Your Captain Speaking: Stop Hitting Me!—Workplace Violence in EMS

“Samantha, I know you have experienced workplace violence just as I have. It was mostly low-level pushing and shoving, but there were times when it wasn’t low-level at all.

Let’s talk about workplace violence for a few minutes. Up front: We are not lawyers, and none of this is legal advice.”

Is there a standard definition? Where and by whom does it most often occur? (It’s not always patients.) When should you report it to a supervisor? What should the supervisor do? What is the culture in your organization around accepting this behavior? And can workplace violence be verbal as well as physical?

Supervisors’ Reality Check

If I were a supervisor asked whether workplace violence is a problem in our organization, I would first check our records for the number of complaints filed by staff (and by patients) in the past year. If that number is zero, I might conclude there is no problem and move on to the next crisis. (Yeah, that’s not me.)

Is there an easy, trusted mechanism for paramedics and EMTs to report these incidents? Does your operations manual or medical control policy even address workplace violence? If it doesn’t, that’s a gap that needs fixing. When an incident is reported, does the employee walk away thinking, “What a total waste of time—I’ll never file another report?” Or do they feel genuinely supported by management and other EMTs?

What Counts as Workplace Violence?

The Occupational Safety and Health Administration (OSHA) defines workplace violence as “any act or threat of physical violence, harassment, intimidation, or other threatening behavior that occurs at the work site."¹ In EMS, our “work site” is anywhere—the scene, the patient’s home, the ambulance, the hospital hallway, or your base of operations.

The Four Types of EMS Violence

To make sense of this in our world, OSHA breaks violence into four categories:

The Critical Decision

Before you file any complaint, ask yourself: “What do I want out of this?” Do you want the behavior stopped? Deterrence for others? Compensation? All three?

Let’s say you’re starting an IV in the back of the ambulance and the patient slaps you while calling you a name. Unacceptable. You document it in the patient care report (PCR), notify your supervisor, and give a verbal handoff to the receiving staff. You also get examined by an independent medical professional (doctor or nurse not affiliated with your company) to document any injury.

If there are no visible injuries, no video, and no witnesses, the case is harder to prove. If there are clear injuries and impartial witnesses, your options become stronger. In the real world, some family members will swear you “tripped and fell” and got that black eye on your own. Document everything anyway.

Captain’s Tip: Always include in your PCR exactly what was said, by whom, what physical contact occurred, what care was given, and what you told the next caregiver. This single step strengthens every report.

The Police Report Decision

This is the step that causes the most anxiety. Here are the four real-world complications:

1. The report may not be taken seriously—especially if injuries are minor.
2. Evidence matters: Your PCR helps, but impartial witnesses or video are gold.
3. Even with a solid report, the prosecutor (or grand jury in federal felony cases) may decline to pursue charges or indict.²
4. There can be push-back: counter-lawsuits, vandalism, or harassment.

Final Thoughts

Workplace violence isn’t going away anytime soon. The best long-term solution is prevention—training, scene safety awareness, and a culture that treats every report seriously. But when it happens, you need a clear plan: document, report, get examined, and decide what outcome you want. Is there an organizational culture that marginalizes workplace violence? A strength of EMS is that we see and recognize situations and patterns before others. Be situationally aware and alert to avoid the problem in the first place. You can do this!

“Samantha, we’ve both been there. The more we talk about it openly, the safer we all become. Check your rig, know your policies, and stay safe out there. You’re no good to your patients if you’re the one who needs treatment.”

Footnotes

1. Occupational Safety and Health Administration. Workplace violence. U.S. Department of Labor. https://www.osha.gov/workplace-violence (accessed March 2026). Recent studies show that nearly 60% of EMS workers experience verbal abuse and more than 23% experience physical violence from patients or family members in a given year. (Roth K, et al. Workplace violence and burnout among emergency medical services and nursing staff, 2025.)
2. While EMS assaults are almost always state-level crimes, U.S. Senators Eric Schmitt and Maggie Hassan introduced a bill called the “Graham Hoffman Act” that would make crimes against first responders a federal crime. It is named after Paramedic Graham Hoffman who was killed by a patient in the line of duty in April 2025. You can track its progress with the following link to Congress.GOV: S.2278 - Graham Hoffman Act. Time will tell.

About the Authors

Dick Blanchet, (Retired) BS, MBA, worked as a paramedic for Abbott EMS in St. Louis, MO, and Illinois for more than 22 years. As a Captain with Atlas Air for 22 years on the Boeing 747, he has more than 21,000 flight hours. A USAF pilot for 22 years, he flew the C-9 Nightingale Aeromedical aircraft. A USAF Academy graduate with a Bachelor of Science degree, his Master’s in Business Administration is from Golden Gate University. Email ACLS911@aol.com

Samantha Greene is a paramedic and field training officer for the Illinois Department of Public Health Region IV Southwestern Illinois EMS system, a paramedic and FTO for Columbia (Ill.) EMS, and full time at the St Louis South City Hospital Emergency Department as a paramedic. She was recognized as a GMR Star of Life.