “reasonable” in a particular situation- many of the comments prove it.

Now, since some still may not be convinced there are problems with the use of force in medicine, watch the video clips HERE for yourself.

It is truly tragic some of the most caring people in the world have changed due to their work environment.

Jaded. It’s what happens soon after a person hits the streets in EMS or works the floor of an emergency department. Jaded, because we all entered the field with one goal, to help the sick and injured only to be spit on, cursed at and aggressed upon. Jaded because we face both those verbal and physical attacks and were not trained appropriately for the situations we face in emergency medicine.

Instead people have tried to insert police style “control tactics”, or a martial art or fighting style of “kill a man in three moves” into medicine where they have no place. Simply training in a technique without having the proper if-when-then critical thinking skills it leads to staff being fired, destroyed by the media or worse… arrested. End result, Jaded.

Because some emergency medicine dinosaurs claim “this is the way we have always done it” when a person new to the field, wishes to pursue criminal charges, they are mocked. Result- Jaded.

Without an understanding of the problem in scope and uniqueness, many employers have a misunderstanding of patient versus attacker. So in many instances the culture, unwritten as it may be, is that employees must accept being the victim of criminal activity such as assault which leads to… you guessed it…jaded.

While choking a person out, punching them repeatedly in the face, whacking them with an O2 bottle, your clipboard, Toughbook, Flashlight, stabbing or slashing with your hidden knife, eye-gouging, throat-punching, groin-kneeing may in fact work in any particular scenario- then again it may not. But if not applied in a reasonable situation, the defender may “win” the street (physical) encounter only to lose in the media and the courtroom.

It is vital staff understand the use-of-force in emergency medicine is unique. Unlike any other profession, when it comes to the application of any use of force, we have to decide in a split second- patient or attacker. We treat one, we flee the other. We are not the police who are trying to take “custody” of someone. We are not there to fight. We are supposed to be offering a recognized from of medical treatment based upon some form of “consent”.

Staff becoming jaded has caused a cultural problem within emergency medicine. Many have a false belief on what they should or should not do in a use of force situation. Never more evident than by the comments and jokes in social media regarding the use of force in medicine.

Here is the universal problem that must be addressed and understood… it is why we teach the “techniques” we do in a DT4EMS EVE class– When faced with a violent encounter, staff WILL respond. How they respond is based upon their training or lack of it. A confused patient can grab, push, slap initially in the same manner as an attacker. The initial response we teach gives a provider a split-second to decide “patient or attacker”. Because if staff treat a patient like an attacker or vice versa, the potential consequences are dire.

For a moment think about what would happen if in fact you had to use force on the job. The actions you chose just happened to be caught on camera. Later it turns out your social media comments regarding the use of force were posted for the world to see along with the video. Would your actions be viewed as reasonable? Before you respond, is your response realistic and reasonable or are your thoughts based upon being jaded?

We get it. We were there too. But once you research the problem, then and only then, can you find a solution. Simply supplying knee-jerk responses to a serious problem helps no one.

DT4EMS’ EVE is not a system designed for law enforcement, but we have several cops teaching for us. DT4EMS’ EVE was not designed for martial artists, however we have many black belt martial artists teaching for us. DT4EMS’ EVE was not designed for military use, but we have several former military teaching for us.

Why? Because they took the time to research the problem that is violence in medicine and what our solution is. Maybe we can return to what we originally entered the field of emergency medicine for- to help others. In turn, we may in fact make this field better, safer, for those who follow us.

People that train with us say things like in this VIDEO Saving Yours, While You Save Others.

Thing is… we are all on the same side in emergency medicine. It is sad the jaded culture keeps so many from essentially sitting at the same table and visiting over a cold one.

Read what those who have experienced culture change have written.

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