One of my EMS heroes is Thom Dick, the author of People Care, and a regular contributor to both JEMS and Emergency Medical Services. He has an interesting column in the April Jems called “Spring-Man: What are your jittery patients going to do next?” The gist of the article is to be quiet, to listen, and be nonadversarial. Don’t try to win an argument. He mentions a paramedic from Iowa who “believes that if you find yourself in a situation…and whatever you say feels good (or you wouldn’t say it in front of your mom), you’re probably out of line.” Dick concludes, “When it’s your job to help people in crisis, the smartest mouth in the room is not necessarily an asset. What is useful is the knack of getting everybody home safe – time after time, and year after year. If that sounds like plain old work, it often is.” I thought of his article yesterday – not in the context of dealing with psychs, but in dealing with people who seem to always push our buttons on calls. You work in the same town, you respond to many of the same places and run into many of the same people over and over. Most are nice, friendly, courteous and helpful. Then there are some who just always seem to get on your nerves. The senior coordinator who repeatedly tries to talk the person who tripped and scrapped their knee into going to the hospital even when it is clear they not only don’t want to go, they don’t need to go — they just have a scrape and they don’t hurt. The nurse who insists on taking phone calls while she writes up the W10 and won’t give you a report until she is done chatting, the cop who won’t let you question the obviously injured patient until he is done getting his answers. Most of the time we suffer them in silence or quietly say what we need to do without hostility. Every once in awhile we say what we want to, and stir up a confrontation. We tell the bystander that the decision is the patient’s and that it won’t be the bystander sitting in the ED waiting room for ten hours only to be told to go home because all they have is a scratch. We tell the nurse to quit the chit-chat, hang up the phone and tell us why we came lights and sirens. We tell the cop he can hobknob with the patient at the hospital, and then step in front of him. One of our biggest nemeses is the chaplain at a local nursing home. He is a large round man who is sometimes the only person with the patient, and who seems to always be between us and the patient, gives inaccurate medical reports instead of getting the nurse for us, and tries to control the way we move the patient. Often it even seems he is forcing himself on the patients, many of whom seem to have little clue who the chaplain is. We’ve been on calls together for years and usually manage to get along after an early rough go. I don’t let him get in the way, but I always will allow him his chance to pray with the patient on the way out, even stopping the stretcher briefly if necessary. Yesterday we arrived at the main building to which we were dispatched, only to find no security guard waiting for us. Instead, here came the chaplain waving his radio at us and castigating us for going to the wrong building. I told him this was the address we were sent to, and then I asked my partner to call our dispatcher back to verify the building, instead of, as I might have, allowing the chaplain his moment of helping to investigate where we were going. As my partner spoke on the radio, the radio squawk made it hard for the chaplain to speak and hear on his. The chaplain told us to hush, insisting “Quiet!” while he tried to raise security on his walkie-talkie. He even jabbed his finger at us. “One moment!” The problem as often is the case at certain larger retirement communities is the 911 call comes in on the enhanced 911 with the address of the main office, and not the address of the actual apartment or room’s location in the complex. Our dispatcher rectified it- providing a more accurate address, and we were on our way back out, past the chaplain who was still trying to raise security on his walkie-talkie, and out to our ambulance and then a short drive to the proper building. There security met us with a smile and asked about our encounter with the chaplain. The security guard shook his head and said the chaplain had complained about our attitudes. He said the chaplain was always getting in people’s ways, always stepping on others toes. We traded stories about him on the way down to the room. Later that day we were called back to the facility for another respiratory distress. The security guard smiled at us and mentioned he had told the chaplain to stay out of our way. He joked he’d restrain the man for us if we requested it. While I watched as my preceptee assessed the patient and prepared with the rest of our crew to move her onto the stretcher, the guard stuck his head in the room and said the chaplain was coming down the hall. I found myself standing with my back to the door blocking it, thereby creating a situation where the chaplain would have to to ask me to move if he wished to enter the room. And briefly, it felt good. I imagined the chaplain standing in the hall being forced to think, well, I’ll have to say excuse me to that paramedic, and I don’t want to have to lower myself to do that. But standing there blocking the doorway, I felt not tall and broad, but fairly petty and foolish and I was relieved when the crew had a little difficulty lifting the woman out of her arm chair and I had to step forward to ease her over, leaving the doorway free for the chaplain to enter should he choose. The chaplain was waiting in the hall when we came out. He didn’t smile or say hello nor did we. He just went right to the patient and put his hand on her forehead and blessed her and told her not to worry. I stopped the stretcher briefly so he could complete his prayer. He told the patient not to worry, and said that we were “good folk.” And then he stepped back and we continued on our way out to our ambulance. Everyone has a job to do, and some of us at times need to prop our chests out to insist we are recognized. Both the chaplain and I like to be in charge. I think we are both well meaning people, although sometimes our egos may get in our way. I think the chaplain probably felt bad that the guard had told him to stay out of our way. The chaplain needed to come down to assert his authority, to do his job, and yet at the same time, he needed to apologize to us, to recognize us, as he did by calling us “good folk.” And we needed to do the same, by letting the chaplain in to do his job, by stopping our stretcher and letting him reassure the patient with his prayer. We all have our flaws and one of the best ways to deal with our own is to allow other people theirs. There isn’t always a need to put someone else in their place, although it might feel good to do so. In the end it’s about getting the patient to the hospital, and doing what needs to be done without making anyone feel bad about it.
