Patients Define Their Emergencies

What if I told you that you could adopt one simple, yet powerful belief that would improve your happiness at work immediately and forever? What if I could tell you one simple truth and, if you were willing to accept it, you would feel less stress and bring more joy and well being to your job starting right now? Would you be interested? Read on.

Carl Jung was the first psychologist to put fourth the theory of the collective unconscious. He recognized that an individuals behavior was driven, not only by their personality, but by the myths, ideas and beliefs held collectively by their culture.

It’s worth recognizing that when you came to emergency services you arrived with some of these beliefs.

No, he's not having a heart attack.

You had an idea in your head of what an EMT, a paramedic or a fireman was. It’s probable that your beliefs were based more in the myths of the collective culture than reality, but the industry could take some blame as well.

We did nothing in your training to convince you that your job would be anything different than what you had seen on TV and in the movies. We may have even used some of these images in your recruitment process. 

If you endured a fire academy you were taught each day about structures on fire and victims that needed to be dragged to safety and turned over to imaginary medical personnel. In EMT class you spent each day learning about the various medical emergencies that befall humans. From aneurysms to zygomatic fractures and everything in between, we drilled you on how to recognize those sick patients and how to intervene appropriately. And you learned. You diligently studied for the day when you would be the one responsible for caring for the sick and bringing calm to the chaos.

But the instructors didn’t say much about headaches. Blinding migraine headaches that make the patient so photophobic they can’t see to drive their car. They didn’t talk about stubbed toes either. They didn’t mention that many of the patients would be depressed, abused, addicted and homeless. Nothing was said to prepare you to kneel before drunks and criminals and people with mental imbalances, social dysfunctions and minor yet overwhelming needs that have nothing to do with your training.

In all your training nobody prepared you for emergency services. We may never have even mentioned that emergency services has much less to do with the real, life threatening emergencies than the collective myths told you. Instead, it has everything to do with caring for people and their problems. Welcome to EMS.

But here’s the kicker … none of this is a bad thing.

I’m going to ask you to let go of the myth of the collective consciousness. I’m going to ask you to make peace with your disillusionment and recognize that EMS is something entirely different from what you once wanted it to be. Once you do, you can begin to recognize that it might just be something much better.

Here is the one belief that will change your job satisfaction immediately:

Patients Define Their Emergencies

That’s it. You don’t get to decide what is or is not an emergency in the patients mind. There is no single collective understanding of what does and does not warrant a 911 call. The system is available to everybody. People with good judgment have access to 911 and so do people with bad judgment. The people who manage their life crisis well can call and so can the people who don’t. The systems greatest strength is also its greatest weakness. Our service is available to everyone … all the time … period.

It stands to reason that the people with bad judgment, who don’t manage their lives well, will call far more often and with far greater frequency than their more responsible social counterparts. Once we let go of trying to define their emergencies for them, we can make peace with that and get on with serving the patient.

As long as we remain attached to the idea that our job is to manage our predefined, true medical emergencies and everything else is an inappropriate distraction, we will never find fulfillment in EMS work. We will simply drive from one frustrating encounter to another, disgruntled, hoping for some genuine crisis so we can go home feeling a greater sense of self worth.

When we let go of this immature view of EMS we can let go of all that angry baggage. We can decide to let the patient define what constitutes an emergency and help them resolve it. Suddenly minor calls aren’t abuses or resource wasters, they are simply problems that are well within our capacity to solve. We see that peoples emergencies will span a vast spectrum of our abilities. Some will challenge us greatly. Many will be well within our ability to resolve. That’s OK, it means were doing our job well.

Yes, some people will abuse our service. This proves our greatness. Our service is available to everyone in

our community, every moment of every day. We don’t turn anyone away. Not because we can’t, or out of fear of liability, but because it’s not who we are. Filtering who is and is not worthy of our service is not what EMS was meant to be about. You work in EMS to serve human beings. The good ones and the bad ones and the nice ones and the smelly ones and the drunk ones and the violent ones. Everyone.

A big part of growing up in EMS is recognizing the power of serving others. Part of that is letting them define their own emergencies.

Welcome to EMS.



I’d like to hear what you think about that. Feel free to leave me a comment below.



  1. Steve,

    I’ve been in this for over 20 years an have never felt the pain of burnout. I still cry over the babies and sit in the floor at 2am with the old folks. When I was training back in 1986, an amazing woman who spent her career as an ECA, taught me a lesson more valuable than anything I have learned in all these years. She taught me that these patient’s are human beings and that they should be treated as such. She taught me that we are treating the whole patient, not just a group of signs and symptoms. Were treating there mind and spirit as well as there body. Sometimes the most powerful medicine, is found in your own two hands, holding that of another. It is true that some patient’s are frustrating and tax our patience, but they are still in need of something. Even if we don’t consider it “what were here for.” I’ll never forget years ago, a partner and I getting called to a medic alert call at 4am. A sign on the door said, “come in, I’m bedfast.” An elderly woman was lying in bed in the front room and stated that she had “messed on herself.” She asked to be helped to the restroom to finish and be cleaned up. We got her into her wheelchair and took her into the bathroom and cleaned her up and gave her privacy to finish. We let dispatch know it was nothing serious and that we would be out for a little while. About that time the home health nurse arrived. We explained what was happening, and the nurse went to talk to the patient. A moment later the woman was so upset and apologizing to us for calling 911. She didn’t realize and she was apologizing over and over again for “taking us away from more important things.” Here we were, both trying to tell her that nothing was more important that being here right now helping her. I hate the social concepts that we are so much more than civilians and I hate even more when an EMT/Medic/Fireman/Police Office believes that they are. Were public servants. One of the simpliest and hardest professions to be part of. We get to show up, see people in there worst prediciments, help, then disappear again. How cool is that? Sorry I dragged that out so much. I’m getting sentimental in my old age.

  2. administrator says:

    Great stuff Jimmy. Thanks for your contribution.

  3. “We get to show up, see people in there worst prediciments, help, then disappear again. How cool is that?”

    This is almost word for word they way I feel about it.

    Great post.

  4. kevin horn says:

    That is godlike..I bow to the author!! Thank you. Let’s get the message out there. Let’s teach this in EMT/Medic school.

  5. Steve Whitehead says:

    I wouldn’t have chosen the phrase “Godlike” Kevin but I’m glad you liked it. I agree that we should talk more about this during our initial introduction to the field.

  6. Steve Whitehead says:

    @Aerindel I’m so glad you agree. Thanks for dropping by.

  7. I agree. I wish this had been taught first day at my school. Wouldn’t have changed a thing for me, but I wish it had been taught.

  8. Steve Whitehead says:

    Scott, I think it is important to somehow interject the reality of what EMS care is in the basic curriculum. I don’t see it becomeing a part of the standard DOT curriculum any time soon, but as an instructor I know it can be done.

  9. I couldn’t agree with you more – as a nurse in a nursing home setting, the greatest “emergencies” are not the medical so much as the need to feel useful, to still matter in life, and to not be ignored by those of us caring for the body, but not the soul. Behaviours occur with some, and it it is a sign they still have the ability to fight…they haven’t given up yet.It is frustrating, but it is also a chance to intervene and help guide the individual in their anger before they truly give up and just begin waiting for the end.

  10. Steve, you couldn’t be more right. I was really lucky in that my instructor told me & the rest of the class how EMS really was. Not only do you need to know your skills backwards, forwards, & upside down–you have to be part psychiatrist—not that all patients telling you their life story want advice, in fact, most just want an empathetic ear. Giving advice is a touchy subject & not always appropriate. Listening is your best bet. When people decide they want to join EMS, if they don’t already know or they’re not told, they think it’s going to be just like t.v.—one adrenaline pumping—mindbending—hair raising—H O L Y C R A P!!!!! call after another. Some get really disappointed when they find out it’s really not like that & feel it’s a waste of their time & skills to answer a call similar to the call in Steve’s article. Steve–what you wrote is so true & I also agree that ” patients define their emergencies.” Who are we to decide what’s an emergency & what’s not? Our job is to just show up–no matter what. As far as what Jimmy wrote, I’ll go with EPIC.

  11. I for one happen to disagree with this. We have alot of people who abuse the system in our county. I for one am sick and tired of my hard earned tax dollars being spent for welfare junkie’s night out at the hospital and my tax dollars paying to get them there. Not to mention my volunteered time for what is not a true emergency. I do not mind helping those truly in need even if it means changing an elderly persons diaper or helping them up after they have fallen that is what I am here for but there should be a method to report and eliminate obvious misuse of the system and my tax dollars.

  12. I stumbled upon this website while doing research for a report on Whiplash for my EMT-Basic course. I have been fortunate to have instructors who have embraced this very philosophy. We are NOT to judge because it is an emergency to them. So don’t worry it is being taught, at least in my school. I am relieved that it is taught because I understand what it’s like being in the callers position. Fortunately, for me my uncle ( who’s now a retired Firefighter/EMT) was on the other line when I called to get advice on what to do for rambunctious children who would flip over furniture and hit their heads on tables or stick their heads in wrought iron trellises. He would patiently tell me how to assess, treat and observe them, or how to remove them from the object. Thanks to him I never had to actually call 911 but in a sense I felt I had because he responded no matter what time of day and never once treated me as if I was some kind of intrusion. In fact he’s one of the reasons that I have decided to become an EMT because he made a difference in my life and is my inspiration. I wish more people would read what you have written so perhaps we could all come to understand the real reason we are in this profession which is to help people in what ever capacity we are able to without judgement or attitude. Blessings to all. Be safe. Looking forward to being a part of the team.

  13. “You work in EMS to serve human beings. The good ones and the bad ones and the nice ones and the smelly ones and the drunk ones and the violent ones. Everyone.”

    That was awesome and once I start working I will keep that quote in mind brother! Thank you!

  14. I was very fortunate to have had the instructors I did when going through EMT school at the beginnig of the year. They spent a lot of time teaching us that the majority of the calls we will recieve will not untilize a fraction of our training. Most of the time, we will arrive to find a scared person that needs nothing more than a kind word from someone they feel they can trust. That our most important tools are our compassion and empathy for another person.


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