This is an editorial I wrote a while ago and just found on the computer, it goes along the same lines as a couple of my other posts regarding "BS" calls. This topic always seems to strike some opinionated discussion. As a disclaimer, let me just say that I don't advocate people calling 911 if they don't need it. I just don't see the point in complaining about it. If you have a problem with the BS call volume, start being proactive, don't let your bedside manor be a reflection of your stress.
Medic 1, please respond to a residence for a 23 y/o male complaining of a nose bleed.
Why did you decide to take the long path towards an EMS career? Was it an episode of Rescue 911 or Emergency? Did September 11th open your eyes, and make you want to be a hero? Maybe you liked the thought of shift work, and being behind a desk wasn’t something that you thought would excite you. Whatever the reason may be, I am almost certain, that at some point, the thought of helping another human being was part of this job choice.
Now think about when you were in EMT or paramedic school. Do you remember training for the cut finger calls? What about the “I’ve had an ear ache all day” calls? Probably not, if you were like me, there is a good chance that you were probably trained for the cardiac arrest calls, the major trauma calls, and pretty much everything priority one that required lights, sirens, meds, and diesel fuel. I guess the thought is that if you’re trained for the worst calls the rest will come easy, right?
I remember what a rude awakening it was once I got on the job, to realize that every patient that calls 911 isn’t dying (what a bummer).
I think that these could be the major reasons that we develop these complexes regarding calls that we may not consider emergencies. We will hear those tones drop and the next words out of the dispatchers mouth will dictate whether we yell in anger, laugh at what we might think is stupid, or run out of the station while tying our boots. Have you ever thought about why we react this way? Consider the previous paragraph and you might be closer to the answer. We want the excitement of those calls our instructors promised. Basically we want people that we run on to be really sick or hurt so we can fix them.
IT’S NOT YOUR EMERGENCY
…It’s theirs. It’s hard to think that way, but try to go back to the days when you had no medical training at all. Think about everything you didn’t know and how you would react to the most insignificant symptom. Some of us were raised differently. Maybe your parents would just drive you up to the hospital when you were sick, but Sally’s parents, down the street, would call for an ambulance. This translates to us, and how we respond to the same type of situations now that we are the adults.
Rescue 7 respond to a residence for a 67 y/o female complaining of chest pain, shortness of breath, arm numbness, painful urination, head ache, abdominal pain, and a partridge in a pair tree.
You also should consider that the patients out there are getting smarter and dumber all at the same time. While the media is doing a good job improving the recognition of once commonly missed symptoms, they are also creating more and more hypochondriacs. We have to take the positive with the negative; calling 911, even if the number of unneeded responses is increasing, saves more lives.
It isn’t our emergency, and we aren’t the persons calling for assistance. These patients of ours were most likely scared, and felt they needed a professional piece of mind. They don’t know that you may be missing your meal, much needed sleep, or the American Idol results. They just want help. We get these people when they are at there worst, and we need to appreciate that situation before we judge it.
SAVING LIVES BY CHANGING LIVES
Rescue 3 respond to a residence for an 84 y/o female complaining of general illness.
Upon your arrival you find this patient asymptomatic in a house all alone. Her husband passed away about three weeks ago and you can tell this is just a lonely old lady that may have been scared.
At my agency we call these BLS calls, sometimes without the letter L. These “BS” calls have opened my eyes. When I first started this job I use to ignore the patients emotions, and concentrate on beating the reaper. I was always looking for those priority one ALS symptoms, preparing for the worst. Now I still feel I am prepared, but the back of my ambulance has become more of a social environment.
Always greet your patient, with consideration of their mental status of coarse, and give them your name. I have realized that if you make a good first impression, and a great last impression, all the stuff you do in between won’t matter. This doesn’t mean you can botch treatments, but if you keep your patient happy, your medical care will almost always seem phenomenal.
Hold this ladies hand and tell her that you aren’t going to let anything happen to her. Just give her someone to talk to. You never know, a call like this could always turn sour so never overlook the symptom of loneliness.
Medic 22 respond to Larry’s 8th street motel for a 17 y/o male possible overdose
Ok, so this call is a bit more serious. How do you handle these calls? Do you judge this patient? Do you make this patient feel guilty?
I use to do the exact same thing. Take the time and really consider the situation. We have all done stupid things when we were younger, and if it wasn’t for certain factors in our lives we may still be doing them. There is something called the teachable moment; it is the moment during a life-changing event where your fear and realization of consequence may open up your eyes to reason.
These patients may ignore everything you say to them. They might even argue with you or become angry. It is important to me that I do everything in my power to remain a patient advocate, and this is a prime example. One day you may encounter a patient whose life you might save without a medication, without ventilation, and without chest compressions. You might not ever know that you saved this persons life, and they may never realize how much you helped them, but without you they’d be under a whole lot of dirt in a wooden box. Now think about that for a moment. Do you need to be called a hero, or do you just want to be one?
What does it hurt to give a young patient a piece of mind? Tell them that there are people that care about them. Give them a story that relates to the situation, even if you have to embellish, as long as it sounds genuine. You just may get through to one of them, and that’s all it takes.
Now there may be certain demographics that different people can relate to better. I’m younger so the teenagers, and twenty year old patients listen to me better than the forty year olds. If you are older you may have better luck teaching another older adult about heart disease than you will teaching a young adult about drinking and driving.
THE BIG PICTURE
I have partners say to me all the time, “I may bitch on the way to the call, and after the call, but never in front of a patient”. Now that is a good thing, but why complain at all? This is the job we chose right, so why not make-work enjoyable? If you moan and groan about every “BS” call you will get burnt out quicker, and end up hating this job. Also, if you are in BS mode, and it ends up being a true emergency, you are a step behind.
My response to most people is an easy one that took me a while to figure out myself. My agency has about forty ambulances and 300 employees. We run approximately 75,000 calls a year. I would guess that maybe out of those 75,000 calls, maybe 20,000 are true emergencies. If we didn’t have people call for anything but true ALS emergencies our call volume would be greatly diminished. This would mean that our employers could manage this organization with fewer ambulances, and in turn they would require less employees to operate these ambulances. Now do you get where I am going with this? I probably wouldn’t have a job without these “BS” calls, and that’s why we call it job security.
I am not an advocate of 911 abuse, just an optimist. I will educate patients every chance I get, and tell them when it is appropriate to use our service.
There are other things that you can do to be a part of the solution. Many agencies have started programs designed to educate their citizens on when to, and when not to call 911. Even though we may need these calls to survive, too many of them can be detrimental. If your department has a limited number of transport units, priority dispatching could help with this problem. The thought of responding to a stubbed toe when someone is having a stroke next door can be unsettling.
My department has started a 211 program. When we respond to a citizen that might not qualify as a medical patient, but may need other help, we utilize this system. This 211 program has given us a direct connection to the United Way, and they then assist the citizen with whatever need they may have.
Another part of why we feel the way we do about the serious calls is quite possibly the recognition we receive. Medals are given, you sometimes make it on the media, and doctors, nurses, and coworkers pat you on the back. These things just make you feel like all your hard work and training isn’t going unnoticed. Well, the next time you see a fellow medic holding an old man’s hand, keeping him calm, and providing reassurance, pat him on the back and say “good job” afterwards.
OKAY, I GET IT, SO WHAT?
We may not be saving lives as much as we thought that we would be when we first considered this great career, but we are needed. We do save a few, and we help many, and that may be just as important.
Medic 27, respond to 8th Ave. and Palm for an age unknown male, unknown distress under the overpass.
Now, how will you respond?