Bedside Manner

Can you remember what you thought EMS was before you had a job responding to 911 calls? I bet you were like me, you though that EMS was comprised of trained professionals that saved lives on a daily basis. Someone had better be dying or damn near close, for you to consider calling 911. I can remember breaking bones or being ill on numerous occasions, and my mother driving me to the ER in her makeshift mommy ambulance, a Dodge Caravan. We waited and waited in the triage area of the emergency room, not once did we think we should have called 911 for quicker treatment.

I remember the first time I did call 911. I was still a paramedic student, and my mother awoke one morning with a sudden onset of shortness of breath. Pulmonary embolism was the first thought in my head, and before I knew it my fingers were punching those numbers in the phone. I expected trained professionals and I got trained professionals. The paramedics had no problem being there, and if they did they didn't show it. They moved with a purpose and treated my mother the same as if it was one of their mothers. They held her hand and they told her everything was going to be okay. I am forever grateful for that crew, thank you, wherever you are.

This post is dedicated to bedside manner. What do you consider good bedside manner? Maybe its different than what your patient considers good bedside manner, and its their opinion that matters.

I don't imagine that you respond to true emergencies for the entire length of your shifts. If you are in a system like mine, most calls are for a matter of comfort, not a matter of life or death. How seriously do you take these calls? How do you tell these patients that they should not have utilized 911? I am going to provide a few good tips on this subject. Most may seem like common sense, but sadly we aren't always surrounded by the commonly sensible.

Its not your emergency, its theirs.

I believe that statement says it all. These patients don't have the training you do, and may have no idea what is happening. Indigestion may feel like a heart attack. A little nausea may make them think they have the Swine Flu. These patients may be scared and will probably need a little reassurance from you.

Now you may have just picked up your juicy burger and had it an inch away from your mouth when a call for a sleepy granny came through. These people have no idea how hungry or sleep deprived we are. Aren't you being paid? Although we often have to work through our breaks, think of all the times you have been paid to sleep or eat. It is tough sometimes not to be upset, but it is even tougher to defend yourself for being unprofessional on a call.

It isn't our place to tell them that they shouldn't have called. It is our job to tell them when they should call.

You don't want to scare people out of calling 911. Most often, they thought about calling long before they actually did. Telling them they shouldn't have called will only make them angry. Imagine taking a patient in to the hospital and the physician telling you that you should have gone somewhere else. Instead of blaming the patient for your lack of sleep, use this time to educate. Make the patient aware of their possible risk factors, and give them advice from a medical professional. Let them know of different reasons to call 911. This passive approach may in fact decrease the less-needed calls. If they are under the impression that going by ambulance will get them seen quicker, correct them. I often offload my cut finger patients in the triage waiting room which has to leave them wondering if they should have called 911. I'm not punishing them, just opening their eyes. The patients that should be seen faster, are seen faster, no matter how they get there.

They are our customers.

We aren't salesmen at a dealership, but we do have something to sell. We have to sell ourselves and our service. If you wonder why EMS doesn't get the due it deserves, its because of customer service. Public relations can and will determine the outlook of our organizations. When you are called upon, respond as you should. Greet the responsive patient, and get on a first name basis. Use a calm and reassuring voice. These two things will help you build a personal relationship with your customer, and you better believe they will want everyone to know how great their experience was. They will also want everyone to know how horrible their experience was, if you make it that way.

What would we do if it wasn't for all the less needed calls? My agency could cut resources by at least 50% if we only responded to true emergencies. I like my job, and I will take anyone and everyone who would like to go. Even though it isn't the best use of resources, most agencies have built up their resources for such call volumes. I'm not saying that I advocate misuse of emergency services, but I am thankful for my job. Take from that what you will.

For the matters of comfort, make them comfortable! If the lonely old lady needs someone to talk to, listen to her. If someone is complaining of pain, treat their pain! If they are cold, cover them up. If they have a headache, speak softly. If they are dizzy, for God's sake, don't walk them to the truck. If the only treatment you provide is hand-holding on the way to the ER, be the best hand-holder there is. Treat every patient as if you would want your loved one treated, and you will never go wrong.

We are professionals, and we should act that way. Our patients expect that we will know exactly what is wrong with them and be able to treat it appropriately. Don't prove them wrong.