Part one of a two part series on scene presence. Part two is here.
A regular reader of The EMT Spot asked a great question recently. (Thanks Timothy.) “How do I keep my cool and not loose my head in stressful situations?” I want to give you a tip that has worked well for me in the past. It’s a phrase I learned as an EMT and it’s helped me on countless occasions.
“It’s not my emergency.”
I know. I know what you’re thinking. On the surface, “It’s not my emergency.” sounds like a very callous and uncaring thing to say. But give me a chance to explain.
I was taught the phrase, “It’s not my emergency.” by a talented young paramedic who was a mentor in my early years in EMS. Since I first learned it, I’ve heard it used in a much more callous and uncaring form. More often than not, when I hear people say this catch-phrase it’s said in a dismissive manner. “It’s not my emergency” has become, “It’s not my problem.” or worse, “I don’t care about your emergency.” It never meant that to me. That’s not how I learned it.
For me, “It’s not my emergency.” is a mantra that helps us remember our role in the trial and tragedies that befall our patients. It reminds me of my place in the human drama of EMS. My role is that of the caregiver, not the patient. And, until the day that I pick up a phone and dial 911, that’s how it shall remain.
This is what “It’s not my emergency means to me:
I am part of the solution. I am not here to be a part of the emergency. This is another person’s problem. I’m here to help solve it.
It’s important to keep our perspective about what role we’re playing in the emergency medicine show. We are the solution. We don’t serve the public interest or our patient by becoming a part of the emergency. And, believe me, there are lots of ways to contribute to the emergency.
Here are a few:
- Being emotional to the point that we become ineffective
- Becoming injured
- Bringing our personal biases, prejudices, politics or psychological traumas to the scene
- Adding to the sum total of stress and high energy
- Making bad decisions
- Sticking to our bad decisions and ignoring (or feeling threatened by) helpful input
- Conflicting with the leadership on scene.
But you can avoid all of that. It’s all packaged up nicely into something I like to call scene presence. Develop your scene presence and you won’t have to worry about this stuff. You will always remain a part of the solution.
When we’re part of the solution, we focus on our role on scene. That means if the scene needs us to be in command, we remain in command. If the scene needs us to do patient care we do patient care. We are able to remain focused on our assigned tasks without becoming overwhelmed.
When we’re part of the solution we approach human distress with compassion and empathy, but we never allow our emotions to overwhelm us or cloud our decision making or add to others distress. We can make human connections with others without adopting their emotional state. This is their moment for grief, not ours. We can have our moment later.
When we’re part of the solution we place our safety above all else, knowing that nothing will cause the scene to devolve faster than an injured responder.
When we’re part of the solution we leave our psychological crap at home. It doesn’t matter if our friend was once killed by a drunk driver or the guy in the bar fight reminds us of a bully back in grade school or if our father abandoned us as a child because of his heroin addiction. We all have our stuff. Our patients are bound to stir up that stuff within us. The patient has their own stuff to deal with. They don’t need ours.
When we’re part of the solution we remain calm and professional. Sometimes it seems like yelling, running, barking commands and being visibly stressed is the best thing for everyone. It’s not. It never is. Once people see the ambulance crew looking overwhelmed they start to lose it. Your affect is a catalyst for everyone else on scene. That goes for your co-responders as well. You are the calm at the center of the storm.
When we’re part of the solution we make good decisions. Good judgment is the hallmark of good EMS. It isn’t good knowledge. It isn’t good skills either. It isn’t strong protocols or fancy equipment. It’s good judgment. Make good decisions and things will go well. And know how to ask for help making good decisions when you need it.
When we’re part of the solution we recognize that everyone on scene is a resource. We don’t need to have the right answers all the time, we just need to know how to use the team around us. Let go of the idea that your performance needs to be perfect. Be fallible. Be authentic about your abilities and limits with the other responders on scene and use them as a sounding board. They’ll help keep you out of trouble if they know you want their help and input.
When we’re part of the solution we understand that it’s our job to support the leadership on scene. It doesn’t matter if we like the person in charge. It doesn’t matter if we agree with them. We support them. If they make a mistake, we have their back. When we feel we have valuable input, we give it in a respectful way. We take care not to undermine the trust in the authority on scene, with the team or with the public.
“It’s not my emergency” has served me well over the years. I’ve said it to myself in the back of my rig alone with a patient who needed more help than I could offer. I’ve said it to myself on scenes with way too many patients and way too few resources on hand. I’ve said it to myself with news helicopters circling overhead on incidents that you’ve heard of and probably watched. I’ve even said it when it was my emergency. And it works for me.
See if it works for you.
Now it’s your turn: How would you answer Timothy’s question? How do you keep your cool?
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