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Building a culture of patient advocacy

It’s important to foster effectiveness, professionalism and excellency; as well as core values of human decency, empathy, kindness and respect

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Gina Ferazzi/Los Angeles Times

From the very first days of Johnny Gage and Roy DeSoto to where it is today, modern EMS has evolved and progressed exponentially; and while we are a long way from those early beginnings, EMS is still experiencing growing pains. After all, as a profession it is still quite young.

As cohorts, as this profession changes and grows, we not only experience this progress, but should be active participants in striving for effectiveness, professionalism and excellency; and as patient advocates building on core values of human decency, empathy, kindness and respect.

In looking at the history of EMS, it seems to me that while there are many factors, both successes and failures in patient care boil down primarily to one major contributing element: patient advocacy (or lack thereof). Outside of safety and “doing no harm” (both arguably still falling under patient advocacy), this is one of our major responsibilities.

So, let’s talk about it.

What is patient advocacy? An advocate is someone who:

  • Defends or maintains a cause or proposal
  • Supports or promotes the interests of a cause or group
  • Pleads the cause of another

Therefore, our responsibility to our patients is to defend and support them, promote their interests, and plead their cause regardless of how we feel personally regarding the person or their situation.

The entire basis for our job is patient care. Not exclusive to medical treatments/interventions, this term implies an all-inclusive approach in how we interact with and provide assistance to our patients (yes, even that patient who has called us for the 80th time with the same complaint). To put it simply, it is our duty to ensure that, to the best of our ability, we are protecting our patients’ best interests, understanding that we can and will be held legally liable for failure to do so. We are, in essence, the guardians of our patients’ wellbeing while they are in our care.

Opportunities to advocate for patients

Opportunities to advocate for patients will present themselves in a myriad of different ways, from interagency situations (i.e., requesting that a patient be given a room/bed rather than going to triage, inquiring about seemingly inappropriate interventions, asking law enforcement to confirm a patient’s status when being restrained, etc.), to advocating for patient/family education, patient safety and providing appropriate resources for patients.

Listening is also a form of patient advocacy. Slowing down and listening to what our patients are trying to tell us, understanding our patients’ individual situations, and responding with empathy and compassion provides an avenue for interacting with our patients and finding appropriate solutions for them.

Educating patients on their right to make informed decisions regarding their care is another method of advocacy. While many people are not comfortable in being assertive with providers, being informed that not only are they allowed, but encouraged to speak up for themselves can give them the confidence they need to become actively involved with the care they receive.

While there are obviously many, many ways in which to practice patient advocacy, it is also important to note that we as providers are publicly being held to account more and more frequently when we fail. Aside from agency accountability, there are legal repercussions in failing to intervene and stand up for our patients. We need to be cognizant of this and ensure we are doing our part in speaking up and fulfilling our role as patient advocates.

Sometimes easier said than done, this is on occasion a difficult, uncomfortable or even embarrassing position in which to place ourselves. Sometimes it requires (respectfully) standing up to people in authority over us. It can require having to swallow our pride, and expose ourselves to pushback from others. It requires having the gumption and fortitude to go against the flow, speak up and stand up for your patient.

Hopefully, our EMS leadership is providing their full support for patient advocacy. At the end of the day, if you advocate for your patients, you will know that to the best of your ability, you did the right thing for your patient.

Video: Steve Whitehead on improving patient handoffs

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.

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