Saturday, November 26, 2011

Making the Connection

Way back in the long time ago, before I was an EMT, I started going to EMS calls because I wanted to start learning before I started my Basic class. I did a lot of watching, and a lot of carrying, and a lot of paying attention.

One of the things I paid attention to was the different medics from the ambulance company.  Even when I didn't know much about the medical part, I already had preferences for some of the medics over others. Some had great people skills. Some were very thorough. Some just made me feel like they knew what they were doing. (And a couple of them were in all of those categories!)

As an aside, later on, when I started my Intermediate class, on the first day the instructor asked us to consider who our "favorite medics" were. She said to hang onto that thought, and to see if we still had the same opinion at the end of the class. She asserted that most people would change their minds, once they had a better idea of what makes a good medic, and had better reasons for choosing a favorite.  I didn't change my mind. My favorites then are still my favorites now, and for the same reasons.


My first opportunity to work with any of the medics came during my ride time for the Basic class. Two shifts. Not very many calls. But it felt good, and right, and I appreciated every minute of it. I am fortunate to live in a place where the transporting ambulance company is excellent, top to bottom, a professional, class organization. And it shows.

It was right before then, I think, that something odd started happening.
At the firehouse, whenever the topic of the ambulance came up, some of the people would make disparaging remarks. At first, it was along the lines of "you know how they are" and comments about them being difficult to work with. This was completely outside my experience, and was very confusing.

This went on after my then-partner and I became EMTs, and we discussed it more than once. What the heck? What were these people talking about? We had NEVER had any problem with the ambulance crews. Ever. We had nothing but respect for them.

As time went on, we started hearing more specific comments.
Things like "they just ignore the EMTs."  (Not that we had ever seen.)
Or "they take over the scene." (Well... that's what they are supposed to do, isn't it?)
Or "they think they know more." (No argument there. They DO know more.)

We started speaking up, whenever someone complained about the ambulance, and made a point of saying we had not had any bad experiences at all. As far as we were concerned, they were great, and we not only didn't have a problem with them, we were starting to be friends with many of them.

It was, for a while, a great mystery.
I love a good mystery.
But not always. And this was in the "not loving it" category, largely because it made no sense as far as I was concerned, and also because it felt like people were being rude about people I was starting to consider friends.

So we asked.
Why does everyone say these things?
All we got out of the people making the remarks was a repeat of some of the comments, and some suggestion that "something happened" at some point that led to hard feelings. But no one wanted to tell us what it was.
We finally got the story, or at least part of it, out of a couple of the medics quite a while later. It turned out to be some territorial thing, the kind of which I have no understanding of whatsoever.

That was when we figured out why WE never had a problem.
And it was simple, obvious, and I can't imagine why anyone would ever NOT do what we did.

Right from my first ride, when the medic asked what I hoped to learn, one of the things I mentioned was that I wanted to know what WE could do, out here in the boonies, to make things go as smoothly as possible, and to improve patient care. We had started to hear grumblings about having "problems" and we didn't want to have any. We wanted to work well with the ambulance crews. Isn't that the point? To work together, to provide optimal patient care?

Through what I was told on that first ride, and experiences since then, we came up with a list, of sorts. A plan.

1. Do our job as well as possible. Train, and practice, and get as efficient as we can. The more we can do before the ambulance arrives, the easier it will be for them to continue care, and the quicker the patient will get what and where they need. We are the information-gatherers. We are the first eyes on the scene. If we do our job well, the patients condition will already be improving by the time the ambulance arrives, and we will have great documentation of everything we have seen and done.

2. Provide a patient update to the ambulance before they arrive, whenever possible.

3. Have someone "receive" the ambulance, meeting them, guiding them to the patient, letting them know what, if any special equipment they will need.  Stair chair? Extra large patient? Any unusual conditions?

4. Practice, and become excellent at, patient care transfer. Be able to put the information into a "bullet" and communicate it quickly and succinctly. Learn how to tell WHO to transfer care TO. Don't transfer care to the rider, instead of the medic! Make the transfer as smooth as possible for everyone, including the patient.

5. Once the medic takes charge, get the hell out of the way. This doesn't mean to go away, necessarily, it means to understand that the patient is their patient now. Their patient; their scene. Our role switches immediately to "anything the medics need in order to provide optimal care." It might mean holding things, setting things up, or moving things out of the way. It often means helping move the patient, helping with the stretcher, and/or carrying their gear out of the house. Learn where their gear goes. Learn how to close and put away the stair chair.

6. Continue that assisting role as long as necessary. Sometimes that means hopping into the rig and pulling out equipment to hand to them as needed. Sometimes it means riding to the ER, giving compressions or bagging the whole way. Sometimes it means providing more information. Whatever it means: do it.

7. Continue the relationship outside calls. Get to know them as people. Whenever possible, hang out with them in social settings.  Around here, we have a chance to hang out some at local festivals, where the ambulance company has a tent set up, but not a lot of work to do. We've worked alongside them at festivals as well, providing EMS coverage at large events. We take them cookies at Christmas. I'm friends with many of them on facebook, and keep in touch that way. The more connected we are, the better we'll work together- and that means better care for our patients.

I think we have a great relationship with the ambulance company, from the newest Basics as we get to know them, to our interactions with the medics, the supervisors, and even the owner of the company (who maintains his certification and goes out into the field sometimes). I still have favorites, but I have confidence in even the ones I know the least. They treat us very well on scenes, and seem happy to see us wherever we run into them, even at the grocery store.

I wouldn't want it any other way.

Except for one possible change... at some point, I want to work there, too. :-)

1 comment:

  1. Hilinda,
    This is Twyla Dill who wrote the guest post on Skipping School.
    This comment isn't relevant to your blog post, I just wanted to let you know I answered your questions in a comment after yours. I didn't know if you would see the comment unless I found a way to tell you it was there.