Great Emt Communication
Good EMT’s know protocol, Great EMT’s understand their patient…
Empathy is defined by: The intellectual identification with or vicarious experiencing of the feelings, thoughts, or attitudes of another.
I recently talked to a majority of my family, friends and acquaintances to brainstorm with me about what I would write about in this class. I got tons of ideas: EMS in the rural setting, complications of childbirth in a pre-hospital setting, dealing with certain diseases that need specialized care, and overall I received a ton of complaints about how someone was treated. So, because I am the type of person who was taught from a young age to treat others the way you want to be treated, I thought I would do my paper on patient “bedside manner”. …show more content…
Everything I heard, read, and understood is that whether or not you make a mistake out in the field, you are remembered on how you treated your patients. In a world of many technological advances, we often can find that our personal relationships have a tendency to dwindle to text messages, emails, tweets and social networking messages.
So, how do we learn to do what it is we do?
We go to school, learn the local and national protocols, take some tests and get licensed. Do our patients really think about how much education we have had or what our credentials are? No…instead they open the doors to their homes to us, assume we know what we are doing and let us into their personal space. They let us invade them in ways most would not let close family invade. We learn about the SAMPLE, the OPQRST, contraindications of meds, how to deal with airway, breathing and cardiac problems…but do we truly know how to understand the patient? That is something learned and it is a valuable resource when working in the EMS field. For instance, you get called to a 47 year old male with first time chest pain at 4 a.m. You begin your assessment with an introduction of you and your partner and go through the motions. You check his airway and breathing and respond by placing the patient on high flow oxygen with a non-rebreather mask. You are not explaining at all what is going on. You start with the SAMPLE…he responds with all the answers but it seems to him like you are not to empathetic to the need that he is very frightened at the moment that he could be having a heart attack and die. You start asking the OPQRST questions and he becomes agitated because you are just going through the motions, not explaining anything to him, not acting like you have any empathy towards him and his condition, and simply seem to him like …show more content…
you want to get done so you can go about your life or the next call, whichever comes first, so he does not answer in an effective way. You break out the latest and greatest EKG monitor, which is capable of 12-lead field transmissions, communicate with online medical for consultation, and check your PDA or Smart Phone for information on the patient’s current medications. You place the patient on a stretcher; load him into the ambulance, and go to transport him to the hospital. Your patient is not doing well at this point. Due to the fact that he was having chest pain and you followed local protocol about giving nitroglycerin, he did not tell you that he had been taking Viagra on a regular basis because of Erectile Dysfunction….he was embarrassed and also did not feel it was important since you were not empathetic to his feelings or condition. So, what happens now? Ever see the movie “Something’s Gotta Give”? Jack Nicholson plays a 62 year old guy who has a thing for young ladies.
He winds up in the Emergency room because of chest pain and he cannot breath. He figures it is because of getting too worked up with his latest young lady. When he is asked about Viagra he responds with a quick no. However, his tune changes very quickly when he is informed that the combination of the Viagra and the nitroglycerin he had just been given can cause a fatal reaction. This scene in the movie is a funny one, but the not so funny part of it is that it is very true. When one takes Viagra, the effects of the nitroglycerine is more intense and irreversible hypotension can happen. If the two drugs are taken within the same 24 hour period, the combination is fatal. Your patient dies on the way to the hospital. How could this have been prevented? First and foremost, the patient should have informed the EMT about all of the medication he had been on recently. However, the EMT should have treated this patient like he would have wanted an EMT to deal with a grandmother, mother, sister, brother, child or any other family member. It is not ok to tell your patient that everything will be ok…you do not know that.
However you can let them know that you will do everything for them to the best of your abilities to help. It is my belief that a sense of empathy and compassion is vital for EMS providers. Being a caring person is one of the reasons people stay in EMS. What is left when you find that EMS isn 't as exciting as TV portrays it? What happens when the lights and sirens get boring? It is my belief that providers must shift to a higher, more mature calling, the reason most of us get into the field: helping people. Those who get it stay with it and those who don 't move on. Studies have shown that the average length of time a person stays in EMS is 2.3 years. It isn 't the pay that holds people in EMS. There are some that find satisfaction in EMS. They are a different breed. Where does that come from? I believe we are back to empathy, caring and compassion. If you don 't know how or don 't feel compassion, don 't worry. I am sure it is more difficult in the beginning when you are still trying to remember everything from class. Just remember to treat everyone the way you would want to be treated. It really is that simple.
Roger M. Stone, M.D, M.S. FACEP, FAAEM came up with a very helpful tool to help in this situation: He calls it CLEAR…
C Be connected to what you do:
Be aware of what is going on with patients when you reach the scene.
Approach with compassion and make it a life’s mission to never lose your cool!
L Link to the next steps
Any person who feels frustrated should desist and let their partner step in to defuse the situation, rather than resist their partner’s attempts to do so.
E Expectations: What is expected of me?
Never be disparaging to anyone in jest or in tone, even to a patient with poor behavior or in a 911 call by a third party; especially with family, it is considered our job to act above the standards of the layperson or loved one.
A Ability, what tools do I need to do my job?
Approach each new patient with an open mind medically.
Use your EMT training at each level to best of ability, not the least.
Know Patients’ Bill of Rights, available on EMS Quick Links for reference
R Return on investment: What is in it for me (WIFM)?
This approach will keep providers out of trouble. It might even mitigate your shortcomings in the event of an honest mistake situation. This approach may be personally rewarding on the whole, and less exhausting. Above all this approach may help save a life!
References: http://www.montgomerycountymd.gov/content/firerescue/ems/ql/qa/MedDirEducFax7.pdf www.google.com :search empathy and EMS
Numerous news articles, blogs and opinions of family, friends and acquaintances.
Empathy is defined by: The intellectual identification with or vicarious experiencing of the feelings, thoughts, or attitudes of another.
I recently talked to a majority of my family, friends and acquaintances to brainstorm with me about what I would write about in this class. I got tons of ideas: EMS in the rural setting, complications of childbirth in a pre-hospital setting, dealing with certain diseases that need specialized care, and overall I received a ton of complaints about how someone was treated. So, because I am the type of person who was taught from a young age to treat others the way you want to be treated, I thought I would do my paper on patient “bedside manner”. …show more content…
Everything I heard, read, and understood is that whether or not you make a mistake out in the field, you are remembered on how you treated your patients. In a world of many technological advances, we often can find that our personal relationships have a tendency to dwindle to text messages, emails, tweets and social networking messages.
So, how do we learn to do what it is we do?
We go to school, learn the local and national protocols, take some tests and get licensed. Do our patients really think about how much education we have had or what our credentials are? No…instead they open the doors to their homes to us, assume we know what we are doing and let us into their personal space. They let us invade them in ways most would not let close family invade. We learn about the SAMPLE, the OPQRST, contraindications of meds, how to deal with airway, breathing and cardiac problems…but do we truly know how to understand the patient? That is something learned and it is a valuable resource when working in the EMS field. For instance, you get called to a 47 year old male with first time chest pain at 4 a.m. You begin your assessment with an introduction of you and your partner and go through the motions. You check his airway and breathing and respond by placing the patient on high flow oxygen with a non-rebreather mask. You are not explaining at all what is going on. You start with the SAMPLE…he responds with all the answers but it seems to him like you are not to empathetic to the need that he is very frightened at the moment that he could be having a heart attack and die. You start asking the OPQRST questions and he becomes agitated because you are just going through the motions, not explaining anything to him, not acting like you have any empathy towards him and his condition, and simply seem to him like …show more content…
you want to get done so you can go about your life or the next call, whichever comes first, so he does not answer in an effective way. You break out the latest and greatest EKG monitor, which is capable of 12-lead field transmissions, communicate with online medical for consultation, and check your PDA or Smart Phone for information on the patient’s current medications. You place the patient on a stretcher; load him into the ambulance, and go to transport him to the hospital. Your patient is not doing well at this point. Due to the fact that he was having chest pain and you followed local protocol about giving nitroglycerin, he did not tell you that he had been taking Viagra on a regular basis because of Erectile Dysfunction….he was embarrassed and also did not feel it was important since you were not empathetic to his feelings or condition. So, what happens now? Ever see the movie “Something’s Gotta Give”? Jack Nicholson plays a 62 year old guy who has a thing for young ladies.
He winds up in the Emergency room because of chest pain and he cannot breath. He figures it is because of getting too worked up with his latest young lady. When he is asked about Viagra he responds with a quick no. However, his tune changes very quickly when he is informed that the combination of the Viagra and the nitroglycerin he had just been given can cause a fatal reaction. This scene in the movie is a funny one, but the not so funny part of it is that it is very true. When one takes Viagra, the effects of the nitroglycerine is more intense and irreversible hypotension can happen. If the two drugs are taken within the same 24 hour period, the combination is fatal. Your patient dies on the way to the hospital. How could this have been prevented? First and foremost, the patient should have informed the EMT about all of the medication he had been on recently. However, the EMT should have treated this patient like he would have wanted an EMT to deal with a grandmother, mother, sister, brother, child or any other family member. It is not ok to tell your patient that everything will be ok…you do not know that.
However you can let them know that you will do everything for them to the best of your abilities to help. It is my belief that a sense of empathy and compassion is vital for EMS providers. Being a caring person is one of the reasons people stay in EMS. What is left when you find that EMS isn 't as exciting as TV portrays it? What happens when the lights and sirens get boring? It is my belief that providers must shift to a higher, more mature calling, the reason most of us get into the field: helping people. Those who get it stay with it and those who don 't move on. Studies have shown that the average length of time a person stays in EMS is 2.3 years. It isn 't the pay that holds people in EMS. There are some that find satisfaction in EMS. They are a different breed. Where does that come from? I believe we are back to empathy, caring and compassion. If you don 't know how or don 't feel compassion, don 't worry. I am sure it is more difficult in the beginning when you are still trying to remember everything from class. Just remember to treat everyone the way you would want to be treated. It really is that simple.
Roger M. Stone, M.D, M.S. FACEP, FAAEM came up with a very helpful tool to help in this situation: He calls it CLEAR…
C Be connected to what you do:
Be aware of what is going on with patients when you reach the scene.
Approach with compassion and make it a life’s mission to never lose your cool!
L Link to the next steps
Any person who feels frustrated should desist and let their partner step in to defuse the situation, rather than resist their partner’s attempts to do so.
E Expectations: What is expected of me?
Never be disparaging to anyone in jest or in tone, even to a patient with poor behavior or in a 911 call by a third party; especially with family, it is considered our job to act above the standards of the layperson or loved one.
A Ability, what tools do I need to do my job?
Approach each new patient with an open mind medically.
Use your EMT training at each level to best of ability, not the least.
Know Patients’ Bill of Rights, available on EMS Quick Links for reference
R Return on investment: What is in it for me (WIFM)?
This approach will keep providers out of trouble. It might even mitigate your shortcomings in the event of an honest mistake situation. This approach may be personally rewarding on the whole, and less exhausting. Above all this approach may help save a life!
References: http://www.montgomerycountymd.gov/content/firerescue/ems/ql/qa/MedDirEducFax7.pdf www.google.com :search empathy and EMS
Numerous news articles, blogs and opinions of family, friends and acquaintances.