The REAL reason for the rising assaults on healthcare providers!

 What started out as a routine cardiac transport, became a struggle between life and death, and not for just the patient. In the fall of 2000, an early monring call for service, changed me and the direction of DT4EMS forever.

During transport, dispatch asked if we could check on a “body in the ditch.”   Our stable elderly patient was on the stretcher. Her 50ish year old daughter was in the front passenger seat. What was supposed to be a simple checking on a man-down turned into a car-jacking and kidnapping.  When the chaos was calmed, I recall thinking how everyone acted as if the crimes committed were, well, not crimes at all.  Feeling nobody cared, I was furious. I thought, man, if this would have happened while I was in my cop uniform, everyone would have been outraged. But, because it happened to me wearing my medic one, it was treated as no big deal.

That started me questioning, if this happened to me and nobody knows about it, because it never really made the news; what has happened to others I never heard about? I started seeking any and all research done on violence in healthcare. To my surprise, I had great difficulty finding formal studies or research.  Without formal, published studies available, I started asking every nurse, medic, and EMT about their experiences. I found nearly everyone had a story. If one hadn’t happened to them personally, they had specific knowledge of ones occurring to peers. My heart would sink each time I heard a story. So many of them: stabbings, beat to unconsciousness, permanently disfigured, sexual assaults and the likes…so much worse than mine. They made my car-jacking seem (to me) trivial, in comparison.

I have made it abundantly clear, upon my death, I would like the stories shared with me in confidence, be shared with the world. I have been told so many stories, that never found their way into formal statistics. For culture, fear of reprisal, or ridicule, hundreds of stories quietly shared with me start with: ” I have something to tell you, but please don’t tell anyone.”

The culture says we are to accept violence as part of the job, and if someone  didn’t like it, they should quit. I had to admit, until my carjacking, every other violent encounter I had been a part of in EMS, I viewed as a deal with it kind of thing. Contrasted with,  if the drunk or drugged aggressor assaulted me the day before or after, on my other job as a cop… I was not only expected to defend myself, but charge the aggressor with the crime. This was the first of my real “ah-ha” moments in finding the truth behind why criminal assaults were rampant in healthcare. Even worse, how those victimized were treated, or lack of, after the fact.

Through a slow but constant growth of my network of peers, I would be receive a study, or research paper, from various locations throughout the country. Usually these research results were from people who recognized there was something going on, and conducted research for college, or to raise awareness locally within their agency or organization.  Sometimes, as in the case with Greg Natsch from Missouri in 1995, there was the occasional  study being conducted by someone in a state office of EMS.

By 2005, I was citing 20 years worth of various studies including one from 2005 that had been conducted by the NAEMT. All of them showing violence was a real issue, that still was being ignored. Not to mention their studies never, not once, reflected what I was finding. What I have found, even in the class I just completed in a major urban environment, 80-100% admit being criminally assaulted on the job, but only 2-3% ever reported it formally to supervisors or law enforcement. I no longer quote the over 20 years worth of small studies. Instead, I cite more recent and nationally recognized ones by Non-DT4EMS sources like the ENA, Bureau of Labor, OSHA and the like, who all now claim violence is a huge epidemic. Now mind you, their studies don’t reflect what we show in classrooms all around the country… 80-100% admit being criminally assaulted on the job, but only 2-3% ever reported it.

When people are fearful of real/perceived: peer-ridicule, lack of administrative support, and law enforcement/judicial injustice, they won’t report the criminal assaults. In DT4EMS’ EVE courses, we afford healthcare professionals the opportunity to talk about violence, and how it has affected them. Since it’s in a non-judgmental environment, they will admit to one-another, the truth. It is those times, face-to-face, the culture begins to change. 

It is why news reporters continue to ask me, “Why is there such a rise in assaults?” I tell them their isn’t. As they look at me with a  puzzled expression, I explain the frequency has always been here, the numbers haven’t changed. It is that only now, people beginning to talk about the dirty little secret in healthcare.