Punch a Cop- Ride the Bolt… but Punch a Provider and it’s a Joke… Why?

By: Kip Teitsort

Tons of reports (finally) surfacing in the media of assaults on paramedics, nurses and EMTs coupled with various studies showing violence directed at staff is a serious issue. Why then is there so little acknowledgement of violence directed at medical staff? Little to no coverage on the national or even the local level?

Many states have enacted laws that are supposed to protect providers (EMT’s, Paramedics, Nurses) from assaults. But know this- Penalty does not equal protection but it proves there is a problem! Some states put EMS/Fire on the same law as assaulting a police officer. Punch a cop, you might get to ride the bolt (Taser) but punch a healthcare provider and it’s made out to be a joke… (1)IMG_3592

Although there may be many reasons assaults on healthcare get little acknowledgement, our research at DT4EMS we have found three main reasons why there is such little acknowledgment of something we all know to be an epidemic.

Ironically, these three reasons are not unique to one service or the other, they are across the board in emergency medicine- EMS, Fire on the EMS call or within the emergency Department.



To prove my point… this is some information I received from ONE HOSPITAL
Interesting stats from my hospital: 2013 had 388 calls to security for ‘disruptive or aggressive pts’. 84 employees injured by patients severely enough to report to employee health. 19 injured enough to file workmans comp and require care beyond what employee health could provide. And that is only scratching the surface as ED never reports. Only 3 fully reported ed assaults, and multiple calls to same ED bed are logged as one occurrence. Got permission to pull more years to trend it, but don’t have the numbers yet.”
 I have NO RECORD of these incidents in my In-Hospital ASSAULT ON STAFF LOG…. why? Because they don’t make the media.

Since there is a fundamental misunderstanding of  what is and is not a”patient” (1) in medicine this leads to a synergistic effect of :

  • Failing to report true criminal assaults.wontreportcrime A criminal assault is usually committed by a person under the influence of alcohol or drugs. In most places committing a crime (DUI, Rape, Robbery, Theft, Assault etc) while under the influence is not a defense to criminal activity. So in medicine many are confused and fail to report a true criminal act.
  • Theory of “it’s just part of the job. Yes, it is part of the job to have a person who is truly sick or injured swing, push, punch at staff because they are confused due to a medical emergency such as hypoglycemia, they are hypoxic, septic or similar situation. But to say that a person committing a criminal act while high or drunk is just “part of the job” is ludicrous. If a person was driving high or drunk, runs over a child crossing the street, do the police arrive and say “awe shucks, he didn’t mean it, he was just drunk”? No.  What if a person high orPartofthejob drunk pushes, punches a police officer? Does the officer again reply with he didn’t mean it or does the officer charge the suspect with assault? Criminal assault is NOT accepted in any other profession…yet we have come to accept it in ours.
  • Mocking by fellow or senior staff. “Suck it up buttercup”, “if you can’t hang…quit“. All too often when staff have realized they have been criminally assaulted and wish to press charges, fellow or senior staff mock them for wishing to do so. I will tell you from personal experience… if truly assaulted by a suspect while I worked as a police officer, other officers did not mock me. Nor did I them when it occurred to other officers. This trend is sickening in medicine and it is due to so many years of being expected to handle violent acts of mockingbypeersaggression toward us. That has led to a culture of accepting the fact we get attacked and if you don’t like it “quit”. That attitude may be fine for you if you are some super-tough person that doesn’t mind a punch in the mouth… but me and most of the paramedics, nurses and EMTs I have met don’t agree that being assaulted is “OK”.


If there is to be a true change in the the safety culture in emergency medicine, one must address the three things outlined above. They work hand in hand, and feed off of one another, to fuel this violence against staff epidemic. It is NOT a simple as learning a few fancy techniques that will help keep providers safer on the job… it is a culture change. That culture change must have within it behavior modification, a new understanding of what IS and WHAT IS NOT “My patient”, safety tactics for prevention of an assault as well as escape techniques for when a tactic was not an option.

Elephant in the room


(1) Missouri RSMO Assault Officer

(2) What is and is not a patient


**Don’t miss the blog post on The Elephant in the Room