McGuire Sarayna S, Lampman Michelle A, Smith Olivia A, Clements Casey M
Division of Prehospital Medicine, Department of Emergency Medicine, Mayo Clinic, Rochester, Minnesota.
Department of Emergency Medicine, Mayo Clinic, Rochester, Minnesota.
Prehosp Emerg Care. 2025;29(2):129-137. doi: 10.1080/10903127.2024.2381218. Epub 2024 Aug 5.
The objectives of this study were to: (1) understand the personal impact of workplace violence (WPV) on staff within a large multistate emergency medical services (EMS) agency, (2) describe the impact of WPV on subsequent patient interactions, examining how experiences of violence affect the quality of care provided by EMS clinicians, (3) examine the influence of WPV on perceived workplace safety among prehospital personnel and its correlation with retention in the EMS field, and (4) solicit recommendations from staff for the prevention and mitigation of WPV in the future.
We conducted virtual focus groups and individual interviews with 22 prehospital personnel using a descriptive qualitative design within a large multistate Midwest EMS agency between 4/5/2023-6/20/2023. Data were analyzed using Thematic Analysis to identify common perceptions among and across participants.
Major themes of personal impact; impact on patient interactions; influence of WPV on career longevity/sustainability; and relationship between EMS culture and WPV were identified. Overall, participants shared the perception that WPV is "part of the job", and that verbal abuse was so common that they hadn't previously considered it as violence. Participants provided several examples of WPV and described how these experiences impacted them personally (e.g., hypervigilance) and impacted their subsequent interaction with patients (e.g., quicker to use restraints, loss of empathy). Participants shared the perception that EMS is no longer valued or respected by patients or communities. Several voiced concerns for the next generation of colleagues and nearly all participants reported the need for education and training in situational awareness, de-escalation, and self-defense tactics. Participants referenced desire for more coordination and communication with law enforcement, change in culture of abuse from patients without repercussions, and improved agency mental health support and peer support/mentoring following a violent event. Despite experiences with WPV, the majority reported plans to remain in EMS.
Emergency Medical Services personnel are commonly traumatized by violence in their work and nonphysical violence is underappreciated. Despite its impact on staff and subsequent patient interactions, most participants reported plans to remain within EMS. Multi-faceted system-focused efforts are needed to shift toward and support a zero-tolerance culture for WPV.
本研究的目的是：（1）了解工作场所暴力（WPV）对一家大型多州紧急医疗服务（EMS）机构员工的个人影响；（2）描述WPV对后续患者互动的影响，研究暴力经历如何影响EMS临床医生提供的护理质量；（3）研究WPV对院前人员感知的工作场所安全的影响及其与EMS领域留任意愿的相关性；（4）征求员工对未来预防和减轻WPV的建议。
2023年4月5日至2023年6月20日期间，我们在一家位于中西部的大型多州EMS机构内，采用描述性定性设计，对22名院前人员进行了虚拟焦点小组访谈和个人访谈。使用主题分析法对数据进行分析，以确定参与者之间以及参与者群体之间的共同看法。
确定了个人影响、对患者互动的影响、WPV对职业寿命/可持续性的影响以及EMS文化与WPV之间的关系等主要主题。总体而言，参与者普遍认为WPV是“工作的一部分”，言语虐待非常普遍，以至于他们以前没有将其视为暴力。参与者提供了几个WPV的例子，并描述了这些经历如何对他们个人产生影响（如过度警惕）以及如何影响他们随后与患者的互动（如更快地使用约束措施、失去同理心）。参与者普遍认为EMS不再受到患者或社区的重视或尊重。一些人对下一代同事表示担忧，几乎所有参与者都报告需要进行情景意识、缓和局势和自卫策略方面的教育和培训。参与者提到希望与执法部门加强协调和沟通，改变患者虐待行为不受惩罚的文化，以及在暴力事件发生后改善机构的心理健康支持和同伴支持/指导。尽管有WPV的经历，但大多数人报告仍计划留在EMS领域。
紧急医疗服务人员在工作中经常受到暴力创伤，非身体暴力未得到充分认识。尽管WPV对员工和随后的患者互动有影响，但大多数参与者报告仍计划留在EMS领域。需要采取多方面的、以系统为重点的努力，转向并支持对WPV零容忍的文化。
