Oatmeal Cookies

My grandmother's name was Edna A Ball. For as long as I can remember she lived with us in our house in a small addition off of the back porch. She was a fixture in my life and provided me with many great memories.

In a family of Republicans she was a staunch FDR Democrat. She didn't argue politics with us, she simply told us we were wrong and that was that. As a strapping 18-year-old full of myself, one of the few people I truly feared was Gram. I knew she could whip my butt if she really wanted to. But she left the discipline to my parents and concentrated on her cooking and baking. She liked to help my mom with the Sunday meals. I still remember the Sunday noon meal waiting for us when we got home from church: Pot roast with brown potatoes, gravy, corn and rolls. Desert was usually pie of the chocolate or lemon variety.

But what she really did best was oatmeal chocolate chip cookies. She always had some stashed somewhere and they were awesome. I remember helping make them. Flour, sugar, water, eggs, shortening and cinnamon were all mixed with the chips and baked to perfection. It was a kid's dream come true. I used to think no one could bake her cookies like her. That is until I did. Yes, it's true. I bake oatmeal cookies just like Grams. The secret is the recipe off of the back of the Quaker oatmeal carton. Disappointing but true; Gram's recipe was available in every store in America. What I thought was magic as a 4-year-old was freedom as an 18-year-old. Now I could have her cookies anytime I wanted without pestering her all the time.

So why the long dissertation about cookies and Grandma's recipes? The point is this: anyone can do the same thing I did. Nestle does it all the time and makes a fortune at it. If all else fails, follow the recipe.

A recipe is no different than a protocol. A recipe is a list of ingredients and instructions that when followed result in good food. A protocol is a list of actions and instructions that when followed result in a good outcome. Now I know and you know there are no guarantees in life. Things can still get messed up even with a recipe or a protocol to follow. But we certainly stack the odds in our favor when we know what we are going to do, how to do it and when we are going to do it. We should view a protocol as a tool to simplify our job. It gives us freedom to act as well as a safety net for protection.

As I see it, protocols provide three distinct advantages:

First, a protocol defines our duty. In the most common or severe circumstances a protocol tells us what we are responsible for and gives us permission to act.

Second, a protocol decides our actions. It gives us clear steps to take to resolve certain situations. We can take these actions without fear of reprisal.

Third, a protocol defends our decisions. The framework provided by a protocol was built by our medical control doctors. They have empowered us to act in their names. As long as we neither exceed nor neglect the protocols we can defend ourselves and our actions based on the authority given to us by medical control.

A fourth and more subtle benefit is that a protocol allows us to emphasize or prioritize our assessment and skills. The hard part of EMS is figuring what is going on with our patients. Once we have an idea of what is going on we can initiate the correct protocol, and suddenly the whole team is on the same page. Our actions as a unit suddenly fall into place. The EMTs can carry out their assigned tasks knowing they are providing the appropriate initial care and paving the way for advanced care to proceed unhindered. The EMT-Is and medics are now free to concentrate on advanced skills and scene management. The whole process becomes more organized. In addition, when we are with an unfamiliar crew due to a normal crew member being ill or on vacation, the protocol gives us the framework to coordinate with each other even in new surroundings.