I’ve been observing “us” for a while now – we EMS folk – and to non-ems folk it may seem, based on our speech patterns, that we don’t transport patients at all.
I do not mean that we disavow the people we’ve cared for; that is, we don’t deny picking people up from Bad Situation, and taking them to hospital. Nor do we in Transport Gig deny that we also take them from standalone EDs to definitive care, or from definitive care to rehab, or from rehab to home… or wherever.
Instead, what I find in our speech patterns is that we seem to transport chief complaints.
“I had this chest pain,” one might begin. “We ran this auto accident.” “They toned us out for an arm pain, but it was really a hip fracture.”
It isn’t usual for us to begin “I had a guy with chest pain,” or “I had a lady with leg pain.” Indeed, unless there is a need for this kind of knowledge, differential diagnosis information inherent in the patient themselves, we don’t mention it. For instance, “I had a lady with abdominal pain” WILL be stated. Women have much more that can be going on, abdominally.
And that in itself I find interesting. We will, in telling our stories to each other, include any and all information which will allow our audience, other Bambulance Folk, to follow along at home down the diagnostic path. “So, at 02:30 we found a 69-year old male prone, unresponsive, in the kitchen wearing slippers” – this we toss in because stocking feet tend to slip and slide – “with a bottle of orange juice on the floor near his hand” – this we include because OJ is, (as ever), a clue.
“Aha!” our audience exclaims. “What was his glucose?” And yes, they got it. The stories, you see, are never really about People. Rather, they seem like stories about Problems, And How We Solved Them.
I’ve been thinking about this, and I believe it’s because we’re all about The Data. Give me What I Need To Take Care of My Patient.
You will not, at the station, hear this:
“I transported a young new mother, flaxen haired. Her blue eyes: now distant with worries of tomorrow, now sparkling with merriment at the thought of today. Her smile flashed brightly, in joyous competition with those eyes, and…”
Nah. Our stories to each other don’t work that way. They follow the cut-and-dried approach of a patient care report. Although I have been tempted to begin a PCR with the immortal, “It was a dark and stormy night,” or, “Lounging at the station, my Medic Sense began tingling moments before the tones dropped. We leapt into action.”
BUT – and this is the whole point of this – we seem only to tell our stories to each other to Find Things Out. “This is what I saw, this is what I found,” and the unspoken, Did I miss something? Or, What could I have done better? Or, what else should I have checked? We constantly seek feedback.
Not for every call. Just once in a while, there IS a call where one’s Medic Sense tingled, and we want to know, Why?
Listening to us talk, I find we never bring up the calls where our Medic Sense didn’t tingle – we don’t tend to brag about the calls where we did everything right, and know it. We constantly seek peer review and aren’t afraid to draw it out.
Which I find to be uber-cool. Regardless of how well the patient contact turned out, and even if everything went fine, the fact is that we through these stories turn to each other and, in essence, say, “Help me to be better for next time.”
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