Updated May 24, 2017
By Tom Balliett, BS, VFF, NRP
I was an EMT for about seven years before earning my paramedic certification, working in private transport, public 911 emergency, urban clinics and the medical supply industry. I was always told that in order to be a great paramedic, I needed to be a great EMT first. During my career, I have been blessed to work with some very talented EMTs, paramedics, doctors and nurses. Additionally, I have travelled the country to hear some of the best speakers in the nation passing along their skills, experiences and insights to fellow EMS professionals like myself.
With my experience as an EMT in an ALS system, I learned the importance of my role in providing basic care for the patient and assisting paramedics in their more advanced roles. A tenured crew will have a mutual respect for each other and an understanding of how to work together as a team. Collectively, I challenge EMTs and paramedics to step out of our collective comfort zone and truly advocate for the patient, not just from a medical standpoint, but as one who is truly empathetic with the patient’s situation.
What is advocacy?
What does advocacy really mean? To me, it means treating every patient like they are my own mother — literally. Another way to think of it is that you should treat every patient like he or she is the most important patient. Every patient, no exceptions. Even if the patient has cried wolf by calling 911 three consecutive times in one day because she has dementia, that call you are on is the most important one.
I am often accused of caring too much and getting too close to the patient, which can be mentally exhausting. But these moments have been some of the most memorable and fulfilling of my career. Purchasing and delivering a new coat to a young girl after an accident since we needed to cut hers off after being immobilized. Holding the hand of the dementia patient and talking to her with eye contact as she asks you the same questions over and over. Looking in the women’s face and listening as she opens her heart and tells you about how she was raped as a child and thinks her current medical condition is a resulting condition. Intentionally walking out to the emergency room lobby and escorting a family member to their loved one who was just in a motor vehicle accident. These are the things I would do for my mom, my friends and every one of my brothers and sisters in EMS.
I could be complacent, but I choose to make each run the most important run and each patient the most important patient.
Guilt by association
Recently a friend of mine was critically injured in an out-of-state, off-road motor vehicle accident. Shattered extremities, severed liver, internal bleeding ... the list goes on. Fortunately, local EMS responded quickly and got her to definitive care in time to save her life. However, this is not the part of the accident she remembers.
She remembers being transported several days later from the receiving hospital to her local hospital several hours away. Her experience was very negative. The crew got lost several times during the transport, their empathy meter barely moved and she was treated like a project instead of their most important patient. In this case, complacency won over advocacy. And, since we are all part of the same EMS family, we are guilty through association.
I hope that the previously mentioned transport was an anomaly and not the norm. But I think we need to hold each other to a new level of accountability, with daily reminders that our current patient is our most important patient. It’s easier said than done for sure, but if our intentions are in the right place, our actions will follow.
Tips to give compassionate patient care
So where do we start? The first step is getting out of our comfort zone and adding a little extra care to our most important patient. Once you see the results first hand, it will not only be rewarding, but it will add an entirely new dimension of patient care that you may have never seen before. Here are a few tips to get started:
1. Caring touch
When auscultating lung sounds, comfort the patient by gently putting one hand on their shoulder or back. Always respect modesty and personal space, but a caring touch is an amazing comforter in a crisis.
2. Offer your hand
Ask if they want to hold your hand en route to the hospital after all medical interventions have been completed. It’s awkward at first, but what you will find is that they won’t want to let go once they do.
3. Seek to understand before being understood
What this really means is just keep listening and encouraging them to speak without the need to interject or offer your opinion. I have heard some amazing war stories from WWII vets and some great insight from hospice patients.
4. Talk to the patient respectfully and assume nothing
The old adage says that if you assume something, you will end up making a you-know-what out of you and me. Remember that dementia patient earlier that called 911 three consecutive times in one day? The third time could be an actual emergency. Don’t assume otherwise — treat the patient with more empathy on every returning visit.
5. Stick with the patient through the transfer of care
Stay with the patient until they are comfortable with the transfer of care and check on them before you go back in service. If you have another run to the same hospital, stop by to say hello and even offer a light-hearted joke if the setting is right.
Webster’s dictionary defines advocacy as “supporting the interests of another.” On your next run, remember to resist complacency at all costs and provide true care for your most important patient: your current one.
About the author
Tom Balliett has a bachelor of science in industrial design with a specialization in product design from The Ohio State University. Prior to 9/11, Tom held senior-level marketing, operations and management positions in publishing, software and motorsports marketing. Deeply impacted by 9/11, he found a new calling in Fire and EMS and soon became an EMT and VFF. He continued to utilize his marketing background by working for one of the largest healthcare distributors. Now a practicing paramedic and instructor, Tom continues his passion for patient care through education, hands-on field experience and medical product innovation.