Friday, November 17, 2017

Gary's Granola: Fiber for Today's EMS Professionals

Bloggers note- we're featuring a post written by our Quick Med Claims colleague and retired paramedic, Gary Harvat. This week, he reflects on his 40+ year career…


Gary's Granola: Fiber for Today's EMS Professionals
Earthward Bound

A few weeks ago I had the unfortunate experience of plummeting to the ground while on a ladder sixteen feet above the Earth’s surface in my own backyard. I didn’t have much time to think as I fell (it was a quick ride) but I do recall hearing my wife’s voice in the back of my mind stating “You’re going to end up in an ambulance if you keep thinking you can do things you did 30 years ago.” Upon hearing that voice, I tried to make a last ditch grab for the gutter. Sadly, that idea ended in a $50 gutter repair two days later. Fortunately for me, my earthward re-entry ended in a large tree-like bush that broke my fall but not my body. As my son helped me disentangle, I knew I was very close to having my wife’s prophetic words come true. Fortunately, I only suffered some road-rash from the brick on the house and minor abrasions. I was sore for a few days but overall, I was pretty darn fortunate.

With over 40 years in EMS involvement, I have seen my share of roof-plungers and most all of them had significant injuries and sadly, some suffered permanent scars from making the wrong decision about their involvement with ladders, clogged gutters and roof tops.

After I had some time to reflect on my foolish decision, I began to think about that “ambulance thing” that my wife had mentioned. Even though many years of my professional life were spent in the patient compartment of emergency vehicles, the thought of being an actual patient petrified me probably even more than the injuries I might have suffered.

While I no longer work in the field as a line medic, I have evaluated many a young paramedic as they treated patients under my watchful eye. I have seen some great medics and some that are well, you understand. Over the years I’ve watched this industry change and grow. It’s been great with aggressive protocols, drug therapy and field equipment that I only wish I had available to me in the while in the back of that Omaha Orange KKK-A-1822 ambulance.

I’ve noticed that we’ve done a great job at teaching our medics too. They are better trained but have so much more to absorb now than I did 4 decades ago. I honor and respect all of these folks who work this job. They have so much to do and their critical thinking has to be pinpoint.

While the advances have been tremendous, little has been done to address the issue of compassion and personalized attention in the patient compartment. We have worked hard to make sure all that can be done is being done for every patient we encounter. However, along the way we forgot to teach people the importance of looking a patient in the eye and developing a dialogue with them. Have you ever read studies about the importance of holding an older person’s hand? Incredible things happen. The therapeutic effects of human touch cannot be underestimated in the back of an emergency vehicle. While I am not stating that these things are a cure-all for every patient, they do have an incredible calming effect for most.

Today, I watch as many medics try to cram so much into a 15 minute ride to the hospital they forget to even remember the patient’s name. Start the IV, run the meds, adjust the oxygen, monitor the pulse ox, read the EKG and more. The protocols and care we are charged with carrying out seemingly demand so much of us that we don’t have time to even chart our care – let alone converse with our patient.

During my hey-day we didn’t have all of this technology. Sure, we had a 3 lead cardiac monitor and a drug container the size of a Hasbro kiddie’s toolbox. This little box contained the “big meds” we knew as Sodium Bicarbonate, Lidocaine and Atropine. In the 70s, we didn’t have protocols as we had to call for orders and many docs weren’t really sure who we were coming over that squawking box in their ER. As a result, we got a lot of “O2 and transport” for critically ill patients. While these were not orders that changed the save-rate in most cases, it did give us more time to talk with the patient, hold an old woman’s hand or simply carry on light conversation during the ride to the hospital. Don’t get me wrong, I am all for the incredible and positive changes this industry has made in the delivery of pre-hospital care but along the way can we please not forget that these are human beings who are lying beside you? As humans, we like conversation and we genuinely appreciate people who can communicate - even in our worst moments when we as patients may not be so pleasant.

So, after my plunge I began to wonder who would’ve come for me that fateful day. Would I have “La Machine” pre-programmed and trying to cram 10 pounds of treatment into a 5 pound bag or would I have a compassionate human being who put a firm grasp on my shoulder and told me to hang in there during my ride? Or, might I get lucky and have one that did both. I don’t know, it worried me quite a bit and I thought about it a lot after my fall.

My age now dictates the chances of being supine on an ambulance stretcher are much greater than sitting on the squad bench. So, next time you have a roof-plunger or an MI or a broken hip in the second floor rear bedroom, take a moment to remember that the care you deliver is important but don’t forget how equally important eye contact, a firm hand on the shoulder and a caring voice can be. You’ll be pleasantly surprised at the response you will receive.

Post a Comment