EMS Providers Solve Problems & Give Care - Patient Care - @ JEMS.com

EMS Providers Solve Problems & Give Care

Most patients need both



Guy H. Haskell | | Monday, September 20, 2010

Exhibit A: As I walked up to the house, the patient was strapped to the stretcher cursing and fighting. The family was watching as the medic in charge was getting redder and redder, his body tense, his posture combative. He was restraining the guy’s arms, and the patient was begging to be let up. It was the tipping point in the encounter; the patient was out of control, and the medic was on the edge. That’s when the patient spit at him.

Exhibit B: When we walked into the house, the boyfriend was holding a blood-soaked towel to his head. His girlfriend, who was drunk and crying, had hit him with a mug and was sitting on the couch surrounded by cops. The boyfriend refused medical attention. We wiggled our way to the girlfriend and began assessing her. She was carrying on about nobody loving her and the tragedy of her life. We tried to calm her down and talk to her. One of the police officers grew weary of our efforts and told her to get up and put her hands behind her back. She was still babbling about life and her cigarettes when he shot her with his TASER® for not complying quickly enough.

Exhibit C: I turned around from cutting the battery cable on the vehicle that had crashed into the tree to see my partner, Joe, standing toe to toe with one of the inebriated passengers he was trying to assess, but the passenger didn’t want any part of it. The passenger was trying to push Joe away and Joe was getting mad, telling the patient he was doing his job and not to touch him. Joe’s jaw was jutting, and his fists were clenched.

In the criminal law world, they call these cases DOC (disrespect of cop). In our world, we might call them DOM (disrespect of medic). But what they all have in common is ego, taking it personally. Just like cops, we have to deal with drunks and jerks all the time, but every time we take it personally, every time we let ego and machismo get involved, we stop doing our job as dispassionate directors of the scene and climb onto the stage as actors in the patient’s drama.

It ain’t easy—taking abuse never is—but that’s the job we signed up for, and the harder it is, the more important it is. I’ve actually learned to relish the challenge: the more irrational, the ruder the patient, the more I enjoy figuring how to get them on my side. I don’t always succeed, and more draconian measures sometimes have to be taken, but it’s usually possible to discover some weakness in their psychic armor that will lessen their resistance and diffuse a potentially dangerous situation—both to physical being and professional career.

In the first case, the patient had lost all control over the situation. He was strapped down and felt threatened by the angry, confrontational medic. I ordered the medic to step away. I told the patient I’d release the belts if he promised not to hurt me and that I was putting my safety in his hands. I gave him back some control and dignity.

In the second case, I sat down on the stoop with the lady, nodded sympathetically and listened to her tale of woe. She calmed down and was completely cooperative. Of course I had to listen to the continuing tale of woe all the way to the hospital, but that sure beat restraints and a possible lawsuit.

In the third case, I backed Joe away and told the guy he had every right to refuse medical treatment and that we’d be happy to leave him with the police, and if he changed his mind, we’d be over by the ambulance. Problem solved.

In the TV show Third Watch, veteran cop John “Sully” Sullivan is mentoring rookie Ty Davis. They respond to a fight-in-progress call that turns out to be two homeless men fighting. Ty wants to arrest them. Sully sends them on their separate ways. Afterward, Sully asks Ty, “Our job, what are we doing out here?” Ty answers, “enforcing the law.” Sully says, “No, we’re solving problems. We go from job to job solving problems as quickly as we can.”

Sully adds, “Solving problems has always been my motto. I know it’s a joke with the young guys like Bosco and even Ty sometimes, but it’s just my approach. I'm not all into the whole glory thing the way some are. I don't care about excitement or getting big collars. I just patrol the streets and try to help out where I can, no more, no less.”(1)

Me too.

1. Third Watch Dot Net. www.thirdwatch.net/sully.html.


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Related Topics: Patient Care, Special Patients

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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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