Give a Little; Get a Little

It was about the time I passed the 5-year mark in EMS when a paramedic friend of mine shared a remarkable story about a recent call he had been on. Oddly enough, it wasn’t the details of the call itself that made this particular event so noteworthy. In fact, it was a routine transfer of a nice little old lady—who he had actually moved several times prior to this—from an extended care facility, where she lived, over to the hospital.

The care facility was only a couple of miles from the hospital, so these earlier events were short hauls of just a few minutes duration. Prior to this call, all the previous runs had gone quite smoothly. Due to the short time window, there was just enough time to look over the transfer paperwork, get a set of vitals and breath sounds, before they arrived at the ED door. The hand-off reports had all gone smoothly, but today that was not the case.

The ED was really hopping, so the triage nurse had them transfer the patient to a bed in the hallway, and said she would be back shortly to take their hand-off report. As it turned out, it was close to 15 minutes before the triage nurse would be able to get back to them. With nothing to do and time to burn, my friend struck up a conversation with the patient. What he would hear over the next few minutes would shock him. He heard how this woman was the sole survivor of her family, as the Nazis had killed her husband and children. She managed to survive and came to America to try and rebuild her life with the one real skill she had—music. She did, in fact, manage to survive the nightmare of Nazi Germany and became an accomplished musician.

The woman had modest needs and was very generous with the money she earned, often sharing with others in need. Amazingly, she chose to give back to society, though society had taken the most valuable things in life from her—her family. The story got told, and the nurse returned. The hand-off report was given, and my friend put his rig back in service and headed back to quarters.

On his next shift he was surprised to hear that the little old lady from the previous shift had unexpectedly passed away. And, as he shared with me, had he not encountered the delay in the ED, this patient would have died and he would have known nothing whatsoever about her previous life or her remarkable will to survive. He told me at that very moment he made a promise to himself to do his best to never let that event repeat itself; i.e., the promise he made to himself that day was simple. Barring unforeseen circumstances, he would not run a call without asking something personal about his patient. In return, he would share a little personal something about himself. As I finished listening to his story, I made that very same promise to myself.

On the vast majority of calls, we are not in such a high-pressure environment that there is no opportunity to have a brief personal exchange. The simplest thing may dictate the topic you choose—your patient is wearing a baseball hat identifying him as a retired soldier; a unique, obviously hand crafted piece of jewelry hangs around your patient’s neck; a charm on a bracelet urges you to “Ask me about my grandkids.” Why not? Go ahead and ask.

The truth be known, we frequently encounter patients who we will, in fact, transfer many times from care facility to hospital, then from hospital back to the care facility. Once you have planted these personal seeds, you will be surprised how well and how quickly they grow. When you know a patient by their first name, and can connect with them about some personal element of their life, it improves your patient care relationship and the connections you cultivate with your patients. I would argue that it also helps change your medicine from the perspective of you providing care to a patient, to you working to provide care in harmony with a patient.

I do understand that when we see patients in dire straits, these social exchange opportunities are just not available. And then there are some patients with whom you would never choose to share any personal details whatsoever. That being said, I would argue that those patients are truly the exceptions rather than the norm, and for the rest of your patients making an effort to step outside the sterile world of medicine for just a brief moment can be a very positive experience and will serve to enrich your medical practice.

You just need to give a little, to get a little.

Until next month…

Mike Smith, BS, MICP, is director of clinical education and lead instructor for the Emergency Medical & Health Services program at Tacoma Community College in Tacoma, WA, and a member of the EMS World editorial advisory board.