The Occupational Safety and Health Administration (OSHA) has identified violence in the medical setting as a potential hazard, and found the training of medical staff to identify and deal with potential violence ineffective. It is the third leading cause of on the job injuries in EMS (only lifting patients and vehicle collisions injure more EMS workers) and the second leading cause of on the job fatalities (behind vehicle accidents), yet the only training we get is "don't enter the scene unless it is safe." This approach is obviously not working.
There remains a reluctance on the part of EMS agencies and hospital administrators to provide training to effectively address workplace violence. Why are EMS agencies so reluctant to face this issue? In most agencies, there is no policy for dealing with violent encounters, training for dealing with such encounters is rare, yet the problem seems endemic. There appears to be a variety of reasons for this: some may not recognize the extent of the problem, and thus don't perceive the need for training personnel in basic defensive measures, while others erroneously perceive using defensive tactics as fighting or a form of aggression. Still other agencies feel that the liability that defensive uses of force would bring upon the agency is greater than the costs of treating injured employees.
Whatever the reason, allowing the situation to continue as it is now is resulting in seriously injured workers, and the problem is not going to get any better until we as a profession find a way to deal with this issue. Some changes are desperately needed if we are to see an improvement in the number of injuries that are inflicted upon EMS workers by their violent patients. It is obvious that the current policy of "scene safety" is not working. There is a definite need for research into this area that impacts the safety of our medical workers, so that a solution can be found for preventing and dealing with this epidemic of violence.
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