Your Captain Speaking: Be a Duck

“Samantha, I overheard you talking with the new paramedic and her new EMT partner. Just before they answered a 9-1-1 call, you told them, ‘Be a duck.’ Can you explain to me what that means?”

This is what Samantha has told her students for years. If you’re a duck on a call, your patient, your partner, and you will all be confident in your skills and ability to deliver care, no matter the situation. “Be a duck” was the best advice I could ever have received in medic school.

The advice originally came from a wonderful medic instructor and former St. Louis battalion chief, Monroe Yancie. My explanation of it is that when you see a duck gliding across the water, they are smooth, calm, graceful, even effortless. What you don’t see is the alligator behind them and their little feet paddling as hard as they can underneath the water. They may be paddling 100 miles a minute, fighting to survive, but they look confident to your eye.

In any emergency, medical or trauma, no matter how chaotic the scene, if you can slow down, take a breath, and appear confident (because you are), then you can make it through. In turn this gives your patient the comfort and confidence they need to trust their life in your hands. If you’re all over the place and appear chaotic, it only makes the situation worse and may make your patient uncomfortable, questioning your ability to take care of them. 

On every call we project our body language to the patient, family, and bystanders. People are really good at reading body language. They read more as we speak. Are we displaying an easy, confident demeanor, or do we look frazzled and unsure of ourselves? In a crazy situation, it’s easy to get caught up in the moment and let panic spread. Maybe it’s a situation you’ve never seen or heard of before, or you’re unsure where to start.

Duck Skills

In the military I had the good fortune in basic training of having multiple people screaming at me to move faster, complete tasks without mistakes, multitask, and recall by memory a multitude of standing orders and historical facts. They were trying their best to rattle me. In the airplane simulator it was a steady firehose of problems little and big.

You don’t need to go into the military or aviation to learn to be a duck. Start by knowing your protocols and SOPs. Back when we used paper copies of paramedic SOPs, mine was highlighted, tabbed, and dog-eared. I studied it all the time and kept up with changes.

Practice scenarios. Read EMS World! Go to its website—there are many situations you may never have heard of presented right there. When you get on scene and see a similar presentation, you will be more confident in your decisions and actions.

Take courses all the time. Take them in person where available, take them online. That’s what I’ve been doing for years. Talk with your supervisors. What calls have been run lately? How did the crews handle them? Being prepared will help your confidence and reflect in your body language, words, and actions.

We’re not talking about putting on a false front. Others will see through that. Confident does not mean disinterested or removed. You can be caring and compassionate as well as projecting calm. You might imagine a bubble around yourself where things are under control and secure. Expand that bubble to include your partner, then your patient(s).

What do you do when things suddenly seem out of control? Once we were assigned to standby for a house fire. The fire department seemed to have things in hand. We were relaxed when suddenly a firefighter burst out of the front door carrying an infant in full arrest. We sprang to action. Minutes later, to our horror, a second firefighter emerged with a second infant in full arrest! Seen that before? You fall back on your training and practice. Every call starts the same, with the basics. Start at the top and move down your list one step at a time. Precious minutes can be lost while a crew flails ineffectively. If you’re paddling hard but staying calm, others will follow your lead.

Wind the Clock

There’s a longstanding expression in aviation: What’s the first thing you do in an emergency? “Wind the clock.” This means to take a moment, maintain aircraft control, analyze the situation, and then take proper action. This is the official answer for pilots of any airplane, big or small. It’s better to be slow in doing the correct procedure that fast in doing the wrong one.

“Dick, it makes me giggle, because all my students know what I mean when I tell them to be a duck. I’ve had medics come to me after calls and laugh, saying “I wasn’t a very good duck.” And that’s OK, because they learned something and reflected on being a better duck next time.

“I love this saying. I’ve even had medics quack at me on the radio. That can really confuse a dispatcher!”

Remind yourself to just be a duck on your next call.

Dick Blanchet, 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 is a paramedic and field training officer for the Illinois Department of Public Health Region IV Southwestern Illinois EMS system, a paramedic and FTO for Columbia (Ill.) EMS, and a paramedic in the St. Louis South City Hospital emergency department. She was recently recognized as a GMR Star of Life.