You're approaching the ED entrance of a small community hospital with Jorge Lopez, a house painter with stomach ulcers who's been urping coffee grounds tonight. You've known Jorge for years; he's a quiet man with soft, sad eyes, who's a little high-strung, but who never complains. About the most he'll communicate about his GI pain is an occasional wince, and that never seems to be in response to your questions. He usually doesn't allow his family to call for an ambulance, because he has no insurance and he can't afford the bills. Tonight he's pale, weak and diaphoretic, and he can't stop vomiting.
Jorge has told you in the past that he's worried about his two kids, both in their late teens. Jorge is a chain-smoker who rolls his own smokes. His fingernails are stained from the tar in the butts, and you're pretty sure his habit has a lot to do with his history of ulcers.
Your newly assigned partner is Vince Nelson, a 22-year-old wannabe cop who seems to know a lot more about everything than he's old enough to have learned. Vince is affable enough, but sometimes you wish he would work a little more and talk a little less. The fact is, he's a gossip. He gossips all the time. In fact, sometimes he gossips about people he hasn't even met. You get a sense he just likes to hear himself talk.
You're still transporting when he pulls alongside an ambulance from a neighboring district and greets the crew, blabbering on through the driver's window, apparently forgetting the fact that you're both here with a patient who's growing increasingly more uncomfortable. Jorge meets your gaze for a moment and grimaces. You apologize.
You prompt Vince about movin' it along, and he does. In fact, that actually shuts him up. Three hours later, he's still not talking at shift change, and the two of you clean the entire rig without a word.
Q. This is a really uncomfortable situation. Vince is a nice guy and it's not my job to be his boss. He can talk to any old body, and I think that's a good thing in this business. But sometimes he just doesn't know when to shut up, and it gets on my nerves. What can I do?
A. Especially working 24s, we probably all do some things that irritate other people. Fortunately, none of us has to be perfect. Here's hoping this is an isolated example of what bothers you about one person, and you're not struggling with lots of things about lots of people. (That would be a different kind of problem, and it would be all yours.)
Q. I've noticed we all seem to gossip too much. I don't know why, but it's one of the things we do in our downtime. Is this something unique to our agency, or is it a concern for others as well?
A. You can visit just about any agency's day room, and if you spend more than 10 minutes with even just a few people, you're bound to hear somebody talking smack about somebody who's not there. Hospital providers seem to do the same thing. You can destroy people's careers (and their lives) by disseminating things about them that are simply nobody else's business. And strangely, even the nicest people can be some of the worst offenders.
Q. One of the things I've often wondered about is, exactly what is gossip? I mean, you get pretty close to people when you work 24-hour shifts with them. You have to talk about something, right? So, what's off-limits and what's not?
A. Maliciously lying, maybe, or breaching somebody's confidence. I think one trusty guideline is, if you find yourself wondering if you're gossiping, you probably are. Another is to ask yourself if they would be offended, walking in the door and hearing what you've just said about them.
Q. What if you find yourself surrounded by people who routinely gossip?
A. Gandhi had a solid strategy of non-violent non-participation. Simply don't participate in defamatory or judgmental conversations about other people. Remember, these folks are trained observers. They won't tolerate sermons, but they'll quickly recognize the kinds of things you simply don't discuss.
They're also thinkers—smart enough to realize that if you routinely don't gossip about others, then you routinely don't gossip about them, either.
That can change them. In fact, it can change whole organizations.
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 Magazine's editorial advisory board. Reach him at email@example.com.