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Patient Care



   It's a beautiful morning in early fall, and you're beginning your suburban shift with seasoned medic Steph Trenhale. You head for a local diner, and you're still jabbering with your server when the tones go off for an elderly man not breathing. The two of you roll your eyes, sigh and head out the door. You're soon on your way to a residence on Minot Avenue, and you hear an engine responding from a distance.

   You know the plain stucco house at that address, so you don't bother to map it. But approaching Third Avenue, you're in the process of clearing the intersection for Steph when you realize she's not slowing down. In fact, she accelerates to 45 miles per hour and busts the opposing red light without so much as a glance for cross-traffic. A mild gutter spans the intersection, and you feel the rear suspension bottom and bounce.

   Your agency's policy is pretty clear: Stop at opposing signals, then proceed with caution. It's a good rule, and you're wondering if you should say something when Steph blows the signal at Fourth as well. Fortunately, traffic is light, and you're soon focused on Brett Haney, a 58-year-old guy you've met before. Brett's breathing just fine, but he's unresponsive enough to tolerate an NPA, and you know him to be an insulin-dependent diabetic with lots of problems. Sure enough, he's soon responding like he always does. You're pretty sure he'll sign AMA if you just wait a few minutes.

   Brett's wife is a doll, and she offers you a cup of tea. You decline politely and counsel the couple to please see Brett's physician as soon as possible. You even offer to make the call for them, but Brett ain't havin' it. You pay your respects and stow your gear. You're wondering how to broach the subject of your partner's driving.

Q. This is really uncomfortable. I'm in no position to tell Steph how to drive. She has more than three times my experience, and I'm not her boss. If I involve a supervisor, she'll get in trouble and everybody will know I ratted on her. So what do I do?

   A. I definitely wouldn't go right to a supervisor. If Steph's driving worries you, chances are it worries someone else too, only they haven't given her the honest feedback she has earned. None of us is perfect. We all need reminders from time to time. What would you want if you were in her boots? I think you'd be doing her a favor by telling her what you think.

Q. What's a good way to do that exactly? I can't just tell her that in my expert opinion her driving sucks. And she's surely not going to be impressed because I know what it says on page 42 of the policy manual.

   A. Sometimes the best way to start this kind of discussion is simply and honestly. Sit down with Steph as soon as you can and look her in the eye. Tell her you realize she's been operating emergency vehicles a lot longer than you have, but that her driving scares you. See how she takes that. If she doesn't apologize and modify her practices on the very next call, you can take stronger measures. If she does, you've given her the respect she deserves, and you've probably made life safer for her and the next person she works with (not to mention the public and all those patients in the interim).

Q. What if she blows me off, or says she'll slow down and doesn't?

   A. If you don't feel safe on the very next call, get out of the ambulance. Demand your right to be safe. And make no mistake, it is your right. The fact that you're nice enough to spend your life helping people doesn't mean you don't deserve to come home safe to the ones who love you, shift after shift and year after year. If necessary, get on the air and ask to have a supervisor meet you at your next destination.

Q. I'm still worried about the whole idea of running to a supervisor. I'm going to have partners throughout my career. I don't need a reputation of being a snitch.

   A. If worst comes to worst, I think you may just need to cowboy up. The responsibility for this doesn't just belong to your boss.

   It's yours, too.

   Thom Dick has been involved in EMS for 40 years, 23 of them as a full-time EMT and paramedic in San Diego County. He is the quality care coordinator for Platte Valley Ambulance Service, a community-owned, hospital-based 9-1-1 provider in Brighton, CO. Thom is also a member of EMS World Magazine's editorial advisory board. E-mail

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