Early in my career I truly believed that everything was my responsibility, and without me the outcome of the emergency would be compromised. My incessant worrying about every aspect of the response: apparatus placement, crowd control, hazardous materials mitigation, the weather, the press and anything I could think of, was crippling my effectiveness as an EMT.
I even took my insecurities to the ER and when transferring care to the ER staff would obsess about every detail, giving a report full of unnecessary findings. Knowledge is useful, and gathering all of the information available is always a good idea. There is, however, a limit to what is needed for a good report. Passing the vital ingredients to the patient’s ultimate outcome on to the next person in the continuum of care is best done clearly and concisely.
Tension on the scene of an emergency or in the ER is nothing new in the emergency responder’s world. It seems everybody thinks that they are the ultimate authority. There is little I dislike more than arguing with a person from a different agency on an emergency scene or at the triage desk. I have finally found an answer to my problem of over-informing or over-controlling.
Do your job, and be excellent at it
Everybody has limits. As an EMT, I knew better than to confront an out-of-control person. I did not break up fights. I seldom ran into burning buildings. I never cracked a person’s chest. What I did do was to act within my scope of practice, following state protocols most of the time, thinking on my feet the rest.
Sometimes it’s those unexpected, unscripted moments when you need to act, and act quickly that define you as a first responder. Most of the time adherence to established practice is prudent. Knowing exactly what you are capable of helps when time to analyze a situation does not exist. Instinct is wonderful, but will not help if you have no idea how to accomplish what needs to be done. Wasting precious time on scene wrangling in your mind what you should, would or can do need not be your standard operating procedure.
Things you have to do as an EMT
- Be aware of scene safety.
- Assess and treat patients.
- Transport patients to appropriate facilities.
These three things seem so simple, yet somehow we manage to get caught up in awkward situations with fellow responders. Overbearing fire department paramedics are seldom shy about voicing their opinions concerning patient care. Police officers would rather not wait eight hours at the emergency room for their intoxicated driver with a seemingly minor head injury to be cleared. Even patients sometimes feel the need to take control.
By performing your job, and doing it well, everybody wins. There is no shame in delegation. Let the police handle the crowd. Allow the firefighters to stop the leaks, stabilize the vehicles or establish a safe zone. Give the patients as much control over their lives, injuries and conditions as prudent. Firmly inform the police that their prisoner needs to be taken to the ER for an evaluation, and briefly explain why.
Just make certain that you are capable of doing the job of the medic in such a fashion that everybody on scene is comfortable delegating the most important element to the scene to you. The patient is the reason for all of us being there, and the patient is ultimately EMS’ responsibility. By acting in a calm, professional and confident manner everything will fall into place.
Confidence is contagious
A confident medic has the ability to control the emergency scene far better that the arrogant medic. Emergencies have a tendency to increase a responder’s adrenaline level, and their actions often are a result of their emotional reaction to the emergency rather than a rational reaction to the scene.
All emergency responders have one thing in common — the power of observation. Everybody is aware of what the other people are doing. We subconsciously judge our fellow responders, making mental notes for the next time. Focusing on what you know, and leaving the rest to what other people know relieves stress, improves patient care and sets the stage for future well run emergency scenes with the people we respond with. Establishing yourself as a go-to person takes a little time, but is never done by accident, or happenstance.
