“Samantha, can we go over to the picnic table and talk?”
Samantha is partially hidden by a huge stack of paperwork on her desk, a phone in one hand and a pen in the other. Obviously multitasking, but she now sits straight up, pauses for a moment, tosses her pen in the air, and declares with a smile, “Yup, let’s go!”
If you don’t have a “picnic table” at work, maybe you should get one like ours. Let me explain.
Whether firefighter, EMT, paramedic, or supervisor, we respond to some terrible calls. We sometimes have a “bad” call where it’s difficult to keep our emotions in check. High on that list for many of us are pediatric patients, but a bad call could be for someone of any age. Afterward, perhaps as you try to clean up the back of the ambulance, it hits you. For me, you can hear it in my voice—I struggle to get words out as there’s a lump in my throat and my vocal cords just seem to fail. Others might cry after closing the ambulance doors for some privacy. A tremble of the hands, fingers that perhaps don’t seem to grasp as they should. Sometimes this loss of fine muscle control happens during the call, other times after.
Now it’s after the call, maybe after the shift, and you’re bothered by what you went through or saw. From a formal point of view, the answer is critical incident stress management or whatever your department offers. Follow your standard operating procedures. But informal methods like the picnic table can help too.
Here’s how the picnic table works: Most EMS facilities seem to have one outside. It’s not required and need not be subject to any written procedure, but simply, if anyone says, “Can we go to the picnic table to talk?” you stop what you’re doing and head out to the table. No need to press about what’s going on; it’ll come out on its own as your colleague has a chance to unload.
Once there allow a little small talk. Be patient. It’s fine to be an active listener. “Can you tell me more about that?” is nonjudgmental and doesn’t derail the conversation. It’s also OK to ask, “What do you think is best to do next?” toward the end of the conversation, inviting your colleague to self-direct. You may be asked what you would do. Be patient and sincere, the answer will present itself. It’s a big compliment when someone comes to you for a picnic table chat—they trust you enough to ask.
Picnic table talks need not be limited to critical incidents. Sometimes people need to talk about something else bothering them. Maybe it’s a screwup on a call, an adverse patient safety event. We’ve all had calls where nothing seemed to go right. It can damage your confidence and execution or leak over to your partner or family. Allowing someone to talk about a problem will help them work it through. Maybe you’ve had the same situation in your past. Let them explore, and often they’ll already know the answer unconsciously.
CISM can offer wonderful support; by all means take advantage of all official avenues for assistance if you need it. But sometimes it’s awesome just to be able to talk about a problem with someone without it being on the record.
Dick Blanchet (ret)., BS, MBA, worked as a paramedic for Abbott EMS in St. Louis, Mo., and Illinois for more than 22 years. He was also a captain with Atlas Air for 22 years and an Air Force pilot for 22 years.
Samantha Greene has been a paramedic, field training officer, and operations supervisor for Abbott EMS of Illinois for the last 10 years and a lieutenant for the Madison, Ill., Fire Department for the last five.