For nearly 20 years, I’ve worked in EMS at various levels. I’ve worked wrecks on the side of the interstate, carried patients out of tiny bedrooms, treated people in emergency departments, and flown some of the sickest patients of my career. In that time, I’ve watched our profession grow in incredible ways. We have better equipment, a pharmacy of medications and better science guiding our decisions.
But there’s something I’ve noticed over the years that bothers me more than almost anything else: we’ve become incredibly good at treating illness, yet sometimes forget to care for the people experiencing it.
|MORE: To practice compassion in EMS, do the small things well
A few weeks ago, my flight partner and I were called to transport a critically ill patient to a higher level of care. The ED staff at the sending facility had done a fantastic job caring for the patient, but they had reached the limits of what they could provide. EMS recognized the severity of the patient’s condition early, transported them to the ED, and hospital staff continued appropriate treatment while arranging transfer for definitive care. By the time we arrived, the patient was ready for transport. There wasn’t anything I would’ve changed medically. Easy, right?
After receiving a brief report at the nurses’ station, we walked into the larger “trauma bay” of the small ED. I immediately noticed the patient’s family huddled together in the corner. You could see everything they were feeling without them saying a word. They were scared and overwhelmed, trying to make sense of a situation they never imagined they’d find themselves in.
As I looked around the room, I realized the family had received very little attention. No one had introduced themselves or explained what was about to happen. They stood quietly in the corner, watching strangers prepare to take someone they loved out of the room. The patient had received excellent medical care, but in the process, an opportunity to care for the family had been missed.
For as long as I can remember, I’ve had a habit before I start working, regardless of whether I’m working on the ground or as part of an air med crew. If the situation allows, I stop for just a moment, look at the patient or their family, and say something like, “Hey, I’m one of the paramedics, and this is my partner. We’re here to take care of you or your loved one and take them safely to the hospital. Before we leave, we’re going to move them onto our stretcher, hook them up to our equipment, and make sure everything is secure. It’ll look like a lot is happening pretty quickly, but we’ll explain what we’re doing as we go.”
It takes maybe 30 seconds. In the grand scheme of caring for a critically ill patient, it seems insignificant. Yet I’ve watched those seconds change a room. The tension eases just a little. Faces soften. Questions finally come out. The family knows who’s taking their loved one and what we’re about to do. More importantly, they know they’ve been seen and acknowledged.
If I’m honest, early in my career, this habit probably had as much to do with helping me as it did the patient or family. Those 30 seconds gave me a chance to slow down, look around the room, take in what was happening, organize my thoughts, and focus before jumping
into work. Over time, I began to recognize how much that same moment meant to the people standing on the other side of the stretcher; it wasn’t for me anymore, it was for them.
Building compassion
We sometimes talk about compassion in EMS as though it’s simply part of someone’s personality. Some providers are naturally good with people, while others aren’t. After doing this job for as long as I have, I’ve come to see it differently. Compassion is a skill, and like so many of the other skills we rely on every day, it can be taught, practiced, modeled, and improved.
Think about how much time we spend teaching the technical side of this job. We teach people how to intubate and interpret a 12-lead. We practice cardiac arrests repeatedly until everyone knows exactly where to stand and what to do. We build scenarios around difficult airways, trauma patients, shock, strokes and STEMIs because we know that practicing those situations makes us better when the real thing happens.
I think the human side of this job deserves some of that same attention. A new EMT can be taught how to introduce themselves and establish trust. We can talk with our crews about how to approach the wife who’s convinced she’s about to lose her husband or the scared teenager riding in the back of an ambulance for the first time. We can model those interactions for younger providers just as deliberately as we model a good patient assessment.
Communication, empathy and compassion are part of caring for people. Sometimes the person who needs something from us isn’t the one lying on the stretcher. It may be the spouse standing in the corner trying not to cry, the son who keeps asking if his dad is going to be OK, or the elderly woman who apologizes three times for calling 911 because she “didn’t want to bother anybody.”
Those people may never receive a medication or procedure from us, but they’re still experiencing the emergency. They may be frightened, confused or completely overwhelmed by what’s happening around them. A few words, an explanation, or simply acknowledging their presence can matter more than we realize.
Of course, sometimes there isn’t a family in the room. Sometimes it’s just us and the patient, and the same principle applies. The person on our stretcher shouldn’t have to wonder who we are, what we’re doing, or whether the people surrounding them actually see the human being underneath the monitor cables, oxygen tubing, IV lines and vital signs.
Doing the job well
One of the greatest mentors I ever had told me something that’s stayed with me throughout my career: “You have one job, and it’s to do what’s in front of you. You do it right, and you do it well.”
I’ve understood those words differently at different points in my career. When I was younger, doing the job well meant mastering procedures, knowing my medications, and making good clinical decisions. Those things still matter tremendously. Experience has simply broadened my understanding of what’s actually in front of us.
The respiratory distress patient is also a scared person struggling to breathe while their family watches helplessly. The trauma patient may have a husband standing nearby as his wife disappears into the back of the rescue unit. The stroke patient may have a daughter wondering if the conversation they had that morning will be the last normal conversation she ever has with her father.
All of that is part of the call.
Medicine gives us remarkable tools to treat illness and injury. Experience has taught me that how we care for people while using those tools matters too. Excellence in our skills and compassion can exist in the same provider, on the same call, and at the same time.
Taking a couple of seconds to connect with someone doesn’t detract from good medicine. I believe it’s part of practicing good medicine.
Our profession will continue to evolve. We’ll have better technology, better treatments, and better evidence guiding our decisions. Twenty years from now, EMS will probably be capable of things we haven’t even imagined yet. I just hope that as our medicine continues to advance, our ability to connect with the people we’re caring for advances with it.
Years from now, a family probably won’t remember what size IV we started or which medication we gave first. They may not remember our names, and they certainly won’t remember every detail of what happened in that room. What tends to stay with people are the human moments: someone looking them in the eye, taking the time to explain what was happening, answering a question, or simply acknowledging how scared they were.
On one of the worst days of someone’s life, taking a few seconds to make them feel seen may be one of the simplest things we do.
And to me, that’s patient care.
