Patient Care

Punctuate Your Performance With Great Patient Packaging

Issue 11 and Volume 37.

I remember an awkward visit once, with a crew at shift change.

I was a new quality coordinator at the agency where we all worked, and for some reason one of the oncoming medics didn’t seem to like me. I had already introduced myself all around. I had also taught some classes in which part of the topic was collaborating with first responders to keep sick people as comfortable as possible. (I’ll never give that up. You’d have to kill me.)

He threw a pillow out through the rear compartment doors, onto the bay floor.

“There are three things that don’t belong in ambulances,” he proclaimed loudly to the off-going crew. “Pillows, blankets
and firefighters.”

That puzzled me, but there was no doubt about his general target. It was me, and I dodged the comment. One of the first things you learn in the EMS quality biz is patience. I’ve come to believe it takes about three years to change an organization for the better (and maybe a week to wreck one).

I think how you package people communicates. It does that whether you know it or not. And it does so whether you intend it or not. It communicates to the objects of your care, to their families, to your coworkers, and to the staff at receiving facilities. You can bet on that like you can bet on the effects of salmonella.

This may sound odd, but think about FedEx for just a moment. A FedEx package talks. No matter whether you’re a customer shipping something, a casual observer noticing it on a table, or a recipient receiving it, a FedEx package says this is a no-nonsense container. And it says the package has probably arrived at its destination intact and on time.

What tells you that? FedEx has spent a lot of money and a long time making themselves recognizable. Even their drop-boxes, their vehicles and their aircraft look like their packages. Their logo is important to them. And what’s more, the combination of their logo and that white background are important to them.

Obviously, people are not just packages. But make no mistake, how you package them matters. When you show up in your $160,000 ambulance and take somebody’s loved one into the cold night air without any thought about weather, the cost of your equipment becomes irrelevant. The patches on your uniform mean nothing at all. And your vast experience and amazing skills don’t alter what you’ve just demonstrated. You’ve made it plain that, regardless of the urgency of their emergency and the power of your best contrived explanation, you’re a freakin’ amateur. And you’ve shared that distinction with your agency, whose expensive conveyance happens to be a three-dimensional billboard with their identity plastered all over it.

Why would you want to make this important work of yours so much more difficult than it is?

Now consider the following alternative. Let’s say your call is in a private residence. Maybe it’s a little cool outside. Not only do you take the trouble to pre-warm your scoop or board in the shower, but you pad it. Or you explain why you’re bringing your stair chair indoors for a few minutes, so you can let it warm up while you examine and treat. Either way, if your oxygen source isn’t fastened to the equipment, you don’t just strap it on top of the patient. Somebody carries it. In fact, that’s a great task for a worried family member, who will no doubt remember how you welcomed their help.

Nor do you just flop your guest on the cot and toss a token blanket on top of them, like a big piece of cardboard. You acknowledge their dignity—and the cold outside. You put them on top of a first blanket, and use it to wrap them like a burrito. And then, especially if anyone on your healthy crew is wearing a jacket (because it’s cold outside) you use one or more additional blankets to tuck them in. And just before you cart them out the door, especially if you’re taking them into wet weather (or bright sunlight), you cover their face. Of course, you explain every step of that in advance. (Or better yet, you ask permission and explain it.)

This would all make so much sense if a crew were responding to your mom’s house, and you were a fly on the wall. Would you notice their packaging process? Would it be important to you? Of course it would.

Think of sick people’s anxiety as a barricade. Why would you want to reinforce it? Instead, convince them they’re in the hands of professionals. There’s an easy, effective way to do that, you know?

Demonstrate it to the family, and let them do the convincing for you.