Saturday, April 25, 2009

compassion, laughter and tact

I really like the medics I'm riding with. They have great senses of humor and are really good at the job, but seeing them in action reinforces my belief that not only do I have what it takes to be a good medic, but I have what it takes to be a KIND medic.

Don't get me wrong, they care about their patients and weren't nearly as heartless as a lot of the medics I've run across, but there were a few things that made me raise my eyebrows - things I would've done differently, things I hope I would never do.

Our first call was an intentional overdose, a middle-aged woman with a history of depression. Because of the nature of the call, by the time we arrive, the scene is crawling with volunteer first responders and law enforcement not to mention several nosy neighbors. The patient was conscious and, for the most part, alert. We walked her out of the house to the stretcher.

Eye raise #1: The woman's condition was stable so there was no real rush to transport. When we arrived she was wearing a flimsy, strappy night gown that fell about mid-thigh. The straps kept falling off her thin shoulders as we helped her to the front door of her trailer and the stretcher just outside. It was warm outside, but my instinct was to wrap a sheet around her shoulders or something before we paraded her outside.

Eye raise #2: As we walked through the trailer with her, one of the medics questioned her about why she took so many pills. She tearfully admitted that she had done it on purpose because "they had taken her grandbabies away from her." The medic responded that this wasn't the way to handle things and that doing things like this would ensure that she never saw her grandbabies again, at which the woman howled that she "was never going to see them again anyway." Once we got her into the ambulance, the medic reminded her several times that her attempted suicide was not the way to handle things, that she had to be strong and couldn't be "pulling stunts like this." He was never really ugly about it, but was extremely firm in his tone. I couldn't help but feel sorry for the woman. Here she was, obviously feeling as though there was no hope, to the point she tried to take her own life, and the entire ride to the hospital she had to listen to a medic telling her how she'd fucked up. I understand what he was trying to do, I really do, but the way I see it, this woman was about to be swarmed by doctors, nurses, psychiatrists and law enforcement once she got to the hospital - all of whom would be telling her how she'd fucked up. Seems to me, she needed at least one person who wasn't judging her. Maybe I'm looking at it all wrong, but we can treat her, transport her and be kind to her without adding to the chorus of people telling her how bad she'd fucked up because she was so miserable she would rather die than live.

Another patient was dispatched out as a breathing difficulty. We arrived on scene to find an elderly man in a nursing home who was a bit beyond "breathing difficulty." The poor man was literally drowning in his own fluid. He was conscious, but didn't seem at all alert or aware of his surroundings, although he did grunt in response to verbal stimuli. The nurses assured us that was his "normal" mental state.

Eye raise #3: As we were wheeling the patient out of the facility, the two medics were laughing and cutting up with each other. I can understand this, they weren't being inappropriate or anything, but they never told the patient where they were taking him or what was going on. I know he was only semi-alert, but just because he was not responding very well to us doesn't mean he wasn't aware of his surroundings - it doesn't mean he wasn't frightened about what was going on and it seems to me that instead of laughing and cutting up, you should be taking a minute to reassure the patient and explaining what's happening.

Eye raise #4: The laughing and cutting up crossed a line as we were leaving the facility though. The smell of carnations was strong in the lobby and one of the medics commented on it, which began a brief conversation between the two medics about how they hated the smell of carnations because it always reminded them of death. It just seemed like an inappropriate conversation to me given the circumstances and I kept hoping our patient couldn't hear them.

I think both medics felt a bit bad about it a couple hours later when we came back through the ER with another patient only to find the elderly gentleman was feeling much better, smiling and talking with two family members. Obviously that had not been his "normal" state, regardless of what the dipshit nurse had told us. It just goes to show that you should ALWAYS watch what you say and assume that the patient can hear you.

I know it's easy to judge from the "outside," but I would hope that as I gain more experience, I would continue to believe patients should be treated with respect and dignity, regardless of their state or how they came to be in such a state.

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