I love posting articles controversial enough to warrant a disclaimer. Today I have the pleasure of bringing you another post by guest author Sean Fontaine. Sean is a graduate of Regis University and a Firefighter / Paramedic for The South Metro Fire Rescue Authority. He lives in Denver, Colorado with his lovely wife Oz and their two sons Jonas and Axel.
Today, Sean throws down the gauntlet on an issue that must be addressed by every emergency caregiver; the delicate balance between delivering objective, impartial medical care and the urge to interject our emotions into the often emotional drama that is emergency medicine. Can you make real emotional connections in the process of administering medical care, or does the emotional aspect of the job directly impact the effectiveness of your care? Some of us may address this dilemma only in our own private thoughts. Others may wish to publicly declare their position. To that end, here’s Sean…
Let me preface this post with the explanation that this topic comes straight from my discussions with paramedic school students and co-workers and the differing/agreeing viewpoints that resulted from those discussions. These are my opinions (not Steve’s) and I know full well that there are many of you out there that will disagree and some that will think I’m an insensitive ass. So be it, we’re here to listen to different viewpoints and think through them for ourselves, deciding in the process what our own thoughts truly are on a given subject.
The Argument: Your level of objectivity effects the quality of your patient care.
I contend that when we emotionally care about our patients we become subjective caregivers and as such render subjective care, transitioning to reactive rather than proactive medicine.
I really enjoyed this video that was uploaded today over at EMS1‘s ParamedicTV. I’ve seen a few of these videos come and go over the years and I’ve even contemplated putting one together myself.
What I appreciated about this video was the focus on the commitment and compassion of EMS providers as well as the multicultural scope of the photos. Some of these videos get a bit over the top with the “hero”aspect of the job…a characterization that I’ve never been entirely comfortable with.
I think this video gets it right and I’d like to share it with you.
“There can be no real freedom without the freedom to fail.”
-Eric Hoffer (American Social Writer)
But can we really? I mean, really fail. In the course of delivering emergency care can we completely fail?
I imagine that somewhere at the core of each and every one of us is a secret fear that the next call, the next major incident, the next patient contact might be the one where we fail. I think we all carry around with us the fear of a massive, public, ugly failure in the course of our care.
I say that because it’s entirely plausible that we will experience one of these failures in our careers. They happen all the time. They happen more frequently than we want to admit. And I would like to assert that we are better caregivers when we can put that fear aside.
What does your organization do to help resolve that fear? What does it do to feed it?
What your organization does to respond to critical failures in patient care will determine a lot about how free their personnel we feel to go out and practice good medicine. It’s worth thinking about.
“The opposite of love is not hate, it is indifference. The opposite of art is not ugliness, it is indifference. The opposite of faith is not heresy, it is indifference. And the opposite of life is not death, it is indifference.” -Eli Wiesel (Holocaust survivor and author of the book Night.)
Sometimes we equate behaviors like anger and frustration to burnout. I often disagree. It isn’t the angry EMS worker or the frustrated employee that concerns me, it’s the indifferent one.
Anger is OK. Don’t be afraid of your anger or the anger of others. Anger means that we sense injustice and we care enough about it to want to take action. Angry people have done some great things. As long as we find respectful and appropriate outlets for our anger, it can be a very powerful emotion.
The same goes for frustration. Frustration is the birthplace of innovation. Frustration is often what we experience right before our breakthroughs. Frustration tells us that we are still ingarged and we haven’t given up.
Neither of these are burnout.
Burnout is the point when we no longer care. Burned out individuals may still see the injustice. They may still sense the need for a breakthrough. They may even be able to define it. The difference is that they no longer care.
Indifferent caregivers are dangerous. Avoid them like the plague. You have permission to feel angry. You have permission to feel frustrated. You never have permission to be indifferent.
If you find yourself at a point of indifference, it’s time to move on.
What do you think?
Posted 2 months, 2 weeks ago at 7:04 pm. 7 comments
My latest Remember Two things video is posted over at EMS1.com. In this episode I discuss a crucial moment in patient care that is often overlooked. I’m talking about the moment we say goodbye to the patient after we’ve dropped them off at the hospital or their designated destination.
It’s an important moment because it’s an opportunity to make a very real, human connection with our patient and leave them with a positive impression of their experience with us and our service organization.
I worked for some great EMS organizations through the years. I’ve worked for some really awful ones along the way as well. Finding the right EMS organization and contributing to them in a positive way can be tricky. Sometimes, the struggle can be deciding whether to stay and help make things better or move on and plant your awesomeness elsewhere.
If your current EMS employer doesn’t value and respect you, there are plenty of organizations out there that will. If you are in a toxic work environment, it may be hard to imagine that there are places out there where respect, dignity and good patient care are the norm. Good organizations are out there and, as you might imagine, there are many common elements to their success.
Are you wondering if your being treated the way you should be? Let me help you answer the question of whether you’re working in a top-notch company or scraping the bottom of the EMS-service barrel. Here’s a list of some of the positive attributes of well run EMS organizations.
Best in class EMS organizations:
1. Value 2-way performance evaluation and are open to employee feedback.
Some EMS organizations prefer to give no feedback what-so-ever to their employees. (Unless someone screws up.) There are no scheduled performance reviews and supervisors say very little about job performance on a day-to-day basis. Most companies provide some sort of formalized performance review, though they may do it out of the misguided perception that it protects them from liability. (It doesn’t.)
The very best EMS organizations give generous real-time feedback to their workforce, both good and bad. Feedback is received in a timely manner, when it is most relevant and appropriate. But they don’t stop there. They also seek out feedback and create channels for employees to evaluate their leaders and their workplace. They encourage feedback and then they do something amazing with it, they listen and respond.
Sam Abell is a photographer. He works for National Geographic. Your first thought might be, “What can a photographer teach me about being a good EMT?” Well, as it turns out, quite a bit. Sam is a world class photographer for a million complex reasons and one simple one. Let’s start with the simple one.
He has passion.
In this video Sam describes the year long process of taking a single photograph of a bison skull on the American plains. Watch the video and listen to Sam’s story, then I’d like to make a few observations.
While listening to this interview, I had several ideas about what makes Sam Abell a great photojournalist. As he relates his experience, he gives us clues into what it takes to be really good at what you do. Here’s what I got from his story:
When your quality assurance manager wants to talk with you about a call you ran, do you lean in or do you lean back?
When the local nursing home calls for a patient who’s been feeling ill, do you lean in or do you lean back?
When the monthly continuing education lecture starts, do you lean in or do you lean back?
When the E.R. doctor wants to talk to you about the care you just gave her patient, do you lean in or do you lean back?
When you are scheduled to work with the partner who’s has the social skills of warm Bisquick, do you lean in or do you lean back?
When it’s near the end of your shift and there are inter-facility transfers pending, do you lean in or do you lean back?
Today you’ll be presented with countless opportunities. There will be opportunities for growth, connection, effort and fulfillment. There will be opportunities to bring quality to your job. There will be opportunities to learn from your colleagues and coworkers. Most of those opportunities come dressed up like work.
When they do come, do you lean in, ready to hear what the next person has to say. Are you looking for the connection with your next patient, the new home medication you haven’t heard of yet, the next piece of advice from your Q.A. person that might refine your skills? Or do you lean back, scared of what it all might mean, upset about the missed off-time, frustrated by the weaknesses and failings of others?
Lean in or lean back. It’s a decision we all have to make each day.
What do you think about that?
Posted 5 months, 2 weeks ago at 2:52 pm. 7 comments
The argmentum ad antiquitatem is sometimes better known as the appeal to tradition or the appeal to common practice.
If you’ve ever heard anyone say, “I know this is right because that’s the way we’ve always done it.” You’ve heard the appeal to common practice, the argumentum ad antiquitatem in action.
In EMS, the appeal to common practice is everywhere. So much of what we do, from c-spine immobilization to intubation to oxygen administration, is based on the idea that we’ve just always done it that way.
Any time new research suggests that we we may have been doing it wrong all along, the appeal to common practice rears it’s ugly head. The longer we’ve been in EMS, the harder it can be to admit that, perhaps, we were doing it wrong all along. So, instead, we fight it. The appeal to common practice works its way into our language in sneaky ways.
