EMS Reruns is an advice column designed to address dilemmas you may have experienced in EMS that you did not know how to handle. But it offers you a luxury you don’t have on scene: plenty of time to think. If you think of an example like the one that follows, send it to us. If we choose to publish your dilemma, we’ll pay you $50. We don’t know everything, but we do know a lot of smart people. If we need to, we’ll contact just the right experts and share their advice with you. Send ideas c/o firstname.lastname@example.org.
You pull up to the curb in front of your partner’s house and, as usual, he’s on his way out through the front door before you can take the thing out of gear. Bill gets in and offers you his usual friendly insult. You head for the Jitter Bean, your favorite coffee dive. On your way, you hear your medic unit respond for a Martha call (as in Martha, Martha, wake up!) at Third and Palomar, less than two miles from your location. Your routine for years has been to stop for coffee, then arrive 30 minutes early so the off-going crew doesn’t get stuck on a late call—especially if they’ve been up all night. Shift change is an hour away. You suspect there will be no resuscitation; that would put the crew back at the station in plenty of time. But you take the scanner in with you just in case, and order two coffees in ceramic cups.
The crew is on scene for more than 20 minutes, so you anticipate a transport. You finish the coffee and head for the local community hospital, and pretty soon they arrive with a CPR-in-progress. You hand your car keys to the other crew, and proceed to clean and restock the ambulance.
The rig is trashed—still dirty from yesterday morning’s rainstorm, trash containers overflowing with fast-food cups and IV bag containers. The M-tank is down to 300 and there’s less than half a tank of fuel. There are only four charts in the clipboard, so they should have had plenty of time to clean up. But the crew is Larry and Sheila, and you’ve been through this before. You’re cranky. You left them a clean unit, just like you always do. Everybody consistently shows up early for them, but they never return the favor, and they would never think of meeting you at the hospital. You’ve personally confronted them about this more than once. A glance from Bill reminds you, it’s your turn again.
How do you fix a crew who consistently won’t take care of their equipment?
You may not be able to. But if that’s possible, you have already done two things right. The first is to continue to set an example for them. Of course, that means you end up doing all the work. But fuel and oxygen are essentials; if you don’t continue to keep those stocked, that’s not fair to the public. The second thing you did right was to talk directly to them about it before you involved any bosses.
What’s your next move?
Ask them politely how their shift was, and listen to what they say. Although they appear to have had an easy shift and they do have a reputation for being a couple of worthless slugs, it’s possible they’ve run a lot more than four calls. There may be a stack of charts at the station, for instance. Or, if they were up all night, it’s possible they haven’t had time to finish their charting. You could end up looking pretty stupid, in either case.
When you ask the crew how their shift was, Larry shrugs and doesn’t answer. Sheila says they had five calls. You confront them about the condition of the ambulance, and they both act really angry. Sheila tells you to mind your own business, and Larry flips you off.
That wasn’t very nice. OK, now what?
Hmm, those were fair questions—and you deserved answers. Hope those calls weren’t all during the night. Otherwise, you may be dealing with a couple of sleepy brains, and you can expect to see some irritability. Of course, that doesn’t excuse the condition of the ambulance. Lots of busy crews manage to keep their equipment spotless and fully stocked, day after day. But when you’re trying to change the way people act, it doesn’t help to trigger their pack behaviors. A good rule is to offer them a form of respect you would expect to receive for yourself, specifically: praise in public, criticize in private. True, disrespect is the very thing you’re upset about in the first place. But trust me. This simple principle really works. With one exception (described as follows), you will feel like kicking yourself every time you forget it.
OK, so criticize in private. But what if that still doesn’t work?
Then it’s time to invoke some help from your superiors. Give them something to work with by providing them with facts (dates, times, places) instead of sentiments, so it doesn’t sound like you’re just whining. Talk to them when you’re not angry, to avoid saying something you don’t mean. Tell them you’ve already confronted the offenders in person, to no avail. And suggest they stop by for a visit at crew change a couple of times, so they can make their own observations.
We’ve tried that, but nothing ever seems to get done.
Frustrating, isn’t it? I feel your pain. The reason for this article is that, although we get to work with some of the finest people in the world, we do have to put up with a few who don’t realize how much fun they’re having. So, after you have honestly tried everything else on this list, ignore that whole business about private criticism and resort to peer pressure. Post a copy of this article on your station’s bulletin board, fill in the blanks below, and attach signatures from everyone else who works at your station. Then, send a copy to your boss, both as a reminder and as a legitimate form of documentation.
To: ___________________. This article appeared on page 40 in the June 2005 issue of EMS Magazine. We the undersigned hereby suggest that it warrants your attention in particular.