A revealing study in Peel Region, Canada, highlighted a troubling trend: nearly half of EMS providers have faced physical or verbal violence on the job. On average, paramedics encounter violent incidents every 18 hours, physical assaults every 46 hours, and suffer injuries due to violence every nine days.
This harsh reality forces many EMS providers to develop a thick skin, setting aside their emotions to focus on saving lives and serving their communities. However, the impact of these experiences often lingers beyond the workday, accumulating over time and affecting paramedics both at work and at home. The dissonance between coming to work to serve the community and being met with violence is profound and unsettling.
Highlighting Violence During EMS Week
EMS Week provides an ideal platform to spotlight an innovative collaboration aimed at tackling violence against EMS providers. The Violence in Paramedicine Research Group, involving Peel Regional Paramedic Services, Urgences-Santé, the University of Windsor, the University of Toronto, and Queen’s University, underscores the necessity of reporting and addressing violence appropriately. Their multi-site, multi-province study aims to shift the perception of violence as "just part of the job."
Survey Insights and Reporting Barriers
In a 2022 survey involving 204 paramedics, researchers assessed the willingness of EMS providers to report violent encounters. The findings revealed that violence was widespread and often perceived as unpreventable, with no consequences for offenders. The normalization of violence as an expected professional competency was a significant barrier to reporting.
Innovative Reporting System
In collaboration with ESO, the research group launched a new violence reporting system embedded in the Electronic Patient Care Record (ePCR). This point-of-event tool, deployed after extensive organizational change management and discussions with paramedics, facilitated real-time reporting of violent incidents.
Two years later, the data gathered from these reports provided a comprehensive view of the violence paramedics face. Thirty-five percent of the reports documented multiple types of violence simultaneously, with incidents often continuing in transit to the hospital and even after arrival. Additionally, sexist, racist, and homophobic abuse was prevalent, contributing significantly to the emotional distress of paramedics.
Legislative Advocacy and Training
The collected data enabled the publication of six peer-reviewed articles and the procurement of funding for comprehensive threat assessment and harm mitigation training for Peel Region paramedics. Last fall, researchers testified before the House of Commons in support of Bill C-321, which aims to make assaulting a paramedic an aggravating factor at sentencing.
Impact of the New Reporting System
Eighteen months after introducing the new violence reporting system, a follow-up survey assessed paramedics' experiences with reporting violent encounters. The results were promising: willingness to report violence more than doubled, and 85% of participants felt encouraged to report similar incidents in the future.
The belief that reporting would lead to meaningful change significantly influenced this behavior. Free-text responses highlighted the accessibility of the new reporting process, the desire to promote accountability among perpetrators, and the importance of reporting to ensure co-worker safety.
Voices from the Field
Comments from paramedics underscored the personal and professional impact of the new reporting system:
"I just felt justified and validated in filing a report and (it) normalized (me) feeling angry at what happened. It was a healthy way to share my story, even if it was just on paper."
"I (wanted) to show that it’s not okay," while another reported because they were trying to "incarcerate the perpetrator."
Participants emphasized the importance of reporting to promote action against violence and to mitigate future risks: "Wanting the data to help promote action to address violence against paramedics and have hazard flags (i.e., on the patient’s address) to mitigate violence against other responders."
"I truly believe this program makes a difference. Getting more data (from reports) will help you solidify the program."
A Call to Action
The issue of violence against paramedics is vast and sobering. According to the U.S. Bureau of Labor Statistics, EMS personnel face a risk of occupational injury from violence six times higher than the general population and 60% greater than that of comparable health professionals like nurses. Annually, the Bureau records an average of 426 violence-related injuries that require medical treatment or result in lost work time.
Violence should not be accepted as an unavoidable part of the job. Documenting and acknowledging the abuse and violence EMS providers experience is crucial for legislative action and the provision of necessary resources. EMS agencies are encouraged to address the issue of violence against their providers actively. Together, we can foster a safer and more supportive environment for those dedicated to saving lives.
Violence Prevention and Conflict Management Resources
The Center for Violence Prevention and Self-Defense Training: Empowering Communities Through Evidence-Based Programs
The Center for Violence Prevention and Self-Defense Training (CVPSD) is a non-profit organization dedicated to providing evidence-based training in violence prevention and self-defense. With a focus on unbiased program development, CVPSD offers customized programs to individuals and organizations, equipping them with the tools to enhance personal safety and contribute to violence prevention in their communities. The Center reaches individuals and communities through partnerships with schools and other nonprofits, community groups, as well as classes for the public.