Thursday, March 22, 2007

A good conversation

Still waiting to precept, I have been passing time trying to learn by observing others.

On scene for a shortness of breath, my paramedic partner lets out a quiet sigh as we enter the patient's room. He has been here before, many times for the same complaint. The female patient is agitated at the apparent dismay of her home healthcare workers. Yelling, she chastises them for mismanagement of her medications, poor planning, and an "inedible" meal. Turning towards us, she takes a deep breath and begins to explain how difficult her breathing is. Long, elaborate sentences flow easily without a hitch: she's been short of breath all day. No-one will listen to her. She needs to see her doctor right away.

I fight the urge to roll my eyes, an effort made easier as my medic remains perfectly stable. He is focused on the patient, performing an assessment on this that I have already decided to be nonsense. I wonder what it is he sees that I dont.

I set up the stretcher and lug the gear, handing him the bits and pieces that he needs. I assist as his decisions direct our path. He speaks calmly as he describes to the patient what he is looking for. Slowly he eliminates possibilities, narrowing his impression as we get closer to the truth. She has had periods of dyspnea over the past month, transient in nature with acute onsets usually in the early afternoon. The effort and sheer annoyance of the condition, the woman says, tends to render her a little "touchy" about matters of etiquette around the house. The meal wasnt even really that bad, she admits. My partner nods and smiles, a hand over hers as he says that its OK. We'll take you to the doctor.

She smiles, and thanks us.

He rides in the back as I drive. Not because she required ALS, but because they have established a repore. Together they talk as we bounce down the street.

After the call I reassemble the equipment, puzzled. My medic walks to the back of the ambulance and lets out another sigh, louder this time and more clearly filled with annoyance.

"What bullshit was that, eh?"

I ask him why he decided to ride in the back, then, if he knew she was bullshit. Why did he entertain such nonsense? He saw the same thing I saw when we walked in the door. No increased work of breathing. Long, full sentences. Clear lung sounds and stable vitals. Still, he said, he wanted to hear her story. Maybe there was something there, maybe there wasnt.

Taking a sip from his coffee he shrugged.

"At least we had a good conversation."


Ambulance Driver said...

"At least we had a good conversation."

He understands that a great deal of the time, our patients need nothing more than a gentle ride and someone to listen to them, perhaps hold a hand and reassure them.

It isn't sexy and it isn't what you were trained for, but it is "care" that you're rendering, with a capital C. Learn to recognize the value of that, and you'll have a rewarding career in health care, no matter what initials eventually follow your name.

Anonymous said...

A hearty 'well done' to your partner.

So much of what we do is simple PR and communication. It is easy to get frustrated with the non-emergencies, it is much harder to treat these people nicely. She will remember his kindness for a long time.

Blue Ridge Medic said...

I have a hard time with this kind of call myself sometimes. Great post though. Glad to see you back.


Anonymous said...

Miss you. You're a good writer, where did you go?

Stacey said...

"At least we had a good conversation"
He just set an awesome example in one sentance.
When you work with someone alot they tend to rub off on you. If your partner is nice to people it is easier for you to be nice to them. If your partner is a douche bag you may randomly catch yourself being a douche bag too.
I swore to myself when I started in EMS that I would be nice to my patients. I started working at an agency where my partners were overly firm/rude to BS patients on a regular basis. I caught myself doing it on a couple of occasions and I realized how wrong I was. Now I work for an agency where you are strongly encouraged to be nice to everyone. Its a nice change of pace.
Anyway. Long story short. Patients are not going to remember what treatments you performed on them, what size IV you started ETC... But they WILL remember how you acted towards them. Their oppinions of EMS can very well be permanently shaped by the way you treated them in the short time you were together.