Working in the emergency services environment brings about many situations that can be rewarding. From helping deliver babies to saving lives in dire circumstances, it is no secret that the medical profession is invaluable. However, there are many situations in the pre-hospital and hospital market that can be very dangerous for healthcare workers. Sadly, assaults in the hospital are more common than one would think, and emergency room staff are particularly vulnerable.
We were given the opportunity to sit down with Kip Teitsort, founder of DT4EMS (Defensive Tactics 4 Escaping Mitigating Surviving), to gain insight into workplace violence in emergency medicine.
Misunderstanding the Definition of a Patient
Many healthcare providers don’t recognize when the provider-patient relationship becomes a victim-aggressor relationship. When a patient starts acting aggressively, potentially putting a staff member in danger, the incident has turned into a victim-aggressor relationship that should then be taken over by a law enforcement official. Once the aggressor is restrained and in custody, the provider can then continue to provide care.
As you may already know, intoxicated patients can make a world of irrational choices. More often than not, the patients who turn violent are under the influence of drugs or alcohol. If a patient is under the influence, they walk along the fine line between custody and care. Healthcare workers who are treating intoxicated patients should remain very aware and cognizant of dangerous behavior, and once the situation turns violent, they should call in backup from law enforcement.
Staff Believe It’s Just “Part of the Job”
Many nurses believe that violent patient encounters just come with the territory. While this may be partly true, it is also the reason why a large number of healthcare professionals do not know how to deal with attacks properly. With these crimes occurring within the work environment, ironically a culture has developed where getting hurt is ‘part of the job’. However, it is important for providers to recognize that they don’t have to, and, shouldn’t tolerate violence. If the same situation happened on the street, that same person would fight back and restrain the attacker to the best of their ability.
Lack of Restraint Training
An overwhelming majority of criminal assaults occur during a restraint situation. However, restraint training is not mandatory for medical staff. According to DT4EMS, on average, medical staff receive only 0-4 hours of soft-restraint training. In order to mitigate risk to healthcare providers when attacked, it is imperative that they are equipped with the necessary knowledge and tools to protect themselves and de-escalate the situation.
There are supplemental “Escaping Violent Encounters” courses available outside of mandatory compliance certifications that give healthcare professionals the training needed to properly handle criminal assault in the workplace. These 8-16 hour classes teach providers to recognize when there is a change in the relationship from patient to aggressor, restraint techniques including how to escape from grabs/chokeholds, recognizing body language, utilizing customer service as a de-escalation tool, and how to get back to a safe situation after it turns unsafe. These courses also eliminate the paranoia that every patient is trying to attack them—because that’s simply not the case. With these courses and preparation, healthcare providers are able to return safely to their loved ones.