They pointed a gun at them, choked them, beat them: ambulance doctors spoke about attacks on patients

“We don’t wear a stethoscope around our neck, they can easily strangle you with it.”

“Emergency doctors often have to work in extreme conditions,” says doctor Vladimir Varnavsky. — We go to road accidents, provide assistance to the victims, where there is a stream of cars nearby. We find ourselves in dens of drug addicts, in apartments after long feasts, where aggression towards doctors and paramedics can be used not only by patients, but also by their relatives and drinking buddies.

Vladimir Varnavsky worked as an ambulance driver for 9 years, in different cities and regions.

“For example, I was always on my guard if, when entering a patient’s apartment, I saw that a knife was lying in a visible place. At the same time, he asked the patient to take such a position that it would be difficult for him to reach the knife in one second. Or he positioned himself so that I had escape routes. You need to pay attention to details. And don’t forget that the same sweet, quiet pensioner can lock you in her apartment and pour boiling water on you. What happened to one of my colleagues. And also look to see if there are any inappropriate relatives in the apartment who could also block your path.

As the doctor says, they have neither standard weapons nor gas canisters. Doctors have to rely on their skills and defend themselves with improvised means.

“Once our team was called to a teenage girl with inappropriate behavior. She had a psychiatric diagnosis. We were the closest, we came to the call. There was a domestic conflict in the apartment. The girl locked herself in the room. When we entered, she suddenly opened the door and threw a knife at us. Only a good reaction helped us dodge the blade.

Vladimir Varnavsky says that the same psychiatrists advised him not to constantly wear a stethoscope around his neck, as they could easily strangle him.

“Doctors take great risks.” I remember how in the middle of the night I responded to a call to an apartment that turned out to be a haven for Satanists. Pentagrams, the numbers 666, and inverted crosses were drawn on the walls, either in blood or in red paint. I began to carry out resuscitation, realizing that there was a whole group nearby and no one would come to my aid at 3 am. And, of course, it is better if there is no light in the apartment from which the call came, so do not go there without the police. In case of danger, doctors have every right to wait for help. And only upon the arrival of the police squad provide medical assistance.

As our interlocutor says, in cities with a population of over a million people are still trying to staff ambulance teams. And in small towns, doctors and paramedics often have to respond to calls one at a time.

— Ambulance doctors work for days. You need to be not tired even at 5 am, able to quickly make a decision. And, of course, when you go out on calls with your partner alone, you’re not so physically tired.

At the same time, doctors and paramedics are encouraged to remember that patients are their partners in treatment.

— We try to adapt to each patient in order to level out the conflict. Not a single educational institution teaches how to communicate with patients, how to inform relatives that a patient has died. Medical psychologists, of course, give appropriate recommendations. But doctors and paramedics more often have to act purely empirically, based on personal experience and personal characteristics. We learn from our own mistakes, making mistakes.

“He punched me in the face, on the head and pushed me down the stairs.”

Ambulance paramedic Tatyana Ivanova from a Ural town spent a month on sick leave after being attacked while on call.

“This was my first call on shift,” says Tatyana. “We only have two doctors working in cardiac emergency and intensive care units. And on the “line”, due to a lack of personnel, we most often travel alone. But fortunately, there was another paramedic with me that day. We were called to a 65-year-old woman who had a leg injury. Her son opened the door. After examination, a decision was made to hospitalize the patient.

My partner went down to the car to get a stretcher. When the patient’s relative learned that his help was needed to get his mother downstairs on a stretcher, he was furious. The man began shouting at me, insulting me in every possible way, waving his arms and demanding to call another ambulance. I felt scared, and I decided to go downstairs for help, which I warned the patient about. Her son caught up with me on the stairs, grabbed me by the shoulders and hit my head hard against the wall. Then he punched me in the face and head and pushed me down the stairs.

A partner came to the rescue. Pressing the panic button on the tablet, he called the employees of the Russian Guard. Soon I began to feel nauseous, dizzy, and started vomiting. The neurosurgeon on duty made the decision to hospitalize me. I spent almost two weeks in the hospital and remained in outpatient treatment until the end of the month. Now I’m back at work. But the fear that everything would happen again remained.

Paramedic Victoria Shutova from Vyborg, who has been working as an ambulance for 17 years, says that aggression towards doctors has only been increasing recently.

“At one time, my senior comrades warned me: “Make sure that patients do not close the front door. If they lock the door with a key, it’s always a risk.” I was recently locked in an apartment by a drunk patient who didn’t know what to demand. It’s good that we have an agreement with the ambulance driver. He is of impressive size – two meters tall. Realizing that I had been gone for a long time, he got up, started calling, and took me from the apartment.

A similar situation occurred on the last shift. A migrant from Central Asia beat his wife, who needed help, and did not let me out of the apartment. The driver again came to the rescue. We have to work in such conditions, and the paramedics are mostly women. We turn out to be extreme, patients take it out on us for all the grievances, unsettledness and disappointments.

How can a paramedic protect himself? As Victoria says, only putting forward an orange suitcase with medicines, which weighs almost 20 kilograms.

“You go on shift and don’t know if you’ll return home alive.” We had a paramedic named Tatyana, who was almost strangled by a drug addict in the bushes. She was saved only by the fact that the ambulance driver began to worry that she would be gone for a long time. Tatyana was already unconscious. Fortunately, she was saved, and now she works in St. Petersburg.

Victoria Shutova believes that it is necessary to make changes to Order No. 338 “On approval of the procedure for providing emergency, including emergency specialized medical care.”

— In my opinion, it is necessary to introduce such a position as a nurse. He must have an acceptable salary so that guys, for example, students, will work in this place. So that paramedics do not go to calls one at a time. So that they have at least some kind of physical protection. All these panic buttons are, of course, good. But you still have to run to the ambulance to press it.

“I had to jump into a snowdrift from the second floor”

Another ambulance paramedic, Yulia Nesterova, says that on every third call she has to deal with aggression from patients.

— Often an ambulance is called by passers-by who see a person lying on the street. We arrive and understand that he is drunk. We begin to wake him up, and he attacks us with his fists. You can expect trouble from a seemingly harmless pensioner. One day, an elderly woman closed the door behind us and allegedly forgot where she put the key. They began to explain that we had an emergency call and that a child was suffocating in the next entrance. She says: “I don’t care, I’ve had a fever for a week.” It’s good that another ambulance team was nearby. The woman soon had to find the key.

As our interlocutor says, there are a lot of calls for migrants who live quite crowded, with 10–12 people in an apartment. There are quite a lot of drug addicts among them. Once, Yulia and her partner even had to jump into a snowdrift from the second floor.

— A call came in and it was said that the person was feeling unwell. We arrive, ask where the patient is, and see that the bed is empty. At this time, they push us into a room and, pointing a gun, demand that we give us drugs. There was no time to think. While my partner was pushing away one of the attackers, I threw a medical box out the window and jumped from the second floor into a snowdrift myself. My partner followed me.

Julia shares that doctors like to be reminded of the Hippocratic Oath. But few people know that it also says that the patient must take responsibility for his health.

— You get used to working in an ambulance with its rush jobs. You go to an emergency call, where a patient with heart or chest pain is waiting for you, and you automatically monitor whether there is a freight elevator at the entrance and whether it is in working condition. Then, without hesitation, you call rescuers to carry you.

Yulia Nesterova, like Victoria Shitova, believes that the best protection for ambulance doctors and paramedics would be a punishment comparable to the punishment for an attack on security forces.

“I remember how one day I came to a call at the police department, I then worked not in Vyborg, but in another city,” says Victoria. — Where a detainee who needed medical attention beat me. And he got off with just a fine of 1,500 rubles. I believe that strict criminal penalties should be provided for attacks on doctors.

Yulia Nesterova, in turn, recalls how back in 2013 a petition was drawn up calling for the equalization of ambulance workers with police officers in terms of punishment for attacks on medical workers.

“This petition collected a huge number of signatures, it was widely discussed in the media,” says Yulia. — Letters and appeals were sent to the State Duma, from where they came back saying that the Criminal Code already protects us. And we do not need such means of protection as a traumatic pistol and a shocker. We already had panic buttons in our navigators back then, but we didn’t have tablets yet.

As Dmitry Belyakov, an experienced paramedic and chairman of the independent trade union of ambulance workers “Feldsher.ru”, says, the issue of the new legal status of doctors has been raised more than once.

“We were told: now you will ask to equate your position to law enforcement officers, then the plumbers will ask,” Dmitry Belyakov shares with us. – If they attack a plumber, he can, firstly, run away, and secondly, hit back with a wrench on the head. The doctor cannot abandon the patient and run away. Then he will be accused of failure to provide assistance to the patient.

Dmitry Belyakov recalls that doctors used to be insured against accidents.

“But when they started optimizing medicine, they thought it was overkill. Now, if a doctor is injured on the job, he does not receive any insurance. He is simply given a sick leave certificate.

According to our interlocutor, there is no longer an ambulance as an emergency service.

— Having considered that the ambulance should pay for itself, it was equated to service. This is a service of the insurance company that is free for people. Accordingly, doctors and paramedics can now be treated not as saviors, but as servants. They don’t attack, for example, firefighters or police officers. This is a serious article. They are on duty, emergency services, especially since they are armed. But doctors are not protected. We can be rude, we can be hit, we can be filmed. And the doctor and paramedic won’t do anything. As long as there is such an attitude, “ambulance” will be a service – attacks will continue.

As Dmitry Belyakov says, he himself has such an expression on his face that it is better not to attack. It is kind, but merciless.

“There are no statistics on attacks on ambulance doctors and paramedics,” says Dmitry. “In fact, there are many more cases of attacks and rudeness than is becoming known. At one time, a brochure was even published on how to defend ourselves if they start beating us. For example, if you are kicking, you should cover your face and vital organs.

And doctors continue to die. Yulia Nesterova says that she and her colleagues are now trying to officially approve October 8 as the Day of Remembrance for doctors who died in the line of duty. At 13.00 on October 8, as a sign of memory of those who took up eternal duty, the teams on duty at “03” turned on the sirens and beacons on their vehicles for 30 seconds.