On the Decision to Defer the Project Launch

Thursday, January 6th, 2022

Dear Colleagues,

We are living through unprecdented times. The exhaustion of health care providers, coupled with the impact of the Omicron variant have pushed the healthcare system to the edge.

Recognizing that many of you are dealing with deeply challenging circumstances, we have decided to delay the start of data collection for the collaborative viuolence reporting process until at least March 1st, 2022.

We are delaying because some services understandably haven't been able to deploy the EVIR and train their staff. Asking any of you to do that work during this Omicron wave is unreasonable.

We remain available to all services for consultation and assistance over the next few months. If your service has the time and bandwidth to deploy the EVIR, we're ready and available to help. We'll continue to develop and disseminate training materials for you to use.

Our plan is to check in with all services around the week of February 14th to assess where everyone is and what still needs to be put in place to make this project a success.

We are tremendously grateful for the work that you do.

Stay safe, stay well.

Justin & Elizabeth

The role of organizational culture in normalizing paramedic exposure to workplace violence

Friday, December 10th, 2021

Earlier this week, our paper on the Role of Organizational Culture in Normalizing Paramedic Exposure to Violence came out online in the Journal of Aggression, Conflict and Peace Research. We were asking an important question: why do incidents of violence against paramedics often go unreported?

Here’s the problem:

Paramedics are frequently exposed to acts of violence in the course of their duties. In Canada, a 2014 study by Bliar Bigham asked paramedics from Ontario and Nova Scotia about their experiences with workplace violence. In total, more than 75% of paramedics indicated they had been subjected to some form of violence within the past year, but less than 20% formally reported the incidents.

At the same time, a growing body of research internationally tells us convincingly that a concerning majority of paramedics have been subjected to verbal abuse, threats, intimidation, and physical and sexual assault. Epidemiologist Brian Maquire characterizes violence against EMS personnel as a ‘serious public health problem’. Compounding this problem, however, is that workplace violence against paramedics is vastly underreported. We wanted to understand why.

In 2019, we surveyed paramedics in Peel Region and asked them about their experiences with workplace violence, whether or not the incidents were reported, and - importantly - if not, why not. In qualitatively analyzing the survey comments, we constructed a framework to describe how, despite carrying significant risk for physical and psychological harm, violence is often accepted as just ‘part of the job’.

Here’s what we found:

First, our paramedics told us that the violence they encounter is so widespread that it fades into the background as just another chronic workplace stressor. Which, considering the litany of abuses they described having experienced, is horrifying. They commonly told us they’d encountered “too many (violent incidents) to count”.

Second, this drove the perception that exposure to violence is simply unpreventable. Because paramedics respond to emergencies in the community in situations that are inherently stressful and difficult to control, the paramedics pointed out that they “can’t control peoples’ behaviour”.

Third, because the majority of the acts of violence were perpetrated by people for whom criminal prosecution was either unlikely (i.e., in the case of more ‘minor’ incidents) or inappropriate (i.e., because of cognitive impairment), the perception was that there are often no consequences for offenders. This left our paramedics with a profound sense of injustice.

The result of chronic, ‘unpreventable’ and ‘unprosecutable’ violence? The ability for paramedics to simply “brush off” and “move on from” violent incidents becomes normalized as an expected professional competency.

This cyclical process is the entrenched organizational culture within the paramedic profession that we have to break. Although we may not be able to prevent all acts of violence, and even though criminal prosecution may not be appropriate in many of the situations, this does not mean paramedics should be expected to simply tolerate the abuse. And it doesn’t mean we can’t take steps to keep paramedics safe and support them when they experience violence.