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 reprint the series in its entirety.
What do people expect when they call 9-1-1? ER and Third Watch provide the public with a Hollywood view of EMS. Even reality shows like Paramedics are prettied up for TV. Real life can be mundane, graphic, gross or have an unhappy ending. It’s a given that the public has unrealistic expectations. We need to help people understand what we do.
Most of the time we address the following on scene: “What took you so long? Why aren’t you transporting now? What are you doing? Why are you asking me all these questions?” When people ask such questions, it means they have certain expectations that are not being met. They have no clue about all the issues we have in mind. Do your best to explain what you are doing and why. Put yourself in an anxious situation and your expectations could get quite high. I’m not suggesting we lower public expectations, but that we educate our customers in a respectful way using terms they can understand.
Looking and acting professional is a vital element to creating a positive impression of you and your agency. This is important for making your patients feel comfortable about your ability to care for them.
Since you deal with virtually every level of society, your personal grooming and appearance should be what is normally accepted as average.
Always be neat, clean and freshly shaved, and avoid strong perfumes or colognes. Some people could be allergic or uncomfortable trapped with you in the back of your ambulance.
If it’s OK for male bank tellers and lawyers to wear earrings, it’s probably OK for anyone. However, keep in mind that your patients may judge you on your personal choices. Many older patients came of age in a time when these things were “strange” or “weird.” I’m not saying you should avoid any expressions of individuality, but be aware that it could affect a patient’s acceptance of you. When treating a patient who you feel might be judging you, go out of your way to show them that you are a thoughtful, competent professional. Instead of getting your back up if a patient doesn’t like your pierced tongue, take the opportunity to show them that people with pierced tongues are friendly and nice. Smile and be proud of who you are.
The condition of your ambulance is what everyone in your coverage area sees the most. People respect neatness and cleanliness and look down on what is shabby and unkempt.
Dents or damage to your ambulance should be fixed in a timely manner. The repair process begins with telling someone that there is a dent. Nothing frustrates supervisors more than realizing a problem has existed for weeks and no one told them.
The same applies to the inside. Sit on your cot and look around. What do you see? It goes without saying that dirt and patient DNA left on the inside of the rig creates a bad impression and is a health hazard to you and your patients.
Always wear a clean, crisp uniform. Your desire for individual expression in clothing should be limited to your underwear. If everyone in your agency always looks the same, it will impart a “brand-name,” professional image. Leave shirts or hats with non-agency logos at home.
Wear your ID tag with the picture facing out, preferably on your shoulder or upper chest, so people can read it easily when talking to you. Wearing your tag makes everyone’s job easier. On a hot call, it enables anyone who doesn’t know your name to get your attention. If you don’t like your name tag for some reason, such as the photo, get a new one that you can be happy with. Everyone wants to know whom they are dealing with, so help them out and wear your name proudly.
Dispatch is obviously an integral part of the EMS system. Communicating consistently and clearly, even when the system is slow, keeps everyone primed for action.
Your dispatch style should be consistent and clear so crews can get used to you and be able to follow your thinking. Little things like cutting yourself out will frustrate your crews. Find a middle-speed speaking voice and modulate your voice to highlight important information. Too fast and information will be lost; too slow and we’ll all be bored! Deliver the same information in the same order so the crew will know what comes next. Try to anticipate important information a crew might request in a special situation, e.g., a contact agency, phone number or individual.
When taking calls, be friendly and helpful. Resist the urge to yell or be short with an upset caller. If they are not giving you the information you need to dispatch the call, don’t threaten them with “If you can’t tell me, I can’t help you.” They may look for someone else who can. Realize that most people don’t have to deal with emergencies every day. Help them help you. Explain as clearly as you can: “I want to help you, but I need some more information. Is there anyone else who can give it?”
Focusing the caller on specific details may help them slow down when their minds are moving too fast. Ask, “Is the patient breathing?” and if they say “I don’t know!” direct them to look at the patient’s chest. Is it going up and down?
If you are responsible for dispersing your units, try to be compassionate about their needs for food or personal errands. Maybe they’ll bring you a double French vanilla latte cappuccino once in a while. Try to rotate crews out of disliked coverage areas so one unit doesn’t get stuck there all the time. By fostering a team effort, calls will get out better and patients will be better served. Be fair! If you play favorites with a crew, you will quickly alienate the other crews.
It’s easy to think that all dispatch has to do is sit in a chair and rouse themselves when a call comes. The crews have to read maps, drive, treat the patient, carry them down stairs and face the possibility of getting vomited on every day. We may not realize how difficult the CAD can be to operate and how dispatchers may be performing multiple tasks that we may not be aware of. The phone constantly rings in dispatch!
One of the things that annoys dispatchers the most is repeating information they have already given. Keep a pad by the radio to write down information. For them to change screens can be difficult if they are trying to enter information or work on another call. If you do need something from them, don’t forget to thank them.
Try to keep a neutral voice on the radio. It is bad for everyone’s morale to hear the dismal, “I’m so disappointed” voice over the radio. The dispatcher probably has a clue that you may not like the assignment you just received, but it is not their fault. Be professional.
The issues raised in this article are fairly universal. The common thread seems to be talking to others and explaining why things are happening as they are. Keep silent and others will make assumptions about you, usually not to your benefit.
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.