EMS Revisited is an exclusive column that offers reprints of various columns and articles from our archives that are not currently available in electronic format. In the January 2003 issue of EMS Magazine (now EMS World Magazine) we began a year-long series on customer care in EMS. Here we will reprint the series in its entirety.
Driving in EMS can be both stressful and frustrating. How you approach this subject can have a wide-reaching and profound impact on your career and your daily functioning.
When driving around your coverage area, try to be a “friendly” driver. Recognize that people generally don’t like to follow an ambulance. They believe that you will be slow (less common in the era of turbo diesel), and they can’t see around you. Your solution: Let them pass. What is the best place for an aggressive driver—one foot off your bumper or a mile in front of you? An accident takes you out of service, costs your agency money, opens the door for lawsuits against you and your agency, and may go on your driving record.
By trying to be a cautious and casual driver, you will feel better and be safer, and will create a positive image for your agency. If you are not on a call, you are in no hurry. Make the road easier for those who are; don’t compete with them.
Code 3 Perils
Driving code three is not a license to thrill. Be careful. Drive in a manner consistent of “a reasonable person.” This could be an important legal point in an accident. If you are driving in an unreasonable manner, you will not be looked on favorably by other drivers or the courts. What is reasonable? If you can comfortably defend your actions with a clear conscience in a way that makes sense to most people, you are probably reasonable. (This is my opinion, not a legal position.) If you think driving 90 mph might sound bad in court, don’t do it.
Unfortunately, it is a fact that many drivers do not hear or see you coming. We view our job as getting to the scene “as quickly as possible.” That is true, but really means “as quickly as is safe.” Depending on the state in which you work, it may or may not be legal to break traffic laws.
There is certainly a good deal of courtesy given to our profession by the police, but when it comes to an accident, that may not matter. Hitting another driver is definitely bad customer service. You do not deserve extra privilege because you have an altruistic job. Turning on your lightbar to expedite getting to Dunkin Donuts, for example, will create a bad impression for anyone who sees it.
There are several things you can do to help other drivers:
- Keeping to the left side of your lane will make your moves more visible to the driver’s side mirror and telegraph your intention to pass on the left.
- Always stop at stop signs and red lights.
- Inching forward at stops will help other drivers understand your intention to drive through the intersection.
- Do not assume that other drivers will yield.
- Be cautious on blind corners and in high-density areas.
- Use your siren when needed; otherwise, turn it off. (Your agency protocol may vary.) Example: A suburban street at 3 a.m. has little traffic and many sleeping people. You can always turn off your lights as well.
- Change tones often. In today’s world, people tune out electronic noises almost as soon as they hear them.
- Don’t mercilessly tailgate someone who doesn’t notice your cacophony three feet off their bumper. Just imagine going to that driver’s funeral and explaining to his/her kids how the accident happened.
- Wave thanks when someone goes out of his/her way to yield.
- Do not, under any circumstances, curse, yell or make obscene gestures.
- If you use your PA system, say “please” and “thank you.”
Improving Response Time, Safely
It is well known that patients rate response time as one of the most important elements of their calling 9-1-1. This is due to perception. In an emergency, with one’s adrenaline pumping, time expands greatly. Five minutes seem like 20. We also know that in the majority of our calls, response time has little effect on patient outcome. Therefore, we are torn between providing good service to our patient by getting there quickly, and providing service to other drivers by being safe. How do we do that? One way is to reduce time spent not driving. If you take off your shoes, put your feet up, unbutton your shirt, unbuckle your belt and have your lunch on your lap, I guarantee it will take you a minimum of 1–2 minutes to get going. Have the discipline to be ready at all times. Don’t separate yourself from your ambulance. Posting in ambulances helps reduce response time, as the crews are already on board ready to go. Take personal responsibility to avoid involvement with anything you can’t walk away from, like a sitdown meal. If you are fluent with your maps and coverage area, you will locate the call quickly and get there by the best route.
Once your patient is on board is when your driving skills can really shine. Greatly increase your starting and stopping distances to give a smooth ride. It is disconcerting for the patient to constantly have to brace themselves through normal stops, starts and turns. It also makes life more difficult for your partner, who is trying to work. If your driving seems ridiculously conservative, you are probably doing it right.
Paramedic and nurse Chris Hendricks has been in EMS since 1994 when he joined the Ortley Beach First Aid Squad. When he authored this article, he was a field instructor with Pridemark Paramedics Services in Boulder, CO. He now works as a paramedic and ER nurse, and serves with the Wyoming Air National Guard as a flight nurse. He will be receiving his Masters of Science in Nursing Education in summer 2011 and is a certified emergency nurse and a certified forensic nurse.