6 days ago
A knife to my throat, spat on and screamed at: Life as a paramedic in peak summer
He came at me with a bread knife, threatening to cut my throat as I was working to resuscitate the unconscious woman I'd found at the bottom of his stairs.
As a paramedic, I've been in many of these dangerous situations before. Your body goes into survival mode and you just try to get out of their way – though it was easier to duck and dodge punches when I was younger and more nimble. As a 59-year-old man, I'm no longer quite as quick on my feet.
In this case, which happened early in my career, my crewmate came in just at the right time and managed to push the man into a cupboard – and kept him in there until the police arrived. We got the job done without coming to harm.
I've worked in the health service since 1989. For my first 11 years, I was a nurse who cared for the elderly. I joined the ambulance service in 2000 and, after completing my training, became a paramedic in 2006.
Unfortunately, verbal abuse and physical violence are common features of the job. Nowadays, we're sent on self-defence courses where we're trained to reduce the risks to ourselves when it inevitably occurs – breakaway techniques, to disengage from physical confrontations, and different ways to stand if someone's going to hit you, to defend yourself more quickly. But you normally find the attack that hurts you is the one you're not expecting because it just comes out of the blue.
I've had a fair few of those in my time.
The attacks I've faced
In August 2024, we received a call about a young man who was lying unconscious under a flyover in town. When I spoke to him, he opened his eyes. I asked if he wanted to come into the ambulance, he agreed and seemed perfectly fine.
But, once in the back of the vehicle, he became verbally abusive and launched himself at me and pinned me against the wall. I quickly pushed the record button on my body camera but, because he pounced at me unexpectedly, I didn't push it hard enough. He kept coming towards me, and I prepared to defend myself. He screamed at me and then left the ambulance.
My crewmate was still outside and he chased after him. Then, as my colleague tried to get into the back with me, the patient tried to follow. We had to wrestle with him to get the back door closed. We locked ourselves inside and contacted the police.
Shortly after that, maybe a month later, there was another attack from a patient. Another young man, who was on drugs and alcohol. The incident was similar – lots of verbal abuse and trying to attack me, though this time I successfully recorded it. At two points I had to put my hands up in front of me because I thought he was going to hit me.
Both of these incidents went to court, but only the second man was sent to jail straight away, as I had the video evidence.
Limited options for protection
There aren't lots of options available in terms of protecting yourself in these situations. We're told to hit record on our camera, push the panic button on our radios and defend ourselves as much as we can. But in the back of the ambulance, once the door is closed, the area is so small that there's nowhere to go.
When the worst violence happens, it's not usually the ones who look angry – you can spot those and do something before it escalates. It's the ones who have expressions that you can't read. Those are the dangerous ones.
Another incident I faced was a call-out for a man who was acting erratically in a supermarket. He told us he was suicidal and we told him we could get him to the hospital, where he could speak to somebody.
When we arrived at the hospital, he refused to get out of the ambulance. I could see there was a police car, so I asked my crewmate to go and see if there was someone there who could help. As a result, I was on my own in the back of the ambulance when the man pushed me against the cupboard with his arms and legs.
Somehow, I managed to break free from him and actually fell out of the back of the ambulance. Seeing this, a policeman and a crew member from another ambulance arrived. The patient tried to take the policeman's gun from him. The three of us had to wrestle him to the ground until he was eventually cuffed and arrested. There was no stopping him.
That incident left me with a few cuts and scrapes, but I've never had a long-term injury from an attack.
Sometimes the attack isn't as violent, but it's still disgusting. On St Patrick's Day in 2020, there was a drunk 14-year-old boy who toppled over and, as I tried to stop him from falling and hitting his head on the ground, he spat the biggest amount of saliva directly into my mouth, pushed me into the ambulance and then started attacking the vehicle.
Confronting a patient
I've only once confronted a patient about what they've done. It was a woman who we'd have repeated call-outs for and she would give us bad verbal abuse every time. On one occasion, she was in the back of the ambulance and blamed her mental health for how she acted. I said to her: 'What about my mental health? When you're giving me verbal abuse or attacking me, you're not worrying about my mental health, yet I always have to think about yours.' I don't know where it came from, I was just sick of hearing excuses.
It's hard to quantify how often we face violence in the job. It will be quiet for a bit and then you'll hear about lots of colleagues getting attacked over the space of a few weeks or months.
When I first started, Friday and Saturday were the times to be wary, but now it's any time of day or night and from any age group. Christmas is a common time for violence to occur but so is August. People are drinking more during the day and taking drugs because the weather is good or they're off on holiday.
How the pandemic has affected our work
It definitely seems to be since Covid that attacks are on the increase. Alcohol and drugs seem to be everywhere now, among all ages.
Since the pandemic, people have also become a lot more demanding, expecting more from you. I've been told by patients, 'I pay your wages', and they expect to be seen right away at hospital, when they might not be the most serious case. There's an 'I want it now' kind of culture.
But it is the case that patient wait times have increased. A lot of time can be spent queuing in our ambulance at hospital, waiting for our patient to be triaged and admitted. That can take up quite a lot of the day on a shift, unfortunately.
We used to get through 10 to 12 calls a shift; now we're doing five or six. It just depends on how quick you get a bed once you get somebody to a hospital. When not dealing with abusive patients, it's usually a mix of cardiac arrests, falls among elderly patients and mental health cases. Then you'll get a clump of things together, like car accidents. Not everyone has to go to hospital; we treat patients at home too.
What keeps me going
At times, I feel so down about the aggression I face. I'm trying to do what I can for people and I'm getting abused, hassled, attacked. A lot of people have left the job and gone somewhere else, rather than endure the abuse we get. I haven't considered that myself, as I've been doing this job so long, I wouldn't know what else to do.
Any other patient-facing role in the NHS will still leave you vulnerable to violence. My wife, who I've been married to for 33 years, used to be a nurse but quit her career in 1996 after being attacked. An aggressive male patient pushed her forcefully in the chest with both of his hands, knocking her across the room on to one of the beds. It hurt her back so badly that she never worked again.
She is my support, the person I speak to when I get home from a particularly bad day. Luckily, all the crews I work with are all very friendly and we talk among ourselves and look out for each other. There's also a lot of formal support from the ambulance service.
The thing that keeps me going is helping people. That's what it boils down to: helping others. We see people when they're very ill and at their lowest, but you can still make somebody smile. I remember getting a call out for an elderly woman and, months later, I saw her daughter and she thanked me, saying I was the first person to make her mother laugh in weeks and that it was lovely to see. Those things make the job.
