Faced with increased danger at work, paramedics send a ‘call for help’ to management

Two blocks from a shootout, Dmitriy Stalmakov stopped and looked where a bullet had ricocheted off the back of his ambulance. Had he grown 2 inches taller, the 28-year-old paramedic isn’t sure if he’d be here to tell the tale.

“If he had broken through the door, he would have entered directly behind my back,” Stalmakov said.

Over the past three years, emergency medical responders in Hennepin County said they have witnessed a disturbing increase in violence that has made the job more dangerous at a time when rising call volumes stretch already the workforce. A week after being caught in the middle of the shooting in downtown Minneapolis, someone threw a vodka bottle that shattered at the windshield of Stalmakov’s ambulance as he ran through south of Minneapolis. In the dark, he said, he mistook the thud for a shotgun blast that had just blasted through the window.

After that, Stalmakov and other leaders of the Hennepin County Paramedics Association and EMTS sent out a survey to the union’s 160 members to better understand the extent of the problem. The results showed a staggering trend in the ranks of paramedics in Minnesota’s largest county.

Of those surveyed, 87% said they were affected by gun violence in their day-to-day activities. 78% had been physically assaulted by a patient or bystander. Nine in 10 paramedics and dispatchers believe the job has become more dangerous since starting their job.

Shane Hallow, president of the paramedics’ union, sent the data last week in a letter to Hennepin County commissioners and Hennepin Healthcare management, saying staff are not receiving adequate support for what has become a daily phenomenon of violence.

“I am writing this letter on behalf of the paramedics and dispatchers, who provide 911 services to Hennepin EMS, with a plea for help,” Hallow wrote. First responders are assaulted and injured daily. The conditions push some to quit the job.

“The only thing that has spared the lives of our members and union partners is luck.”

Unknown causes

The EMS union survey showed that the assaults fell mainly into three categories: emergency vehicles attacked on the way to calls or outside hospitals, such as a recent case where someone discharged a paintball on an ambulance outside Abbott Northwestern Hospital; patients or bystanders attacking paramedics providing care in the field; or county agency police calling paramedics in “abnormally unusual” and dangerous situations in an effort to “recategorize a criminal event as a medical event,” decreasing police liability but increasing risk to paramedics, according to summary of results.

In a statement, a Minneapolis police spokesperson said paramedics’ concerns were not communicated to department officials, “who maintain very clear lines of communication with Hennepin EMS.”

“There is no doubt that the duties of any first responder carry significant risks, but it is disconcerting that anyone believes that the MPD would deliberately endanger a paramedic or other first responder,” the statement said. “MPD takes the safety of all persons very seriously, and 911 callers and dispatchers do not have EMS to respond to a potentially dangerous scene until MPD officers are present and have made the scene safe.”

The EMS union survey found that a significant number – around 20% – of those who had been attacked had never made a complaint to the police. This, in large part, because people don’t believe it will lead to criminal charges, Hallow said. Stalmakov said that was the result when he reported the bottle incident and the shots fired at his ambulance in the summer, even though the latter took place opposite the First District headquarters.

Many paramedics don’t even report assaults internally to Hennepin Healthcare due to a cumbersome process that requires them to stay up to an hour later to complete paperwork, Hallow said. “Most people, after working a long shift, call after call after call, just want to go home.”

Hennepin EMS chief Marty Scheerer acknowledged reporting has been a problem in the past. Starting in November, to help streamline the process, Hennepin EMS placed a new reporting function on the computers inside each ambulance. Scheerer said it was too early to know if it made a difference. Ambulances are also now equipped with signs stating the law against assaulting medical workers in Minnesota, an offense punishable by five years in prison and a $10,000 fine.

Scheerer said there was no clear explanation as to what is driving the attacks on paramedics. The job has always been dangerous, but saw a new trend emerge during the riots following the police killing of George Floyd, he said. “We don’t understand why the violence is directed against us.”

Assaults follow with an increase in violent crimes that began in 2020 in Minneapolis. Although on pace with lower numbers than last year, crime trends remain above the city’s average in the decade before the pandemic. In 2022, Hennepin paramedics responded to more gunshot and stabbing calls than ever before, Scheerer said. “It’s been a banner year for us.”

Hallow said he doesn’t think rising crime alone explains the increase in assaults on paramedics. Emergency medical service workers are also responding to more mental health or drug-related calls in recent years. Some people who don’t trust the police confuse paramedics with an extension of law enforcement. “It’s hard to pinpoint exactly what it is,” he said. “I think it’s a combination of everything, to be honest.”

Not just paramedics

A similar trend is also playing out in hospitals.

In 2020, about 280 attacks — triple those in 2019 — injured Minnesota hospital workers and forced them to miss work, according to the latest data from the U.S. Bureau of Labor Statistics. In a survey by the nurses’ union, 75% said they had seen or experienced physical violence at work in the past two years and, like paramedics, many were too busy to file a report.

The letter calls for additional safety measures for paramedics as well as hospital staff, including the provision of panic buttons for hospital staff to wear, the implementation of visitor registration with metal detectors, a plan to improve safety and a better process to identify patients with a history of violence so that paramedics can go on future calls prepared.

In the meantime, the number of calls for Hennepin paramedics is up 35% from 18 months ago, Hennepin Healthcare spokesman Thomas Hayes said.

“It’s been a pretty tough summer, and it’s going to be a tough winter,” Scheerer said.

He said the hospital system plans to hire 50 paramedics over the next six months to make up for staffing shortages. In the shorter term, Scheerer said he is working closely with the union to help address violence and pay more attention to the mental health needs of EMS workers in the field. He also created a safety committee with paramedics to look into these issues.

But assaults help to lower morale, Stalmakov said. Some paramedics quit.

“The tools we’ve put in place just aren’t designed to solve the problem,” he said.

Correction:
An earlier version of this article incorrectly listed membership numbers for the Hennepin County Paramedics and EMTs Association. The union has 160 members.