We responded to a house for the dreaded “unknown medical.” As we arrived, dispatch told us that the caller thought there was something wrong with her sixteen year old son because he was hallucinating. When I opened the door, I saw a teen male who was covered in sweat and acting quite agitated. His mother told us that she had taken him in for his methadone injection when he started acting funny. She also tells us that he has been with her all day and he has not had any other drugs. As she was explaining this, the teen kicked me in the groin without warning or windup, and that is how the fight began.

Any fight that begins with a kick to the groin is going to be a nasty one with no rules. He hit me several more times and kicked my knee fairly hard. I closed the distance, managed to get a grip on his arm, and got him in a headlock. Since I outweighed him by about 100 pounds, I took us to the ground. While on the ground, he tried throwing elbows back into my face, but couldn’t reach due to the angle. He fought pretty hard, and wasn’t really responding very well to pressure points or other pain compliance techniques.

When the police showed up, the responding officer helped me get him in handcuffs, and we were able to move him to the stretcher, where he received some much needed Haldol and a pair of restraints. Once we got to the Emergency Room, they did a drug screen and it showed that he had cocaine, methamphetamine, and methadone in his blood stream. He wound up having one ruptured ear drum, some bruises, and two broken ribs.

Wirecutter posts about a Paramedic who was caught on camera punching a patient because the patient was attacking him. Attacks on medical personnel are a real problem. Years ago, when taking a course called “Advanced EMS Administration” I had to write a paper on this exact problem. The entire report came in at over 2,000 words, but I will give you an excerpt:

Fifty two percent of all EMS responders report having been physically attacked on the job at some time within the previous twelve months. According to the University of Maryland, the risk of nonfatal assault resulting in lost work time among EMS workers is 57 cases per 10,000 workers per year. The national average for all professions is about 1.8 cases per 10,000 workers per year, making the relative risk for EMS workers about 30 times higher than the national average. This isn’t just EMS getting hurt: in 1999, the Bureau of Labor Statistics estimated that 2,637 nonfatal assaults occurred to hospital workers–a rate of 8.3 assaults per 10,000 workers. Healthcare providers are twice as likely, and EMS workers 15 times as likely, to be assaulted on the job as are police officers or prison guards. Some locations and cities are obviously seeing injury rates that are far above the average.

The Occupational Safety and Health Administration (OSHA) has identified violence in the medical setting as a potential hazard, and has 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 medical workers get is “don’t go over there 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.

This begs the question: Why are EMS agencies so reluctant to face this issue? In most agencies, there is no policy for dealing with violent encounters and training for dealing with such encounters is rare, yet the problem seems endemic. There appears to be a variety of reasons, 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. There are a number of possible solutions to this problem, but none of them are ideal, and none of them can guarantee that there will be no injuries to patients or medical workers.

I wrote that paper in 2010, over 13 years ago. I haven’t looked at the numbers lately, but I am fairly certain that the problem has gotten worse. Recently in Florida:

It isn’t just nurses. Paramedics, too.

Why is this happening? The fact here is that many in health care, including administrators, feel just like the nurse who filmed that paramedic’s punch:

It infuriated me. It made me really angry, cause I mean, it wasn’t just a tap; I saw a full-blown punch. I’ve been a nurse for 16 plus years, and I’ve endured a lot of physical abuse, emotional abuse, verbal abuse, kicked on, spit on, called names, and I’ve never physically put my hands on my patients.

What this stupid cow is saying is that she is willing to let someone beat her, injure her, and do whatever they want, and she will not respond. I say fuck that. I am not letting some asshole who thinks that it is OK to hit people to injure me, possibly causing permanent injury or death, and not respond. No one should have to put up with that just so they can claim that they have “never put their hands on a patient.”

Read the facts again: these attacks are resulting in severe injury and death at an alarming rate. Since workers can’t sue employers if they are injured as a result of being attacked in the workplace, the only liability that an employer faces for these attacks is Workers’ Compensation. This means that employers are willing to allow their employees to be injured because the cost of paying Workers’ Comp claims are less than the cost to PR and liability for workers using force in self defense. This is the same philosophy that causes places like Pizza Hut to not care when their delivery drivers are attacked and shot during robberies.

I don’t care. I will lose my job and hire a lawyer to defend myself in front of the nursing board before I see myself get disabled or killed by some asshole who wants to use me as a punching bag. I get paid to treat you for your illness, not for you to attack me.

Categories: Crime


Jen · May 7, 2023 at 8:51 am

Totally agree. Administration treats nurses like used kleenex: plenty more where that came from. And they fire anyone who defends themselves. I walked last year from an ER job I had loved, when, with 8 patients already, they gave me a naked combative drunk guy. And no help. I realized I was gonna get hurt, AND NOBODY CARED. Meanwhile the sassy 20yo they appointed as charge nurse sat up front in the princess chair flirting with the security guards. The next night when they called me in, I passed. No fucks left to give.

Grumpy51 · May 7, 2023 at 9:32 am

Age old problem.

I spent eh early 90s as a tactical medic. POST-certified deputy. ALL of us on SWAT were doing “extra” defensive work as the DTs (defensive tactics) taught us were crap. Sheriff’s response – cheaper to pay survivor benefits to deputy spouse than to pay for lawsuit of “excessive force”.

That dog don’t hunt…..

BobF · May 7, 2023 at 9:37 am

A bit of an aside, but when a patient is that wild and almost uncontrollable, what happens when the cuffs go on? I’m guessing only two options: they for some unexplained reason immediately calm down, or their pain threshold is so high they don’t feel the cuffs tearing their arms/wrists up.

Been around 78 years and have been cuffed many times when I was the bad guy in exercises, but not stupid enough to resist at the cuffs (I had other ways of “resisting,” taught to me by the good guys with experience).

Michael · May 7, 2023 at 10:39 am

Part and parcel of our disintegrating society.

I’ve asked folks when they think S has HTF and get various non-answers, like you “Just KNOW” it’s time to start shooting.

My answer is when EMS, Fire Department, The Grid Linemen and the Police simply STOP going to work anymore. When those that keep things going STOP, so will everything else pretty quick.

Exhibit #1 Portland OR and CHAD Seattle when police were disabled. It’s pretty quiet on mainstream media but both cities are *still* in trouble and stores and services are dropping out.

A bright FLASH, all the electricity and electronics going down *might* be GO TIME but the slow staggering drunk falling down the social-economic staircase seems to be the current THING.

Aesop · May 7, 2023 at 11:26 am

I’ve been a registered nurse nearly 30 years.
I have been assaulted dozens to probably hundreds of times in that span. If anything, I’m low-balling that estimate. There is no 12-month span in any of that time when I haven’t been assaulted multiple times.
For reference, and to prove the point, the last time was Friday, just two nights ago.
Not even my patient, just helping out the unit staff with another confused asshole on another floor when I dropped my patient off.

If the usual “avoid”, “swarm” and miscellaneous PC bullshit taught at half a dozen hospitals doesn’t work, my default is the hand-to-hand the Marines taught me 30 years ago. If Crazy Violent Asshole gets fucked up by any of that, tough shit; sucks to be him. To include throat punches, crotch kicks, and choke holds that might break a neck. Oopsie. Too bad, so sad. FAFO.

As a brand new ED nurse deacdes ago, in one short summer I participated, just during the shifts I worked, in six full-on dogpiles on patients attacking other staff members, nurses, doctors, etc. The year before I started, several doctors had been shot by a psychotic whackjob who walked into the ED and just started shooting people.

Hospitals don’t give a flying fuck about the staff, and frankly, neither do most states.
In one case, when I was attacked by a patient, and had the entire dog pile fuck up the correct procedures, and simply drop the entire pile on me, I was out of work for two weeks; it was a miracle that a one-ton pile-on that folded my leg double didn’t cripple me for life. The ortho doc who saw me first figured I’d have a totally destroyed set of knee tendons and ligaments.

The city attorney who prosecuted charged the asshole in question who instigated that – a sober relative being a violent dickhead, not even a patient, let alone drunk or crazy – only with trespassing. Trespassing!?!. FML.

If that injury had ended my career, I’d have hunted that motherf***er down and killed him outright, and mailed his severed head to city hall. And dared them to charge me with littering.

I can’t speak to all 50 states, but only Nevada, AFAIK, does it right.
Assault on any health care worker, from the janitor who mops the halls to the CEO, is a felony, treated like spousal abuse: mandatory arrest, mandatory non-negotiable 24 hours in jail on the spot, and felony charges filed. Every single time. Drunk? High? Crazy? ZFG. You’re going to jail. And you’re getting charged with felony battery. On top of anything else you’ve done.

It’s far beyond fucktarded when 10 cops the size of NFL middle linebackers, in kevlar vests, carrying guns, batons, tazers, and OC spray, carry some bundle of waste of skin and oxygen into the ER, throw them on a gurney, uncuff them, and expect two to four 90 pound Filipina nurses in cotton scrubs to deal with them. And it happens every damned day, coast to coast.

One co-worker, a 6’4″ and 220 pound ER tech, reached across the bed of a demented 90-year-old lady to fasten her blood pressure cuff on her other arm, and as he did so, she sat up and bit him square on the bicep, through his scrubs, hard enough to leave a full plate dental impression on his arm that lasted and was clearly visible for three weeks. He didn’t want to hit her (he’d have killed her), but his punch in response blew a hole in the sheetrock opposite where he was standing. The hospital wrote him up for the incident – for damaging the wall. No mention whatsoever was made by way of saying “Thanks for not killing Mrs. Ancient Asshole.” That’s the level of hospital mental retardation and mismanagement that prevails in the executive suites in 50 states and seven territories.

When somebody gets 25-to-life for punching the nurse or doctor on a third strike felony, we can talk about getting it right.

Until then, AFAIK, if anyone attacks anyone from EMS to the hospital staff, anything less than cutting their heads off is in-bounds in response. Including cold-cocking them with an oxygen tank hard enough to fracture their skull, if that’s what it takes to dissuade them from continuing an attack on any staff member.

And the hospital should be sued for seven to eight figures by the entire staff present for inadequate protection every time it happens.

Juries start handing out lotto wins for the shoestring monkey’s-ass bonafide idiots they hire as in-house security – when there’s anyone present at all – and suddenly hospitals will start taking a keen interest in making hospitals the most safe place to work, instead of more deadly than working in a coal mine or an explosives plant.

Until that day, I don’t want to hear about anything done in response that doesn’t qualify for a mayhem charge, at minimum. And if you attack me and injure me, I’m going to do my level best to help you understand what a grave mistake you made, one way or the other.

    Divemedic · May 7, 2023 at 11:37 am

    The problem is that in every state, employers can’t be sued for injuries by an employee who is attacked. Heck, if a business posts a “no weapons” sign, anyone robbed or shot on the property can’t sue the property owner.
    If that DID happen, maybe mass shootings would stop when businesses began hiring armed guards and a few of these losers got capped by some Mall Ninja.

Toastrider · May 7, 2023 at 11:28 am

People can get hurt, crippled, or killed in just a bare hands fight.

That nurse whining about the paramedic punching the patient? Guarantee she’s never been in a fight, never even SEEN a real fight. Her view of violence has been molded by Hollywood and the entertainment industry where someone can get punched in the face ten times and be just fine an hour later.

I saw a similar sentiment during the Rittenhouse trial when one of the prosecutors opined that Rittenhouse ‘should have just taken his beating like a man’.

Beans · May 7, 2023 at 11:51 am

16 year old with coke and meth on top of his dose? Yeesh. Good going, mom. Great child you raised there.

When I was 16 I had no idea where to buy drugs. And I went to a stoner high.

As to attacks against medical staff, I can believe it. I’ve seen some stuff on my infrequent trips to the ER that can’t be unseen.

I do remember when taking advanced lifesaving that they recommended coming upon a drowning person from the rear, and if needed, punching the everlivingcrap out of said ‘victim’ as victims have been known to kill their rescuers.

As to the power of drugs, I worked in a mental health not-prison as a watcher (not allowed to touch patients even if they’re beating the crap out of me.) Remember all those high school football players? Security staff. I saw 5 of them pile on a ‘patient’ who was all of 120lbs, who was seriously screwed up. They all went down and then, I swear, the Matrix music started and the little 120lb dude with organic brain syndrome from too much drugs and AIDS and HepC started tossing the security staff like, yep, in the Matrix.

It’s why I feel no sorrow when some jackalope like George Floyd shuffles off his mortal coil because of the, what, 3 different lethal doses of drugs he took and then decided to fight. (And the officers were railroaded, so much for justice.)

That’s the problem. If the wrong person, and you know who I mean, gets beat by the right person, and you also know who I mean, then the local Soros district attorney will file charges. And it will be in the news. And there will be pressure put upon all administrators involved to fire the professional for defending himself/herself.

Personally, if you do something to warrant a beatdown, then expect a beatdown. I’m seriously surprised that EMS doesn’t carry trank guns (and I’m not joking, not at all) as tasers and other less-lethal methods of restraint don’t work all too often.

    Divemedic · May 7, 2023 at 12:49 pm

    The problem with tranquilizer darts is that the dose required for the 250 pound drugged up man is different from the dose required for the 110 pound woman who isn’t on drugs.

Hat Tip · May 7, 2023 at 12:16 pm

Some cities have to have police escort for EMS and firefighters, Chicago is one.
A little beer and weed every now and then should be all anyone would need.
We were lucky to score those four pack cigarette promos at the race track at 16 let alone score some methadone.
Total societal freefall but you have to burn it all down in order to build the CCCP back better.
Tip of the hat to all medical workers, they saved my wretched ass with some stroke to hospital in less than ten minutes and an amazing doctor with Rollie Fingers mustache and retro clothes.
And of course the dreamy ravishing Nurse C who talked me out of an escape attempt.

Matthew W · May 7, 2023 at 1:29 pm

“Mother, Speed and Jugs”

Anonymous · May 8, 2023 at 1:13 am

What this stupid cow is saying is that she is willing to let someone beat her, injure her, and do whatever they want, and she will not respond.

All of you combat veterans who are now nurses are still obeying the police and legislators and courts and administrators and bureaucrats, and paying them taxes to side with the violent attackers against you. How is your pacifism different than her pacifism?

    Divemedic · May 8, 2023 at 9:21 am

    Is that you, Ray Epps?

      Anonymous · May 9, 2023 at 1:47 am

      Patriotism being read as entrapment strikes me as an example of Temple Grandin type slaughterhouse entrance ramp design. There are more ways to do an ethnic/worldview cleansing than the last century’s gun bans, roundups, boxcars, and camps. Even if “the way to crush the bourgeoisie is to grind them between the millstones of taxation and inflation” is a fake quote, it is good policy analysis. Why is there not the same pushback against taxation and inflation (and regulation and cartelization and monopoly) as there is against gun bans, roundups, boxcars, and camps? My answer: because the middle class doesn’t want to win and thrive, it just wants to be seen doing the well-behaved thing. See also Walter Mitty’s Second Amendment.

      “The Navy has no place for good losers! The Navy needs tough sons of bitches who can go out there and WIN!” — Admiral Jonas Ingram

Bad Dancer · May 8, 2023 at 8:17 pm

I remember in the late 2000s when some mega management company bought up a lot of the local hospitals and EMS seeing the rules change.

One thing that stands out the most was EMS being told not to wear vests even concealed ones because the management company lied and said a patient complained of being scared by how aggressive it looked.

It is crazy how personnel are being treated as disposable assets and I suppose for every one they lose that is another foreign worker they can claim they need to fill the post.

    Aesop · May 10, 2023 at 12:28 am

    Companies that squeeze the jello in their hands like that can get unexpected reactions.

    Hey, that’s a nice medical management company you’ve got. Be a shame if we had to come back and shoot both your kneecaps and your balls off after we beat up your kids and wife in front of you, wouldn’t it? Consider this a horse’s head in your sheets. ” – two unknown guys in ski masks having a private chat with the CEO

    In a sluggish economy, never, EVER, fuck with another man’s livelihood.” – Guido The Killer Pimp, Risky Business

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