L earning and teaching opportunities are available to you every day. All you have to do is identify and act on them.
When I was an operations director, I loved the first two hours of a shift because of the beehive of activity. Our crews were always busy washing, inventorying and restocking rigs before hitting the streets.
It reminded me of the late ’70s when I spent lots of time riding on ambulance tours with my dad and his crews at a busy fire headquarters in Scranton, Pa. The first thing he would do when he walked into the station at 6 a.m. (even before changing into his uniform) was walk over to his ambulance, check the oxygen levels in the three portable units secured safely inside the patient compartment side door, make sure the stretcher was “made up” with clean linen and quickly scan the availability of important first aid supplies.
Because oxygen, basic first aid supplies and a clean, comfortable stretcher were the mainstays of EMS in the ’70s, he impressed on me (and his partners) that it was important to “be sure these ‘front-line items’ are ready before the ambulance ever turns a wheel.”
After his “quick check,” he would walk around to the driver’s door, turn on the key, ensure his rig had a full tank of gas, flip on the red lights and “tweep” the electronic siren to not only ensure he had a vehicle that would clear traffic, but also to alert the sleeping night shift personnel that he was “in the house and ready to go to work.” After dressing for duty, he and his partner would always do a complete vehicle check.
His start-of-shift routine taught me about the importance of vehicle and equipment readiness and inspired in me a sense of duty and strong work ethic. Throughout my career, I felt compelled to pass this sound process along.
Some say that a generation gap exists today between veteran and new EMS providers and causes philosophical differences in our organizations.
But I believe most of our problems are caused by EMS crews (and managers) who either fail to follow (or enforce) standard operating procedures or prefer to shy away from the conflict that occurs when they don’t discipline the “rebels” who refuse to comply with agency procedures.
When we allow inappropriate deviations from standard operating procedures, we expose our organization and crews to lawsuits, or, worse yet, open the door for patient care errors or omissions. Vehicle checks and inventories are classic examples of where this occurs with EMS crews.
Although it’s acceptable to allow a crew to skip the performance of a vehicle inventory if they get dispatched at the start of a shift, EMS supervisors must ensure that consistency is maintained and the involved crew still routinely checks their rig early in their shift.
I’ve found that if you allow crews to “skip” their required vehicle inventory, they’ll enjoy the break and try to do it again. Case in point: A crew approached me one morning and sheepishly reported that they witnessed a crew regularly skipping the required vehicle inventory and signing their form as if they had. They said it started with a few “skipped” vehicle checks and had now become habitual.
I didn’t think this crew was squealing on their co-workers, but rather, making an effort to right a wrong and help me enforce our agency’s philosophy of quality equipment and quality care. In my eyes, they were leaders of the pack, not moles coming out of the dark to expose their colleague’s shortcomings. They showed me they possessed a strong sense of duty and work ethic.
I sensed an opportunity to inform this otherwise solid crew that they were going down an unacceptable path, so I hopped in my car and proceeded to their next destination hospital. Choosing to educate rather than reprimand, I took one of the two OB kits, which we carried in the rare event of twin births, from the patient compartment of their rig, and I left a note on the front passenger seat that simply read: Guess what I took?
My note meant the crew had to perform a top-to-bottom vehicle inventory. Later that day, they came to my office to retrieve their missing item. They apologized and never skipped an inventory check again. Lesson delivered; lesson learned.
Carpe diem—seize the day! JEMS
This article originally appeared in September 2010 JEMS as “Busted: Guess What I Took?”
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