Have you ever been a patient in an ambulance, before or after becoming an EMS provider? Have you witnessed a loved one become a patient? How did it alter your perception of patient care? EMS World’s newest series, “The Patient-Provider Experience,” shares the stories of both patients and providers who have been impacted by their respective experiences with EMS—on or off the cot—and how these experiences changed the way they provide care.
Back when I was a fairly new paramedic, I had bad seasonal allergies. I went to an allergist and he prescribed allergy desensitization shots. I did the first few at his office, but it was a pain to get there and parking was expensive. After a couple of visits, I asked him whether I might be able to administer myself the shots at the fire station since we had ALS personnel and equipment (more than he had in his office) in case anything went wrong. He agreed and gave me the allergen serum to store and take at the station.
I administered myself my weekly shots for a number of weeks without a problem. One nice day, everyone was sitting out on the back patio cooking up some lunch on the grill. I went inside and administered myself my usual allergy shot. I must have hit a venule rather than the subcutaneous tissue because a few minutes later, I started feeling somewhat funny—a bit lightheaded. I went into the bathroom and looked in the mirror. It was clear to me that I was having a reaction to the allergy shot. My skin was pale (as white as milk, actually). I headed back to sit down in the dayroom. At that moment, another paramedic, Eric, came back into the dayroom from the patio. He took a look at me and asked whether I was alright. "I don't feel so well," I said as I slumped to the floor. Eric yelled to the rest of the shift to come back to the dayroom immediately.
I remember feeling as if I were having an hour-long head rush. I could see everything that was going on, but it felt as if I were a spectator watching from over the shoulders of one of my shiftmates. I don't remember projectile vomiting all over the television, but I am assured by those on duty that day that I did. I remember being placed on the medic unit stretcher, but not the IV that Eric placed in my arm. I remember thinking, "So this is what the ceiling of my unit looks like." I also remember arriving in the emergency department at Suburban Hospital and the look of shock on the face of Ruth (one of the nurses there), as she leaned over the stretcher and exclaimed, "Oh my God, that's Erik!"
I stayed in the ED several hours. Although I kept insisting I was fine and could leave, Ruth countered that I couldn't because I was still pretty cyanotic, equating my skin color to my navy blue uniform shirt. Eventually, I was discharged with a Prednisone zip pack in care of my shiftmates who had transported me. When we got back to the station, Eric mentioned that he had come "this close to intubating me." Kindly, the rest of the crew had cleaned up the TV. It made for excellent firehouse ribbing for a while. To this day, there are still some old-timers who remember that event and share a laugh about it with me.
As a provider, being a patient gave me some interesting perspective on what it means to provide care. I learned (and re-learned) some valuable lessons that day:
First, even when your patient seems "out of it" and can't communicate well, they often can still see, hear, and understand what's going on. Take the time to explain what you're doing and why. As a paramedic, I knew what my shiftmates were doing, and I could anticipate certain things. But I know that a layperson might well have been scared by everything that was going on. Even if you don't know whether your patient can hear or understand you, speaking in a clear and reassuring voice will help calm your patient and assuage his or her fears. By extension, joking around and gallows humor will have a negative effect on the patient and the image you project of yourself and your agency.
Second, try to see your unit and the transports you provide from your patient's vantage point (you might even go for a ride on the stretcher). It's disorienting to travel backward and on your back. Bumps in the road, sudden swerves and stops, and high speeds are felt to a much greater degree than by providers who are sitting upright, seatbelted, and accustomed to this mode of travel. Is the unit clean (including the ceiling and back door)? It should be, because that's what your patient is going to see. My opportunity to be a patient gave me a much greater appreciation for how scary an ambulance ride can be for a patient.
Finally, teamwork and professionalism matter. Even as an experienced paramedic, I was comforted that the people who were taking care of me knew what they were doing and were working together as a team on my behalf. We do continuing education and we drill and practice so that we can perform when we need to—because the next call we run may be for one of our own or a family member as easily as it could be for a total stranger.
Erik S. Gaull, NREMT-P, CEM, is Director, Public Safety and Emergency Management Programs, Applied Research Associates, Inc.; Firefighter/Paramedic III, Cabin John Park (MD) Volunteer Fire Department.