Bumper Medics - Patient Care - @ JEMS.com

Bumper Medics

Uncooperative runs affect patient care



Guy H. Haskell | | Thursday, April 7, 2011

The first call of the day was for a “sick person.” We got in the rig and both reached for the “responding” button at the same time. En route to the call, dispatch hit us up. We both grabbed for the microphone. Once on scene, I got out on the passenger side, opened the side compartment and took the jump bag and started to walk to the house. I looked back, and my partner was opening the back doors of the rig and pulling out the cot. I turned around and walked back to help him.

Our elderly patient had flu symptoms and was weak and dehydrated. I knelt next to her chair and started my assessment.

“How long have you been feeling … ” I was asking as he interrupted, “Are you short of breath or having chest … ”

I tried again, “Do you have any allergies?” as he interrupted again, “Do you have a list of medication?”

We finally got our patient in the truck. We knocked into each other trying to get in the back doors at the same time. It looked like a Marx Brothers film, or the Keystone Cops, and his driving threw me around me like Lake Superior on a rough day in a rowboat. When we got to the hospital, I pulled the cot out and waited for my partner to grab the cot legs to lower them down. He just stood there. I pulled the lever and lowered them by foot while balancing on the other leg. So you get the picture: bumper medics, or “what we’ve got here is failure to communicate.”

We’d never worked together before, so a certain degree of fumbling was to be expected, but this was ridiculous. Talk about being out of sync! Hopefully, a few shifts would work out the kinks. But then, maybe not; I’ve worked for months with a partner before, and we never got into a groove. And because so many of the little things that make for good teamwork are not a matter of the “right way” or the “wrong way,” it’s sometimes hard to address. On the other hand, many things can be worked out by agreement and discussion—at the risk, of course, of bruising delicate egos.

I worked with a medic a few months ago that started the shift with, “Just one thing, Guy; when it’s my patient, let me do the talking.” No problem dude, that’s the way I like it too. We agreed that if there was something one of us felt was important to ask after the primary medic was done, that was OK.

I worked with a young woman a couple of months ago who could brook no critique. We were transporting a hard-of-hearing old gal to the hospital, so getting information was a challenge. My partner was tapping out information on the computer while I was completing the assessment, but she kept asking the patient questions I’d already asked. I finally said, “It’s OK; I got that information already.”

She snapped the computer shut and stomped out of the patient compartment. Really? The chances of me working with her again were slim, so I just kept my own counsel.

This past Wednesday, we were pulling into the station after the “last” run of the day when the tones went off—again. Only one of the relief crew was there, so I jumped in with the new partner after losing a rock-paper-scissors game with my previous partner. Within the first couple of minutes, I could sense I was gonna get along just fine with my new partner, even if it was for one run.

She was relaxed, confident, cheerful, and her movements and actions were graceful and economical—no wasted effort. Somehow we intuited who would do what. We communicated a sentence in a glance. We both thought ahead to the same place. It felt like poetry in motion. The call wasn’t particularly challenging, but even the simplest of calls, when done well, can feel like a little medical masterpiece. And when you work with someone like that on a regular basis, the result is better care for patients and more fun for the crew.

There’s little in EMS more satisfying than completing a complex call with nary a word exchanged between partners, like the silent code with no yelling, cursing or wasted effort. It’s a beautiful thing.

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Related Topics: Patient Care, Cardiac and Circulation

Author Thumb

Guy H. HaskellGuy H. Haskell, PhD, JD, NREMT-P, has been an EMS provider and instructor for more than 25 years and in four states. He is a paramedic with Indianapolis EMS, Director of Emergency Medical and Safety Services Consultants, LLC, firefighter/paramedic with Benton Township Volunteer Fire Department of Monroe County, Indiana, and Clinical Editor of EMS for Gannett Healthcare. Contact him via e-mail at ghasell@indiana.edu.


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