We Only Get One Chance To Get It Right

One of the things I will miss about working in the field is the one-on-one connection we make with patients.  Rob Theriault discussed how this is opportunity is unique to EMS on a recent EMS Educast episode.  We get called into people’s most intimate settings, perhaps their bedroom or bathroom, or when they are in public, such as a restaurant or the side of the road.  The we move them to the ambulance, where we continue our care during transport.  At the hospital the patient gets turned over to the hospital staff where each caregiver is responsible for multiple patients.  The nature of our work allows patients to receive more time with the undivided attention of one caregiver than at any other point in their healthcare experience.

It’s easy to take this for granted.  When you have shifts where you run call after call after call, the patients all seem to run together.  Add that to hunger, exhaustion, and possibly ending your shift late, and the patients they become faceless machines with various needs that must be fixed.  It becomes hard to care. It is tempting to take short cuts, such as having patients walk to the ambulance or withholding pain medication.    EMS Basics author Brandon Oto wrote an excellent article about decision-making fatigue in EMS World.  He goes into why those short cuts become so tempting and what to do about it.

On days or nights like that, stop and think about the patient’s perspective for a second.  For the vast majority of people, calling 911 is a really big deal.  No matter how trivial their complaint seems to us, most of them did not plan on needing an ambulance 30 minutes before we arrive.  In the best cases, their plans for the day are ruined.  In the worse cases, their lives will never be the same.   Except for frequent-user club members, most people who call us will never need us again.   We may not remember them after our shift is over, but they certainly remember us.  We only get one chance to make an impression, and we only get one change to get their care right.

When deciding whether or not to give pain medication to someone, remember that it will likely be at least an hour before they receive any medication in the hospital after we turn them over.  This is our chance to ease their suffering, or even prevent permanent nerve damage and chronic pain.  When deciding whether or not it is safe for a patient with chest pain to walk to walk to the ambulance, remember that this may be the one patient who fails their impromptu stress test.  The results may not only ruin their life, but possibly your career.  It is tempting to pull the leads off and leave the monitor in the truck when we arrive at the hospital, but this may be the one patient who has a dysrhythmia in triage that is the cause of their unexplained dizzy spells.  It doesn’t take that much more effort to leave the monitor connected, and helps us make sure we get it right.  And when a sick patient says they do not want to go to the hospital, we must make sure we do everything possible to convince them to go with the one chance we get.

Each patient contact is an opportunity to make a connection and to help someone feel better.  We only get one chance with them, so make the most of it.




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