Sunday, December 18, 2011


The Fire Service, and other Emergency Services, are one big happy family, right?

Sometimes it seems so.
I've walked into fire stations hundreds of miles from my home and felt welcomed and at home.
I've hung out with medics I had never met, and felt a kinship immediately.
I know some of them would go out of their way to help me if I needed help, because they have.

It can be a very wonderful thing.

But sometimes, it can be a pretty dysfunctional "family."
With the same power trip issues and rivalry issues as many families.

Other times, it doesn't feel much like family at all.

The thing is, none of that matters much to the patients.
They don't know, or care, whether you are working with a friend, a family member, or the person you hate most in the world.

They called for help... and that's what they expect, and should get.

So how do we do that?

How do you stay focused on the patient, when you're working with someone you don't like?

I think there are two different scenarios, and they require different solutions.

If I need to work with someone I dislike because of some personality conflict or difference in politics, someone I don't get along with, someone who I'm not friends with, it basically makes no difference at all.  Just like how my kids and I have had to learn to work as professional partners, and not "mother/daughter" or "mother/son," or, in their cases, "brother/sister," working with someone I don't care for simply requires me to remain professional. The personal part really doesn't enter into it.

Working well together on scene does not require being friends elsewhere. We don't have to hang out. There is no requirement of a social connection of any kind. They may not be invited to my birthday party, but they can still set up the Oxygen or take a blood pressure.

The other scenario is much more challenging.

If the reason I dislike someone is because they are not professional, or because they are incompetent, dishonest, or unreliable, then it is a different ballgame altogether.

I may not be able to trust them, but I may also have little to no choice about working with them. I don't get to make those decisions.

In that case, I have to stay alert, and not count on them for anything that may affect the patient's care.
There are some things that anyone can do, like carrying equipment (but make sure to double check what they have carried in), and other things that require a certain level of skill. I would be very hesitant to ask such a person to do any direct patient care, unless it's for something I have some confidence they can do. Since I would be somewhat less likely to spend time with this person other than on scene, and therefore less likely to know what they can and can't do, I would have to be pretty conservative on scene.

Still, some stuff is pretty easy, and either less critical, or easy to correct. I might ask them to do any number of simple things- but I can't delegate responsibility.  Anything I ask anyone else on scene to do, regardless of who they are, I am ultimately responsible to see that it was done correctly.  With someone I trust, this is easy. With someone I don't trust, it can be more challenging, with a greater need to double check. This can create a higher level of stress, and therefore requires significant consideration to be sure that the stress does not affect patient care, or the patient's perspective of their care.

The patient should not be able to tell whether you are working with your best friend, or your greatest enemy. It's your responsibility to be professional enough to see that that is the case.

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