Stuff I Wish They'd Taught Me in Class Part 1: The Human Element

BY SHAO TROMMASHERE ON SEP 30, 2010

I had a patient, a frequent flier many moons ago, who would call us for lift assists. Every time we got there, it was the same thing. A little old lady would be sitting in her overstuffed recliner needing help to get up and out. Her feet couldn't touch the floor, and she was so small that she couldn't rock the chair enough to get herself out of it. We would bustle around diligently; getting her out of the chair, fetching her a glass of water, even heating up a microwave dinner or food that was left by Meals on Wheels.

As a young and dumb EMT, I loathed hearing her address come out over dispatch. I felt the call took me away from the people who deserved my ministrations: car accidents, cardiac arrests and all the other "important" patients. I'd complain, both to myself and my crew, about how much I hated going to her house. We would be there for at least half an hour, and invariably, we'd miss a "good" call. My demeanor would take a sour turn; I'd have that look of a 14-year-old kid who had to visit great-aunt Mildred on a Saturday instead of hanging out with friends.

I didn't want to be there, but I had to stay. I absolutely hated each call, but my crew seemed to relish it. It seemed like the days where I was most surly and angst-ridden, they'd stay longer trying to get me more involved in the "treatment."

One Wednesday, the usual day when she would call, she didn't. She habitually called at 5:30 p.m., no earlier, no later. I settled back in the couch, confident that we'd finally catch one of the "good" calls that always seemed to come in around the same time. No calls. Finally, around 9 p.m., we were called to her home, but this time, there was no moving her from her chair to the couch; we moved her from her chair to a body bag. Her neighbor had noticed that she had been sitting in the same spot without moving an inch all day long. He thought she was sleeping, but worry got the best of him and he decided to call to check. When she didn't answer, he knew something was wrong.

As I moved about to gather information, something struck me so hard it was like a ninja with a 2x4; there were no pictures of family, no cards or letters from friends, nothing. Talking to the neighbor only confirmed my suspicions. She had no family to speak of, but neighbors would stop in to check on her every so often, just to make sure she had the basic necessities and then take their leave.

I felt horrible. From that day, I never took any 'lift-assist' for granted.

It took the death of a patient to know my attitude had to change. EMT and medic school fills your head with how to treat sick patients; people with both mental and physical medical problems. What it doesn't teach is that something as simple as talking to a patient and finding out about their lives can, and will, make all the difference in the world. Sometimes, the best treatment is no treatment at all.

Shao Trommashere completed paramedic class in 2007 after working as an EMT since 2002 in the Northeast corner of the United States. She also has a blog called Looking Through A Pair of Pink Handled Trauma Shears.

Voice your opinion!

Aug 09 2011 07:58Posted by Unknown

As a student(1st year) it troubled me to see "old" medics/emts complain about all the frequent fliers. Sadly bad habits are far more contagious than good ones and soon (internship)I found myself thinking these callslifting assist and fake chest pains) were a waist of my education dollars. It takes true courage to admit to our mistakes and far more to make them public so that others can learn from them.Thank you,Gisselle.

Aug 06 2011 13:36Posted by Unknown

They teach you many things in EMT and Paramedic class. One thing they cannot teach is compassion. It comes from within. I have been in EMS for 13 years and have had my share of frequent flyers. I have come to realize that many of the frequent flyers, regardless of the complaint, are calling to have some kind of human contact. Something that most of us don't really think about or, for that matter undertsand that desperate need. I have been a Paramedic for 10 years. I can ramble off "cool" runs, medication doses and the proper technique for the various procedures we perform. The most profound action is holding an elderly womans hand and talking to her as I take her to hospice. I truly believe that we make a difference in the lives we come across. I also believe it's up to us to decide what that difference will be.

Feb 21 2011 07:31Posted by Unknown

I KNOW WHAT YOU MEAN ,,I LIVE IN P.R. AND AM A PARAMEDIC FOR 10YRS NOW AND WE HAVE MANY PATIENTS LIKE THIS ONE THAT CALL FOR THE SAME REASONS OR JUST BECAUSE THEY HAVE A STOMACH ACHE..OR FOR OTHER REASONS ,,BUT ITS ALWAYS THE SAME THING ,,SOME OF MY CO-WORKERS HAVE THE SAME ATTITUDE ABOUT PATIENTS LIKE HER ,,A CONSTANT PAIN AS THEY PUT IT ,BUT I FEEL FOR THESE ELDERLY PEOPLE THAT HAVE NO FAMILY JUST NEIGHBORS THAT LOOK OUT FOR THEM AND IT'S REALLY SAD TO SEE THESE PEOPLE LIVING IN SUCH HORRIBLE CONDITIONS WITH LITTLE FOOD AND NO-ONE TO TAKE CARE OF THEM,,,EVEN THOUGH SOME OF THESE PEOPLE DO HAVE FAMILY THEY JUST DON'T CARE MUCH ABOUT THEM..I JUST DON'T UNDERSTAND THAT ,,IT BREAKS MY HEART TO SEE SUCH LONELINESS IN THESE PEOPLE'S EYES...I AM ONE THAT I LEFT MY LIFE IN NYC TO COME TO PR TO TAKE CARE OF MY MOM AND DAD TILL THEY BOTH PASSED ON..AND I JUST DON'T GET WHY SOME PEOPLE JUST DON'T CARE ABOUT THERE OWN PARENTS TO LEAVE THEM ALONE AND NEVER COME TO CHECK ON THEM TILL THEY DIE AND THEY START TO CREATE A SHOW ..HUH WHAT A JOKE,, THEY APPEAR WHEN THE PERSON DIES BUT NOT WHEN THEY ARE ALIVE..IT'S A VERY OVERWHELMING,HEART BREAKING FEELING TO SEE THAT..MANY PARAMEDICS HERE JUST DON'T REALIZE THAT ......THEY NEED TO BE EDUCATED MORE ON HUMANITY INSTEAD OF A PAY CHECK..I DON'T MEAN ALL PARAMEDICS ARE THE SAME BUT HERE IN PR SOME OF THE PARAMEDICS HERE HAVE NO UNDERSTANDING OR FEELINGS TOWARDS THE ELDERLY AND THE SUFFERING THEY ARE GOING THROUGH..ANYWAY I AM GLAD TO SHARE MY EXPERIENCE WITH OTHERS ON THIS SUBJECT THANK YOU FOR THE COMMENT..

Oct 19 2010 08:31Posted by Unknown

You are very correct when you say we need to teach these aspects in our EMT courses (etc). I am an EMS instructor and I DO teach this in our courses. I have always hated when my partners said "I want a good call" because to me every call is an EQUAL call as we deal in saving human life----and we as humans are ALL EQUAL. I hope people reading this learn something important and that is to GIVE WHAT YOU WOULD LIKE TO GET (if the shoes were on the other foot)

Oct 18 2010 19:20Posted by Unknown

sad but steal true we realize it that way sometime

Oct 18 2010 14:58Posted by Unknown

"Ah young grasshopper... now... it is time for you to leave". (Kung Fu with David Carradine)when he left the temple after learning all he had to learn...Amen! I have been preaching and teaching that "human element" to my students for years and years. That is something you cannot learn in class. That, and other pearls must be experienced first hand and learned in the field. I feel you... been there... we are so focused on the "technical aspect" of EMS that we often forget the human factor. We are protocol driven, and while we are checking off the boxes in our heads, we forget to "connect" with our patients. Let us all make a conscious effort to smile and say hello and introduce ourselves.Good on ya!Vince(34 year EMS veteran)

Oct 18 2010 11:38Posted by Unknown

One thing most of us in this field miss when we first start is the true value of a call. Can you really define the "good calls" the same way after two years in? How about after 10? I think the true "good call" should be judged after you leave the scene. How many times do we assist the geriatrics, thinking they just wasted our time, but leave them smiling and feeling great about themselves? Arent they the "good calls"? The ones where no one dies, no one is seriously hurt, but we made them better anyway. When we are younger, we think the better calls are the ones where you have to use all your skills, and deal with the most issues. Most veterans, myself included(almost a decade now) will tell you the better calls are the ones where you simply use people skills. They make the most difference, whether it is obvious right then or not. The times we simply make people smile. The times they feel the reason they called us is silly, but we tell them to call us for anything. The times when we simply say "Hi!" to an older person while we drive down the street, or wave to the kids out playing as we pass. The times when we do use our skills in one apartment, but make the kid down the hall smile when we pass. Those calls are the "good calls". I have learned to appreciate them so much more as time goes on. Hope everyone else learns to do the same!

Oct 18 2010 11:34Posted by Unknown

I, too, had a patient who would call for the most benign of reasons. But, we would practically kill each other trying to get out of the door first to get to her. Why? Not because we knew it would be quick call. Heavens no!! She lived all alone, MILES from any other person, on a desolate, lonely back road. We went because not a one of us ever left that residence without some newly-gained insight into life, love and the world in general. Yes, we knew it would involve getting her out of her chair, getting what ever meal of the day that time dictated was to be eaten and, quite possibly, bathing her and putting her to bed. We ALWAYS came away laughing, smiling and with a greater appreciation of the elderly and ALL they have done for this country. When we lost her, we lost a dear friend and inspiration. She taught each and everyone of us to ALWAYS show respect first, compassion second and to, above all else, LAUGH!!

Oct 18 2010 10:59Posted by Unknown

I have been in Ems for over 20 years, I have found those are the patients you should spend the most time with just becuse they are lonelyl

Oct 18 2010 09:21Posted by Unknown

That article touched me. Im an EMT/FF in a paid on call Dept in a small town, so we know a lot of people and their relatives and friends. Many in the dept are related to our pts. We Try and treat everyone in our town the best we can and now I will take even more time with them.

Oct 18 2010 08:48Posted by Unknown

We do teach that in a class.....it is called GEMS - Geriatric Emergencies.

Oct 18 2010 04:28Posted by Unknown

Thank you for sharing such a poignant story. If you don't mind, I will share it with our staff.

Oct 16 2010 09:52Posted by Unknown

Thank you everyone for the great comments, I am glad you have enjoyed the article!

Oct 16 2010 03:19Posted by Unknown

Many repeat callers could have their problems solved if someone would take time to come up with solutions rather than just complaining about the call. Arranging for a donation from someone who has a comfortable chair that is more appropriate for this lady, placing hand rails in the bathroom or other areas where the patient is more likely to fall, replacing rugs that slide easily with nonskid ones and helping to rearrange furniture can easily prevent these calls. Having a contact with the local community health and welfare agencies should be an absolute must for EMS but rarely is that the case. It just takes someone who cares enough to point out an unsafe situation. Fall prevention saves more lives than most of the other interventions done in EMS. A few have always thought that EMS providers would be great at doing so community health situations but for most, their heart is not into all the boring stuff. Their training also does not provide them with preventive care or long term considerations so few will see the relavent issues of these calls. It becomes just another BS call with sole focus on one "skill" of lifting the patient. Much like the drunk in the alley, few in EMS take time to understand or educate themselves about the long term affects of heat/cold exposure and the many disease processes associated with them along with the alcohol to even know what to do for a decent assessment and would prefer not to. The EMS provider will only focus on the alcohol since that is what has been ingrained into their way of thinking by the overall profession and many before them.

Oct 16 2010 00:18Posted by Unknown

Shao, just about every EMT & Paramedic that stays in the field goes through a similar epiphany. The more ALS you do, the more you realize that the patient started getting better once you walked through the door & relieved their anxiety of helplessness. I've been in EMS for 25 years and after being "promoted" to an office as training director 4 years ago I relish EVERY chance to get out and deal with the real reason I got started in EMS, to help others. WELL DONE! I'll be sharing your column with my students.

Oct 15 2010 10:20Posted by Unknown

It is a milestone and a life lesson I think, when we realize that "patient care" is not isolated to what skills we can do - but also our ability to just be present when were needed.Excellent piece, thank you for sharing.