Workplace Violence: A Survey of Nationally Registered Emergency Medical Services Professionals

Abstract

Previous studies on violence against prehospital personnel have mainly reported on "verbal" and "physical" violence. This study explored how provider demographic and work-related characteristics were associated with five different forms of workplace violence (being cursed or threatened; being punched, slapped, or scratched; being spat upon; being stabbed/stabbing attempt; and being shot/shooting attempt). A cohort of nationally registered United States Emergency Medical Services professionals was surveyed to determine the experience of each of these types of patient initiated violence by these providers and their partners. Multivariable logistic regression analyses indicated gender was significantly associated with both being cursed/threatened and being stabbed or experiencing a stabbing attempt (odds ratio (OR) = 0.65, CI = 0.44-0.96; OR = 0.27, CI = 0.09-0.75, resp.). Level of EMT practice was significantly associated with being cursed/threatened, being spat upon, and being punched, slapped, or scratched (OR = 0.17, OR = 0.30, OR = 0.31, resp.). Both community size and experience were significantly associated with all the types of violence investigated. EMS workplace violence research is at its infancy; thus this study adds to a limited but growing body of knowledge.

A Systematic Review of Workplace Violence Against Emergency Medical Services Responders

“…22,47 Gormley et al 44 found that personnel who had experienced violent patient encounters had more than double the median years of experience in a longitudinal cohort study of nationally registered EMTs. Likewise, Oliver and Levine 45 found that EMTs or their partners with more than ten years of work experience were more likely to experience violence in the form of being punched, slapped, or scratched compared to less experienced EMTs. These findings present inconclusive evidence supporting years of experience as a risk factor for EMS responders.…”

“…These four studies utilized survey data from nationally certified EMS responders participating in the Longitudinal EMT Attributes and Demographics Study (LEADS) administered by the National Registry of EMTs. 5,15,44,45 These data are the most comprehensive information on demographic characteristics and occupational injuries and exposures in EMS responders at the present time. Gormley et al 44 note that while the National EMS Certification is required in forty-six states, nationally certified EMS responders are found in each state.…”

“…While some studies indicated with statistical significance that men were more likely to experience violence, 25,28,38,53 others found women were more at risk. 22,39 Not until Gormley et al 44 and Oliver and Levine 45 utilized longitudinal cohort designs was this risk factor studied under more rigorous conditions. They found that among nationally registered EMTs, women had an increased risk for physical violence, 44 while men had an increased risk for verbal violence.…”

“…They found that among nationally registered EMTs, women had an increased risk for physical violence, 44 while men had an increased risk for verbal violence. 44,45 Other research found the female gender to be a predictor only for cases of sexual assault and sexual harassment, 23 while another study found women at significant risk with regard to sexual assault, sexual harassment, and verbal violence. 29 In a review of three fatality databases, women were found to be the majority of EMS assault-related fatalities.…”

Mitigating Violence Against First Responder Teams: Results and Ideas From the Hackmanathon

“…Since the 1970s, violence against EMS responders has been recognized as an occupational hazard, and recent incidents indicate that the problem persists. In studies measuring career exposure to violence, between 57% and 93% of the EMS responders reported experiencing at least one act of verbal and/or physical violence (Bigham et al, 2014; Oliver & Levine, 2015). The extant literature describes verbal abuse, physical assault, and intimidation as the most frequently reported types of workplace violence in EMS (Bernaldo-de-Quiros et al, 2014; Boyle, Koritsas, Coles, & Stanley, 2007), with verbal violence described as the most prevalent form of violence (Gormley, Crowe, Bentley, & Levine, 2016; Rahmani, Hassankhani, Mills, & Dadashzadeh, 2012).…”