What Happens When Police Take You to the Hospital

(Cooperative, inter-agency communication and training can resolve many of these issues)

The Perils of the “Hospital or Jail” Dilemma

Every medical professional dreads hearing the phrase, “You can either go with them to the hospital or go with me to jail.” This seemingly innocent statement can create the false impression of “custody,” not just for the person being transported and witnesses, but also for the healthcare provider.

Soft restraints, which are meant to ensure patient safety, can lead to hard times for healthcare. A real-life scenario exemplifies this issue:

A Challenging Situation

EMS personnel managed to persuade an individual to enter an ambulance and head to the hospital. However, the person became combative once again, prompting the personnel to request assistance from officers in the vehicle. The individual was presented with a choice: receive treatment at the hospital or face arrest. In response, the person made threats and intimidating gestures towards the officers and personnel. Eventually, the situation deescalated when the person was warned with a taser. Despite this, the person remained belligerent and had to be physically restrained by hospital staff upon arrival at the Salem hospital [^1^].

This phrase of hospital or jail is not unique to a particular area. It is a prevalent problem encountered by EMS/Fire and nursing staff across the country, regardless of the service area’s location — whether urban or rural.

Origins of the Phrase

During police academy training, the phrase “You can either go to the hospital with them or go to jail with me” was intended for situations when an officer believed a person needed medical treatment but had not committed a crime. The aim was to convince the person to seek medical care. The warning implied the officer’s ability to temporarily take protective custody of the individual using a law known as the “12-Hour Safe-Keep.” This law allowed officers to protectively detain someone without filing criminal charges. However, in many areas, this phrase has become a way to deflect responsibility from officers to EMS providers [^1^].

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The phrase is often employed when an individual is under the influence of drugs or alcohol but has not committed a crime. Officers use it as a temporary solution to remove the person from the streets due to liability concerns. However, this places the medic in the back of the ambulance in a precarious position. When the doors close, the “patient” perceives the EMS provider as an extension of law enforcement. Yet, the provider lacks the necessary training, tools, tactics, and authority to hold them against their will [^1^].

The Dangers of Miscommunication

As the ambulance starts moving, the intoxicated individual, now considered a “patient,” may become verbally or physically aggressive. They begin threatening the EMS provider’s safety and may even describe in detail how they plan to assault the provider. Faced with confusion over patient care versus self-defense, the provider may feel compelled to restrain the individual on the stretcher. Unfortunately, these situations, where the individual is merely intoxicated and not in need of medical attention, result in a whole new range of legal and situational complications. According to the NAEMSP, it takes five people to properly restrain a “patient,” and EMS/Fire often lack the necessary training to handle such cases [^1^].

Moving Towards a Solution

The first step in addressing this issue is through education. Both EMS and law enforcement need to understand each other’s limitations and authorities within the confines of an ambulance. While EMS/Fire have learned scene tactics through osmosis, they lack the legal and use-of-force training that law enforcement possesses. Merely mimicking what an officer does is not the answer [^1^].

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To prevent such situations from occurring, it is crucial to communicate safety concerns to the officer on the scene. If that fails, EMS providers can attempt to clarify their role to the person in the back of the ambulance. A suggested approach could be: “We are not the police; we are here to help. Our only goal is to take you to the hospital for assessment. If at any point you decide you don’t want to go, just let us know, and we will find a safe place to pull over and let you out.” Naturally, providers can adapt this message to fit their communication style as long as it conveys the lack of authority to detain the person against their will and the commitment to avoid using force [^1^].

Once the call is complete, it is beneficial to discuss the situation with the administration, separate from the officer involved, and arrange a meeting between EMS/Fire administration and local law enforcement administration. This meeting serves as an opportunity for mutual education, allowing both parties to understand each agency’s capabilities when dealing with intoxicated individuals [^1^].

Changed

Conclusion

Numerous assaults resulting in injuries occur because staff attempts to restrain an attacker rather than a patient. Through continued education, we can make our jobs safer. While we undergo extensive training to save others, it is high time we learn how to save ourselves, too.

5 WS


[^1^]: Original article content. (Link to the source is not provided, as per the instructions)

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