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Resolve to Be a Better Provider

It’s the time of year when people make New Year’s resolutions, and many focus on physical and personal development. One of the most frequently made (and broken) resolutions is to lose weight. Now more than ever, this is one that you should stick to because 33% of the population is clinically obese and obesity places inordinate stress on the cardiovascular, respiratory and skeletal systems. In addition, people who’ve never had diabetes before are now falling victim to diabetic imbalances because of excessive weight.

As an EMS provider, you already carry extra weight up (and down) multiple flights of stairs on a daily basis. Kits, monitors, stretchers and heavy patients already tax your body systems. So you shouldn’t carry any more weight than you have to. Shed excessive weight, avoid unnecessary gains and take better care of yourself.

I addressed my extra tonnage in 2009 and was able to get off all my hypertensive medications and eliminate the chronic pain caused by overtaxed ankles, knees and hip joints. I’ve discovered a whole new world that I’d forgotten existed and I believe you can, too. I’ll discuss this more during my EMS Today Opening Keynote, "Climbing Your Own Personal Mt. Everest," on March 4 in Baltimore. Md.

In addition to resolving to take better care of yourself in 2010, I’d also like you to consider focusing on a few areas that will improve the image you project to your patients and the community. I believe my suggestions will also enable you to manage calls in a more efficient and clinically effective manner.

PAY ATTENTION TO DETAIL

From the earliest days of structured medical care, the public has come to equate neatness and cleanliness with high-quality care. Although nurses’ caps have disappeared, white lab coats and gloves remain formal identifiers of medicine.

If a critically burned family member was brought to a highly recognized medical center and you observed an unshaven male walk into the treatment area wearing a faded blue T-shirt, wrinkled pants, unpolished shoes, a cracked and worn-out leather belt, and reaching out with dirty hands, you’d probably worry if he was touching and managing the care of your loved one.

Sound like anyone you know? Look around during your next few shifts and hand out some shoe polish after the call. A little shoe polish and some black marker applied to the worn areas of a belt can go a long way toward improving your public image.

And if your nametag is tarnished or scratched, polish it or treat yourself to a new one. Simply put, look at yourself and your crew members like the public does and pay attention to the little details you often take for granted.

KEEP YOUR BILLBOARD CLEAN

Resolve to apply the same scrutiny and elbow grease to your vehicles. We often forget that the public rarely remembers what our vehicles look like when we’re at their home or the scene of a chaotic call. They see us at our best (or worst) when we pull up next to them at a traffic light, when we’re parked in a shopping center or when we cross through an intersection. It’s at these moments that our vehicle’s cleanliness—and our drivers’ abilities—are judged by the public and emblazoned in their minds.

24/7 INCIDENT MANAGEMENT

Run all your calls like a major incident. Without supervision, people tend to deviate from protocol, freelance and miss important steps. For example, suction is an "immediate need" piece of equipment that should be available to every patient the second they need it. The individual who "forgets" it and leaves it on the truck usually won’t come forward after a call and admit to their omission. The only way you’ll know is if the incident manager observes the deficiency and corrects it before it becomes a patient morbidity or mortality issue.

A team leader should be assigned and responsible for making sure that processes and protocols are followed at the right time and in the proper sequence. As you’ll see from this year’s "State of the Science" supplement, keys to maximizing resuscitation include proper training, strict adherence to procedures and limited interruption of cardiac compressions. Experience and research is showing that this can occur only with a coached, disciplined, consistently practiced and monitored approach.

Last, but not least, the person in charge at any of your scenes must be clearly identifiable throughout a call. The primary caregivers involved from multiple agencies (public, private, hospital-based), as well as law enforcement personnel, need to know who’s calling the shots and to whom they should direct important scene and patient information. This can be accomplished by the lead person wearing a vest or carrying a clipboard that identifies them as the EMS scene manager.

THE END RESULT

Making these resolutions will enable you to meet both aspects of the above definition. You’ll show that you made a decision to do something important for yourself and your patients, and that you’re committed to behaving in a manner that reflects well on you and your profession.JEMS

A.J. Shares more thoughts: jems.com/heightman

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