The call was for an agitated man in a grocery store. The man was reported as ranting and incoherent. Fire/EMS arrived at the same time as the police officer.
We recognized the man from previous calls. We knew his name and his medical issues. We felt confident we could just talk to him and get him to leave the store with us.
But at the urging of the store manager, the police officer pushed past us and confronted the man. He demanded that he put up his hands. The man refused. The officer tried to handcuff the man and he struggled. The man ended up hogtied on a stretcher in the ambulance, an outcome that was bad for everyone, and seemed completely avoidable.
I remember this call because it was such an aberration in our city. Normally, we had excellent working relations with the police department. The officer that day was newer to the force and we had not worked with him before.
Law enforcement and emergency medical responders most often work well together, but there will be conflicts at times. Some of these conflicts arise because of a difference in the sense of primary mission: for EMS, it is patient care, and for law enforcement, it is safety and order.
But these priorities don’t have to cause conflicts. In fact, they are interdependent. Good patient care is not possible without a safe environment in which to provide that care. Order is enhanced when all parties cooperate and resolve problems at the lowest possible level.
That interdependence is underscored by the increase in programs that focus on tactical medicine- emergency medical providers who are cross trained to function inside or close to hot law enforcement operations.
But most EMS providers will not become SWAT medics. They will have only transient interactions with law enforcement officers. Individuals in the two agencies may not know one another well and may not fully understand the challenges the others face.
It is in everyone’s interests for EMS and law enforcement to operate as seamlessly as possible on difficult calls. This type of cooperation is the result of preparation: understanding the essential commonality of the mission and making that mission the highest priority on any response.
Conflict resolution, creating a working relationship
Developing good working relationships with those from other agencies is an effort that must take place proactively, long before those relationships are put to the test. Finding ways to interact and work together apart from emergency response is a good place to start.
Training together with those from different agencies can be a forum for understanding and joint problem solving. For example, both EMS and law enforcement agencies often engage in training to de-escalate dangerous situations. Performing this type of training together amongst different agencies would enhance the problem-solving skills of all involved.
Cross-training ride-alongs are another way that those from different agencies can develop greater understanding and empathy for one another. For example, EMS providers may not completely understand how often police officers must deal with mentally ill individuals, even apart from medical response. Police officers may not fully grasp the intensity and focus of trying to stabilize a patient who may be crashing.
When conflicts do occur, it is critical that those in both agencies have the desire to and will to mitigate them in the moment and work to resolve them in the long run. Interpersonal or interagency conflict can never hinder patient care, as happened last year in a conflict between firefighters and state patrol officers in Pennsylvania. Everyone must understand and adhere to the common mission in the moment, keeping the focus on protecting and serving those in the community.
If there are disputes, there should be systems in place for resolving them after the fact This might involve an informal conversation among the individuals involved, or it might require a more formal intervention. Those in leadership positions can be trained in mediation skills, and everyone in both agencies should receive training in basic skills of conflict management.
Leadership matters when it comes to working effectively together. Leaders of all emergency response agencies should meet regularly to discuss priorities, challenges and critical issues. Such conversations must transcend ego and hierarchy. Career and volunteer, government and private – all must come together equally and with mutual respect if the best public service is to be created.
Ultimately, emergency medical responders and law enforcement officers have the same goals: to keep people safe, mitigate harm and bring order to chaos. When all those in different agencies work well together, the best possible outcomes will occur.
Read next: 5 ways to manage conflicts with cops in a medical emergency
