Street Cred != Store Cred

From time to time, usually every month or so, the transport company hands out prizes by drawing names from a hat. The way to get one’s name into the hat is by having a patient write an endearing letter to the company stating what a fine person one is, what a wonderful experience they had in being transported, etc. The person so honored has his name entered “once per praise”. The prize is usually a $20 gift card.

This is a nice little prize amount, and usually very welcome. Yes, DTs has won a couple of times, thank you, but I’ve been giving serious consideration to having my name permanently removed from the drawings. Couple of reasons, really.

For instance, I can see where if this became a coveted honor or if the prize amount rose to be serious money the temptation to abuse would rise:

“There! The driver has started the engine and can’t hear us. I just wanted to tell you, before we loaded you for transport he told me he wanted to kill you, but I talked him out of it. But,” – here one would look sad – “I don’t know how many more lives I can save from his diabolical, serial-killing hands. They’re having budget cuts, and unless they get letters from patients… Anyway, don’t look him directly in the eyes when we get you home. It angers him. My name is Steve, and I’m your friend.”

So yes, perhaps it’s best to keep the prize money low, and make sure patient praise plays no part in figuring annual raises.

Still, I have had partners who have pimped themselves to patients by hinting, heavily, that words of praise should go to this address, attention this person, or called in to this number during business hours Monday thru Friday – meaning not, “pick a day Monday thru Friday” but rather, “each day Monday thru Friday” – it tends to annoy me because it seems to me unprofessional.

Unprofessional, and I should add, extremely narrow-minded, as if we were the only ones to have provided any service to the patient when in fact we’re a small part of their Illness du jour Adventure.

Let’s take a very simple call: EMS is called to a nursing home for an elderly female, injury from a fall. The medics find that the patient became lightheaded on exertion and had a syncopal episode. They find junky lung sounds bilaterally but their heart monitor shows no acute processes. The patient states she’s been having trouble breathing “because of a cold”. Her O2 sats are in the mid to high 80’s. The lead suspects O2 deprivation secondary to pneumonia as the primary cause of the patient’s syncope. Due to the unwitnessed fall they err to caution and board and collar the patient even though there are no complaints of head, neck, or back pain.

(BTW, I was going to use either sockpuppet.gif or clown.gif, but, like Ray in Ghostbusters, chose something that could never, ever hurt us…)

So, EMS (0) (0) gets on scene and brings her to the ED nurse (0) who calls in the lab tech (0) to get blood to send to the lab (0). Portable x-ray is taken (0) of the patient’s chest due to the pneumonia. The doc (0) orders a CT (0) to check her head, or perhaps even an MRI (0) to which the transporter (0) takes the patient. No traumatic injuries are noted, and a diagnosis of pneumonia is confirmed. The decision is made to treat with IV antibiotics for a day or so, and to observe. The patient is transported (0) to the floor where the floor charge nurse (0) takes ultimate charge of care. The day nurse (0) for this patient might have a tech (0) hang her bag and monitor the IV pump. Nutrition services will bring the patient lunch (0) and dinner (0). The night nurse (0) and night tech (0) will continue care. The same doc or perhaps a different doc (0) will examine the patient next day, declare her on the way to recovery and ready for discharge back to the nursing home. Our team arrives (0) (0) and transports the patient from the hospital.

I left out a lot of marshmallow sailors doing a lot of necessary jobs, and doing them well, but you get the point. It annoys hell out of me to have a partner say, “Hey, you remember that pneumonia we took out of Major Hospital? We didn’t get a letter. I thought we were really nice. Some people, huh?”


So, yeah – from now on DTs’ name does not go in the hat. Instead, let me see the letter (they do that anyway) and find out what it is, specifically, the patient remembered and liked enough to take the trouble to write. I’ll try and do that more often. If one month every patient was well enough served to make a recommendation, then perhaps I’ll take that $20.


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