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EMS: Anyone could do it; not everyone should

“EMS is a privilege that has been entrusted to you for safekeeping”

Trust is vital in EMS: the trust of your patients, their families, your coworkers, your superiors, your partner and your public safety partners.

During my career in EMS, I have met many competent and inspiring professionals who have good self-awareness and knowledge of why they are in EMS and what drives them to continue in this field. They have a passion for medicine and for providing the best possible care to their patients.

Conversely, I have also met many that seem to have not taken the time to evaluate why they are actually in this field, or have forgotten why they originally started in EMS. Understanding the importance of empathetic care, and recognizing that serving in this field is both a privilege and a responsibility is a good starting point in self-evaluation.

Importance of empathy

“It’s their emergency.” You will likely hear this phrase over and over again. In my career, I have had to deal with some true life-or-death situations in which immediate action is required, but the majority of the calls we run are going to be routine ... as much as EMS can be routine.

As far as true emergencies go, the most important thing is the medical care that we provide, right? How important is it, really, to take a few seconds during preparing for intubation, transport or next steps, to explain to the family what is happening? Or to take the time to tell the patient that you’re working to get them feeling better and are going to do everything you can for them? Or to show just a little bit of understanding that this is a difficult situation for them?

Are you going to be the crew that didn’t take the time to make sure someone explained what’s happening? It doesn’t even have to be you that explains the situation. Have a firefighter or law enforcement officer talk to the family. Most of them have been around. They know the score. How would you feel lying there, seriously ill or actively dying, without one word or act of kindness or understanding? How would you feel having to watch a loved one experiencing an emergency with strangers performing what are likely strange and invasive diagnostics and interventions without anyone explaining what’s happening?

Have empathy.

Now I understand there are a few situations where skills, diagnostics and interventions take precedence. But it should always be in the back of your mind that simple gestures can mean the world to someone. Let that family member kiss the patient goodbye; take the time to find that jacket, blanket or bag for your patient. As long as it’s not a safety issue, hold your patient’s hand for a moment. Small actions that convey a little compassion can go a long way.

For less urgent calls, think of them more in terms of situations unable to be mitigated by the patient’s current knowledge or resources. They may not be “emergencies” as we think of emergencies. Sure, some of these less acute patients could find more appropriate alternatives than 911. Some of them will have had someone call on their behalf, whether the patient wants us or not; some will be frequent callers.

These are the calls when finding empathy will be more difficult. It’s easy to be empathetic with the legitimately sick patient that truly needs us. It’s much harder to be empathetic with the patient that we get called out for for the 15th or 20th time. You will get frustrated. You will get impatient. You will get irritated. But ... this is the job you signed up for. This is all part of it. If you can’t say anything nice, say as little as you can and let your partner do the talking.

Practice paying attention to people’s reactions, body language and speech/inflection. Learn to read a room and know your audience. Try to be sensitive to the situations you’re in. It’s easy to get caught up in talking to your partner/crew the way you normally do, but remember someone is almost always watching us, and try to be sensitive to that. Speak up and redirect the conversation if it’s needed. There is a time and place for humor, but sometimes it’s the wrong time and place. Know that even when there are things that need to be said, there are right and wrong ways to say them. Be discreet and discerning.

Ultimately, try to keep the situation, the patient, and the patient’s family in mind, and try to see things from their perspective, whether you understand it or not.

Responsibility and privilege

For those of you who think EMS is just a job; it isn’t ... or shouldn’t be. EMS is a privilege. You worked hard for the patch on your shoulder. That was just the beginning. You are going to have to work even harder to keep it there.

EMS is a privilege. It is a privilege of trust. You are the one who goes into peoples’ homes. You are the one who handles their belongings. More importantly, you are the one entrusted with their lives, their wellbeing, their fears, and those of their families. Trust is vital in EMS. Not only the trust of your patient and their family, but also of your coworkers, your superiors, your partner, your firefighters, your law enforcement officers. Trust is essential in EMS.

EMS is a privilege. You see the deepest beauty of life, of hope, of humanity; more than most people will ever experience. But to be entrusted with this privilege, you must also witness the pain, the sorrow, the tragedy. You are the one who needs to stay calm when everyone else is panicking. You are the one who must tell the family that their loved one has passed. You are the one who must witness the most grotesque scenes, and still walk in and help those you can. You are the one that your family calls for every emergency. You are the one who must stay focused and able to do the job when everyone else is breaking down.

EMS is a privilege. You have the privilege of teaching new people. You have the privilege of learning from them as they learn from you, and of watching them grow and develop into the next generation of healthcare providers. When you have a student, a rookie or someone asking you questions, it is your responsibility to take the time to help them learn. Don’t let your students sit in a corner all day and only talk to them when you run a call. Review things with them. Teach them. Let them tell you what they know. They are the future of EMS. You have a responsibility to them. Don’t ignore it.

EMS is a privilege that has been entrusted to you for safekeeping. It is up to you to keep that trust, and to continue to have the privilege of wearing the patch you have earned.

Why are you here?

Some people have the desire to do this job, to “help people”, but lack the ability to work well with others, or are unable to cope with the effects of the job, or can’t quite manage to effectively run a call well for one reason or another. It’s difficult to make an accurate evaluation of our own ability to perform effectively and whether or not this is the correct career choice for us. But it’s something we should seriously consider and be honest with ourselves about.

Anyone could do this job. Study the medicine, learn the skills, read the diagnostics, put them all together and obtain a clinical picture. Not everyone can do it well. And if you can’t take the time to find the humanity to express a little compassion, try to find a little understanding, and try to make life a little less miserable for the people we encounter, why are you here?


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Gaining patients’ confidence can be achieved by deliberate actions, like connecting with caregivers, as well as small subtleties, like body language and facial expressions

This article, originally published in August 2022, has been updated.

Tamara, a nationally registered paramedic, has been involved in emergency services for over 13 years, with both EMS and fire. She is a senior medic and clinical preceptor in a busy EMS system in central Texas, as well as spending her off days at a local emergency room. In addition to years of experience, she has extensive training in leadership, and command structure/incident control, and holds multiple certifications for both EMS and fire.