Forensic aspects of communication with the patient and bereaved persons in out-of-hospital practice.

It is not easy to characterize a problem patient or bereaved relatives because identifying a patient or his bereaved family as a “problem” is not considered quite ethical. The approached emergency medical service employees and coroner service physicians were asked to complete a specific targeted anonymous survey. 100 % of survey questionnaires were returned. The questionnaire with a request for filling and returning was submitted to forty employees working full-time, twenty of whom were physicians, ten paramedics and ten lower-level healthcare professionals. The questionnaire comprised ten questions aimed at obtaining clear answers to questions about personal experience with problem patients, specifically aggressive patients, and more specifically whether the health care professionals (HCP) has ever felt immediately threatened by a patient in their work, whether they were exposed to verbal or even physical attack in the context of the patients basic diagnosis established during pre-hospital care. Seventy-five percent of respondents answered Yes to Question No. 5: “Have you ever felt threatened by a patient or bereaved relative in your work?” Eighty percent of respondents answered Yes to Question No. 6: “Have you ever been exposed to a verbal attack by a patient or bereaved relative?” Seventy-five percent of them answered Yes to Question No. 7: “Have you ever been exposed to a physical attack by a patient?” The rate of cases in which emergency medical service employees are exposed to verbal or physical attacks is high. The primary experience hypothesis that this happens has been proven as well as the fact that it is a highly topical and therefore unresolved issue that threatens the whole society with its social implications.