Читать книгу The Good, The Bad & The Ugly Paramedic - Tammie Bullard - Страница 9

Every single one of us starts our career with the goal to be a fantastic paramedic, however we may quantify that internally. Most of us are acutely aware, and highly appreciative of the fact, that we’re in a position of immense public trust. Whilst we prefer to go out of our way to uphold this professional image, however, there are times when it can be tempting to take shortcuts, particularly when we’ve been run ragged and are under pressure. Occasionally we may simply forget where we are, or who is around. We become so used to our role, and its environment, that any sense of feeling “at home” in a work setting, can begin to dull our professional senses.

There is a well-known expression that depicts this sneaky, difficult to notice, phenomenon perfectly. The situation in which we want our good paramedic scale to register off the charts, and we feel that it does. We go out of our way to do the right thing wherever possible. We aim for best patient care and the highest of high standards, but we may be letting ourselves down without even realising it. “Familiarity breeds contempt” as the saying goes. We become so familiar with certain aspects of our role, that we begin to disregard things that could be, or perhaps should be, considered more often.

Pleasing The Public v Protecting Our Peace

We’ve managed to snatch five minutes between jobs whilst our partner finishes paperwork. We’re parked alongside the pavement outside a cafe, engine running, with a hot drink in hand. We’ve all experienced it, that sublime moment of the first taste of our coffee, or biting into a long awaited sandwich and savouring the only chance we may get all day.

Just as we start to relax into it, a stranger walks up and knocks on the window to ask how they go about becoming a paramedic. We roll down the window and with a friendly smile spend a minute or two telling them where to find further information. We wish them luck with their efforts, with an encouraging “Might see you on road at some point in the future” type comment. Although it’s not the ideal accompaniment to our lunch, we can easily and briefly point them in the right direction, then look apologetic and explain that we must get our paperwork done whilst we eat, because there will be another job waiting as soon as we finish.

The unexpected visitor’s trust and respect for paramedics not only remains intact, but the sandwich and coffee can continue without guilt or discomfort. Yes, it can be difficult to always be in full view of the public, especially during those brief snippets of down time, but it’s a position that we have chosen to be in. These encounters can make or break public perception if we handle it impolitely because we’re tired and time poor.

Deliberate Driving v Chaos On The Roads

As soon as our attending crewmate picks up the radio to notify control that we’re available, we are dispatched on lights and sirens to a neighbouring suburb. We all know that emergency driving can be absolutely infuriating on busy roads. What is easy to forget, however, is that we, as paramedics, become completely used to it, whilst it remains confusing and may often cause panic in regular road users.

With this in mind, we drive proactively. We aim to pick a lane and stick to it as much as possible, using indicator signals and educating other drivers to abide by the road rules through moving to one side appropriately. We give those that have seen us approach, using their rear view mirrors, time to predict which direction we’re taking. Whilst we could perhaps get through the traffic quicker by zigzagging between vehicles, and changing lanes repeatedly, we know that this creates confusion and increases the chance of unnecessary accidents.

We use our beacons, flash our headlights and cycle through the various sirens, whilst ensuring that we leave enough distance between us and the drivers that haven’t yet noticed us. We avoid rear-ending the driver who slams on the brakes, when they suddenly realise we’re behind them. We’re also careful not to force drivers to enter an intersection, through a stoplight or sign, so that they don’t risk being struck by other vehicles. We take a second, when possible, to signal our thanks for those who have gone out of their way to facilitate our progression.

Growing legal liability on ambulance services naturally increases the pressure on response times, but also results in higher numbers of priority calls. Public perception is of increased numbers of emergency ambulances, therefore how we behave on the roads is under heavier scrutiny than ever before. Most of us have watched video footage of emergency vehicles struggling to get through traffic. We expect drivers on roads to let us pass safely, but how many of us have also watched the aggressive and erratic driving of some paramedics. There are countless emergency services personnel who cause panic and stress amongst drivers en route to calls. If the driver in front of us has been subjected to such emergency driving behaviours in the past, they may be terrified, or even angry, when they see our vehicle approach.

Our expectations of general road users can only match that of our own emergency driving, otherwise any double standards are unreasonable and unfair. Being confident and direct in the driving seat is absolutely necessary to forge safely ahead, but doing this courteously and professionally helps us to maintain a positive image, despite the need for urgency. Such an approach may ultimately keep our patients, other road users, ourselves and our crewmates safe, as well as our excellent reputation intact.

Cleaning Up Our Mess v Destroying The Scene

Once we’ve reached our destination, we attend to an overdose at a bus stop and transport to the emergency department with our now stable patient. Whilst working at the roadside, we drop everything we discard into a rubbish bag and take it with us in the ambulance to dispose of later.

Many of us may notice on our days off, when we go out for a run, or walk the dog, discarded gloves or medical rubbish. We know it just has to be from an ambulance call. Leaving mess and chaos behind at a scene can damage our professional reputation in the public eye.

Whilst occasionally we may find that dangerous environments, bad weather, darkness and urgency prevail, on most calls, good paramedics can tidy up loose ends with very little effort before transporting. We are not exempt from littering in our personal lives, therefore, unless extreme circumstances prevail, we cannot assume to be exempt in uniform. Forming the habit of using a disposable bag, on every call, immediately cuts down the need to even consider this, as we discard everything into it whilst we work. (With the additional benefit of creating a clear working space, it may also help us to avoid confusion in searching for items, and reduce stress on scene.)

Whether in a patient’s home, or out on the street, if we throw everything we dispose of onto the floor as we work, somebody, at some point, has to clean it up. Dropping plastic squares from electrodes onto the floor, bed or couch in an elderly person’s home whilst performing a twelve lead ECG seems innocuous. It leaves them with an invisible slip hazard later on, however, but only takes us a second to drop into a waste container. If we work on a dual response call, particularly with a cardiac arrest, there is usually at least one crewmember left behind to drive the follow up vehicle, whilst the patient is transported under priority conditions. Taking a couple of minutes to dispose of debris from the scene may reduce the psychological trauma experienced by family members or bystanders after the event.

Imagine a loved one is close to death and whisked away in an ambulance, then family members arrive home. We probably don’t want them to see the discarded mess at the scene as a reminder of their pain, before having to collect it up and place in the bin themselves.

Public perception of our professionalism and care extends so much further than clinical interventions. As a good paramedic, we can take countless extra, small measures to ensure that our attention is appreciated, and the trust that we are privileged to feel is protected in the long term.