Watch Your Ps and Qs

It's been a long day. Tracy has been working in the 9-1-1 system and running back-to-back calls since she arrived at work 10 hours ago. It seems half the calls have been for things she considers absolutely ridiculous. On one call Tracy says to a patient, "You mean to tell me you called an ambulance for that? You know, we're not a cab! I can't believe you called 9-1-1!"

As the words leave her mouth, a few fellow EMS providers witness the incident. There she is, the newly appointed field instructor, asked to work a busy shift and losing her cool. Two first responders chuckle when they hear her. One doesn't. In fact, that responder looks shocked at what Tracy says.

In a neighboring EMS system, Roger is preparing for his interview. He recently graduated from a local EMT program and is eager to land his first EMS job. He arrives at the EMS office and begins the interview process. As he is introduced to the interview team, his cell phone rings. The ring tone volume is set on high. The volume on the ringing phone is so loud, it drowns out the conversation in the room. Flustered, Roger curses out loud as he desperately reaches for his phone. When he looks up he notices a few of the interview team have concerned looks on their faces. A feeling of doom sets in.

Roger sits down, and the interview process begins. A member of the team introduces himself as the operations director. He has a quick question: "Roger, please tell us how you respond to stressful situations, including when something does not go the way you want it to. When you answer, please include an example." Roger feels a bead of sweat roll down the back of his neck, and his face turns bright red.

Dario has been involved in EMS for five years. He recently transitioned from being an EMT-Intermediate to a clinical coordinator for a hospital that works with several EMS agencies. He has just finished meeting with an EMS crew for a case review. It was identified that the crew had breached a protocol, and there was a potentially bad outcome. The crew members knew Dario from working with him on the street and accused him of being nitpicky after moving into his new role. There was immediate tension between Dario and the crew, and the meeting essentially ended with Dario saying, "I'll write this up and get back in touch with you. In the meantime, try to play by the rules, cowboys!"

The EMS crew had laughed and walked out of the room. Now Dario picks up his papers and notebook. He storms to the door, opens it very quickly and starts to make a beeline down the hall. As he turns the corner, he nearly collides with his supervisor and another person. "Dario," his supervisor says as Dario tries to regain his composure, "I'd like to introduce our new director." Dario stammers a greeting: "Uh, hi. Sorry about that. I just had a run-in with a crew. I'm sorry, what's your name?"

The above scenarios are based on events that have occurred in EMS. In all three cases the provider appeared to become flustered. One incident involved a patient. Another involved a negative first impression with a potential new employer. The final case involved interaction with fellow providers. Each scenario could have been avoided had the provider maintained a cooler and calmer demeanor. Basically this involves paying attention to details and minding one's manners--watching your Ps and Qs, as some put it.

Consider the following:

Manners: Even in the potentially uncontrolled world of EMS, the ability to use manners can be helpful. In the first scenario the provider appears to "lose it." The fact is that EMS personnel are often called to respond to a variety of cases. Not all cases may appear to us to be emergencies. Whatever an EMT may think of a call, patient care and professionalism must guide their behavior. In this case both appeared to have been overlooked.

Cursing: In the second scenario the interviewers' first impression of their applicant was ruined when Roger swore aloud while trying to turn off his phone. This did not go unnoticed. The first interview question referred to the incident that had occurred only seconds earlier. Roger did not answer the question very well. The interviewers noticed that too. Between Roger's reaction to the phone ringing and his subsequent stammering through the first question, the interview did not begin well.

Composure: Whether you work in the field or an office, it is important to maintain your composure. You might only have one opportunity to create a first impression. Consider the third scenario: Dario appeared to become stressed following his meeting with the crew. This was evident when he stormed out of the room and barreled down the hallway. Unfortunately he almost barreled over his bosses. While trying to recover from the blunder, he stammered his way through a half-hearted apology and introduction.

Presenting yourself: When working in EMS you may find yourself in situations that involve media coverage, bystander interactions and other sources of high-profile visibility. In addition to providing outstanding patient care and managing your scene successfully, it is also important to present yourself as a professional. This includes your attire, your attitude, and what you say and how you say it. Being aware of your actions might look, as well as who is watching, is important in portraying yourself and your organization in a positive light.

The ability of EMS providers to watch their Ps and Qs is key in both the field and the office. Even on days when things aren't going well, it is essential to be aware of how you are presenting yourself. Being aware of your surroundings and engaged in your situation can be invaluable.

Paul Murphy, MA, NREMT-P, is EMS field manager for The Medical Center of Aurora, Aurora, CO.