We all have "them." At least I hope we all have "them." OK, let's put it this way, if we don't have them, then we won't grow as EMS providers. "Them" is epiphanies, moments of clarity, lessons learned. "Them" is thinking about what happens out in the field and trying to derive something positive out of it. "Them" is not doing the same thing over and over again when it doesn't work so well.
In this case, "them" is getting angry at patients for abusing the system, for dialing 9-1-1 because their hair hurts or they have an ingrown toenail. We've all seen medics become apoplectic because of such calls. We've all seen nurses go psycho over such calls. We've all seen docs lose their minds over such calls. We've all slipped a gear or two over such calls. And what good did it do?
So it was 3 o' something in the a.m. when we were roused from our fitful slumber to respond to a kid with a fever. When we got to the Tornado View Trailer Park and Used Tire Emporium, we were met at the door by a young lady carrying her child, who was between one and two years old. We asked, "Why did you call 911?" Her response was that the child had a fever.
We asked how long he had had the fever, to which she replied, "Since yesterday afternoon."
"Why didn't you go to your doctor?"
"Ain't got one," she replied. We asked her why she waited until 3 a.m. to call 9-1-1. "I thought he'd get better, but he didn't," she said.
"You call 9-1-1 in an emergency. This is not an emergency," we said. "Why didn t you call a cab?"
With a sneer, she answered, "'cuz I gotta pay for a cab!"
Epiphany. She was right. Why get mad at her when it's the system that enables its own abuse? Why get mad at her when, in her own not-so-convenient-for-us way, she actually gave enough of a damn about her kid to take him to the hospital and recognized when the fever may have gone on too long? But most of all, why get mad at her when it doesn't change a thing and only serves to aggravate, well, me? I'm still going to take her to the hospital, right? She's still going to do the same thing next time, right? I'm still already awake and out of my warm rack, right?
So I made a pact with myself to chill out and calm down. "Have a seat, ma'am. Put on your seatbelt please. Have a nice evening, ma'am." Want to work to change the system? Fine, knock yourself out. In the meantime, an amazing thing happened, to me anyway. When you remove from a squad run the requirement that each individual be judged as being more or less worthy of your medical ministrations, everyone ends up getting treated better and, in turn, voila, you start getting treated better too.
But most of all, I started feeling better about my job and the people I was treating because I stopped judging, even subconsciously, their "worthiness." If your goal is giving each individual the best treatment possible, even if that treatment is just a ride to the hospital because they can't afford a cab and you're free, then every encounter becomes less stressful and more pleasant. Of course, you may lose the feeling of power that comes from believing your godlike skills should only be available to the seriously ill or injured, but what you gain is taking more pride and pleasure in what makes up the bulk of any EMS shift -- shlepping people to the hospital.