In the course of my travels around the country speaking to hundreds of EMS providers at conferences, meetings and private education sessions, I get to meet and chat with a wide range of people.
It’s always uplifting for me to see just how committed so many EMS providers are. Especially in a time when the world is changing faster than we can keep up with it, it is encouraging to see and talk with, and in some cases help, providers who are consistently striving to be on the leading edge of quality and compassion.
It’s also a great way to check the pulse of the industry by considering the questions I am asked by participants. Often the question can be far more illuminating than any answer I can give.
Some are funny, some are serious, but most all of them point to shared issues - and some misunderstandings - among EMS providers. I’m providing a sampling below, a top five list of actual questions I’ve received that have particular relevance to the careers of EMS providers - particularly those who wish to keep their jobs.
1. If the patient referred to “the Big Butt Lady,” why shouldn’t I refer to “the Big Butt Lady” in my report?
Well, let’s see…while it may be true that the person to whom the patient is referring has a larger Gluteus Maximus than others, conventional wisdom and common sense dictate that “the Big Butt Lady” will never look professional or appropriate when projected on the giant screen in a court of law.
First and foremost, EMS providers are supposed to be professional. A key measure of professionalism is maintaining a certain degree of decorum when it comes to…EVERYTHING!
Characterizing a person as “the Big Butt Lady” in a patient care report may be funny (and, OK, it kind of is), nevertheless, it does nothing to advance the narrative and it does even less to engender trust and credibility in you.
Simply put, it does not belong.
2. If a regular person can take pictures on scene and post them online, why can’t I?
Hopefully by now, this doesn’t represent a common confusion. Of course, we’ve seen far too many providers burned by social media and posting scene pictures to even consider taking chances.
But here’s a simple answer: It’s because EMS providers are not regular people!
Nevermind the fact that it requires a particular kind of lunacy to even want to be in EMS; EMS providers, by their very nature are held to a much higher standard than “regular” people, both ethically and legally.
The ethics of EMS demand a significant degree of respect and dignity for every situation we face, no matter how “unbelievable” or “totally cool” it may be. The law of EMS, from the Federal level all the way down to local agency policies, requires the strictest confidentiality for every patient.
In fact, many of the rules and laws governing confidentiality among EMS providers have arisen from providers who captured gruesome or humiliating images on scene and published or posted them only to have patients or family members see them.
3. If the cops don’t want “the guy” transported, who am I to tell them no?
Who are you? You are the person who is responsible for the care and treatment of the patient; that’s who you are. You are the one who will be held responsible when something (bad) happens to the patient. Think of yourself as the parent in the situation and you are supposed to know better than the baby sitter (police).
The simplest rule of thumb is this: There is no “guy,” only a patient; and a patient is a patient is a patient is a patient. It does not matter where or how you find them; what matters is that you exercise every last measure of due diligence for every single patient without exception. Period.
4. So, are you saying I can lose my license for something that may have happened off-duty?
Yes. That is exactly what I am saying. In most states, as it is in California, the agency or authority that regulates EMS likewise regulates the conduct of its providers 24/7/365.
Off-duty allegations of DUI, domestic violence, drug use, or anything else can and likely will be investigated by the licensing authority and action can and likely will be taken against your license regardless of the outcome in criminal court.
This year in California, for example, the State EMS Authority levied a $2,500 fine against a client after the original charges were dismissed in criminal court. My client was left with the choice of paying the fine or having an administrative trial for revocation on the original charges…hardly a choice, right?
Think of it like this: EMS providers are held to a higher standard — on duty and off — because that’s what we invite when we accept the responsibility of other people’s lives.
5. Can I really be held liable for what my partner does?
Yes. Yes! A thousand times YES! I get this question every single time I lecture. It seems that no matter how many times I say it, some providers just don’t seem to grasp the concept that EMS is a team sport and the players win and lose with the team.
Each provider can be held to the standard of every other equally trained and licensed provider on scene. That is, every EMT can share responsibility with every other EMT.
Every paramedic can share responsibility with every other EMT and paramedic on the scene. Every paramedic supervisor can share responsibility with every EMT and paramedic on the scene. Get it?
If you see a mistake or you know or should know that that a particular provider is deficient and you do and say nothing about it, then you can be held liable for the mistakes that provider makes on a call with you.
Worse yet, if you are a supervisor or a training officer and you are aware of a deficiency that is not corrected, you can share liability even if you are not on the call. In one jury verdict in Louisiana, that failure cost one agency $117M.
I challenge every EMS provider in the country to act on one question: Do I truly want to provide the best — and only the best — patient care there is to offer?
If the answer is “yes,” then go forward and leave your own mark on EMS. If your answer is “no,” I thank you for playing, but ask that you kindly step aside.
Otherwise, stay safe, do good, and have fun…but not too much.
