My day in court: 3 lessons for EMS
What I learned about professionalism, advancing EMS and the importance of attention-to-detail in a PCR during my week at jury duty
A hazard of the job for healthcare providers is the walking diagnosis – seeing those around you and mentally noting and diagnosing that hacking cough, or even jugular distension. For editors, aside from cringing at poor grammar, our occupational hazard is seeing story ideas in everything we encounter. My phone notes are full of quickly typed ideas on how to relate my day-to-day to prehospital medicine, to public safety recruiting, to professional excellence.
I had the occasion to serve as a seated juror in a medical malpractice civil trial last week. And as we do what we do, I drew a few parallels and lessons that could certainly apply to EMS. Here are three lessons I learned from my day(s) in court.
1. Documentation is in the details
We’ve published numerous articles about how to compose a patient care report narrative and why the information contained is critical to the future care of the patient.
In the case I just heard, the main issue at stake was if the primary care physician deviated from the standard of care by not directing his patient to a higher level of care sooner. The expert witnesses testified that a simple question could have made a life-or-death difference had another symptom been reported earlier. Over the course of the trial, the lawyers debated the meaning of three little words – at length. Those words? “About a week,” used to describe the onset of the patient’s symptoms, centered in the paramedic’s PCR, blown up by the projector on three different screens around the courtroom.
Did he mean 5 days, as another witness testified, or did he mean one week? Did the physician who called 911 report the timeframe, or did the patient? What about where “about one week” was noted in reference to the symptoms? Did the timeframe refer to the more severe symptom the paramedic discovered with his on-site examination, or solely the seemingly innocuous “nausea and vomiting” originally reported to the office CMA?
The paramedic’s PCR was thorough and to the point, and he comported himself clearly and confidently in his testimony. His choice of wording did not affect the patient’s subsequent care, nor the eventual outcome. But it was striking how important a time estimation became in deciding a verdict that would greatly impact several people.
2. Explain yourself
Further, while we’re on the subject of occupational hazards, nothing was more cringeworthy to me than hearing a physician “expert witness” refer to EMS professionals’ role as nothing more than transporting patients to the hospital. The plaintiff’s lawyer, who came down on the side of “about a week” meaning a literal 7 days, continuously referred to the paramedic as an “EMS tech,” despite establishing his credibility by asking him to detail his rise through the ranks to lead paramedic. At one point, I’m almost positive I heard him call the paramedic an ENT.
These lawyers and expert witnesses were professionals, who expect the respect and diffidence their titles deserve. They were paid, and paid well (really well), to understand the intricacies of this patient’s care. One of them was an ED physician, who surely interacts with EMS on a daily basis. And yet, they were at a loss when it came to understanding the roles and the levels of practice involved in EMS.
When it comes to teaching people about EMS, educate far, and educate wide. But don’t forget to educate the ED doctors proverbially next door.
3. A little kindness goes a long way
As the judge put it, jury duty is our civic duty; it is a privilege not enjoyed by people in all parts of this world, but it can also be a burden.
While I am lucky enough to be able to work for a company that guarantees my position and my salary, and to make arrangements with family and friends to care for my children after school, I can’t say my mind wasn’t on my inbox while we were sequestered in the jury room while the lawyers consulted, just days before I was scheduled to fly out for EMS Today. And sitting around a table with 13 strangers you’re instructed not to talk to about the one thing bringing you together is more than a little awkward.
But the staff of bailiffs who were our constant companions as they escorted us through the maze-like Charleston courthouse did all they could to make our days a bit easier. They waited in the unusually brisk morning air to move the cones that reserved our parking spots. They kept our coffeepot full and our snack basket replenished. They gave us as much information as they were allowed to about how the days and week would proceed. All of this made us as comfortable as possible, but what made the biggest impact on our group was the way in which they performed their duties.
They were genuinely friendly and warm. One gentleman wore a snappy bow tie, color coordinated to his trim jacket. Green the first day. Lavender the next. When one of my fellow jurors commented, he noted the clothes make the man (and that he made the clothes look good). They held open doors, were quick with a quip, poked lighthearted fun and performed all of their duties with a smile. Before long, our group was comparing our morning commutes, joking about the bevy of presidential candidates descending on the city for a town hall, and pouring over the yearbooks one of our number brought in when he realized that he and another juror had attended elementary school together some 40 years ago.
The professional and friendly service made the whole experience so much better than we had anticipated, and allowed us to serve our purpose to the best of our ability.
I edited an article written by Page, Wolfberg & Wirth’s EMS attorney and founding partner, Steve Wirth, Esq., EMT-P, recently, in which he detailed the positive effects a smile can elicit, from pain relief to disarming a stressful patient encounter.
After my week in court, I can attest to the power of a smile. Though a bow tie can’t hurt.