Countless Many

“Why Can’t We All Get Along?”

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There’s a new guy on the sports radio channel I listen to who drives me crazy. He is so annoying. The local radio station decided to preempt the national syndication with a young local guy who could discuss local sports and maybe comes a lot cheaper than the syndicated show. The reason the guy annoys me is because he is constantly talking about what annoys him, and listening to an annoyed person, just makes me annoyed — even to the point where I have to switch the channel. Thanks to the annoyed sports radio guy, I am actually up on many of the Top 40 songs these days. I really like that “You Cut Me Open (And I Keep Bleeding) song and the one that goes “Take Me Awaay to a Special Plaaace.”

I feel the same about partners. You get a partner who is pissed off or discontented and after listening to them all day, then you find you are pissed off and discontented, too, and I find that being pissed off and discontented wears me out and I don’t like to be worn out. And the problem with annoying partners, unlike annoying radio talk show guys, is you can’t turn the channel and turn them into sexy female pop stars singing breathlessly about how crazy they are for you.

I write this all as an introduction to the topic of EMS relationships with other disciplines — nurses, ER and nursing homes, doctors, family practitioners to ED docs and trauma surgeons, etc. I have heard so many stories over the years and have told my share about EMS being mistreated that it tends to wear me out too. Unless its a really good story.

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There is an EMT I know who is at war with one of the hospitals. And he provides me with weekly updates of his skirmishes. The thing he doesn’t and many people don’t like about this hospital is that they have shifted many of their responsibilities onto EMS. You bring a patient in, you have to first register the patient — a fairly simple procedure which consists of giving the registrar the patient’s name, date of birth, social security number, and complaint. If all goes well, a minute later the name will pop up on the triage nurse’s screen and the triage nurse is now willing to hear your patient’s tale. While you are giving your report, and giving it in convenient snippets so the nurse can type it all into the computer, including name and dose of all meds, your partner is supposed to be taking their vital signs and temperature using the hospital’s BP cuff, pulse oximeter and in the ear thermometer. Recently, it has also become EMS’s job to fill out an allergy bracelet and put it on the patient’s wrist. Once all this is taken care off, assuming there is not a line of five patients in front of you, you are then given a room number. Sometimes before you can go down to the room, you have to wait for the register to finish having the patient sign several forms. When you go down to the room, almost always there is another patient in the room, so you put the patient in the hallway, provided you can find a bed. You can usually find an unmade bed in the back hallway, and so you wheel it into the main ED, and then find sheets to make the bed up, and then transfer the patient over. If they are on oxygen, you often have to find an oxygen tank, as if there is one under your bed, it is usually empty.

My EMT friend takes great delight in passive aggressively blocking a hallway to transfer a patient from the stretcher to the newly found ED bed. He sets the transfer up so that there is only the narrowest passage for a person to get through, but like a miniature golf windmill whenever a nurse tries to get by, a slight adjustment in body position or stretcher and the passage is blocked. If the nurse says excuse me, I need to get through, he’ll smile and ask her to help with the patient’s legs. If a doctor needs to pass, he’ll courteously point out to the doctor that passage can be effected by a quick short cut through the soiled laundry room that opens just around the corner. He is very artful in how he does all of this. He is not hesitant to “innocently” ask an attending if he can find a pillow for the patient’s head or request a nurse to hold the foley.

His latest tale involves a patient with MRSA. He and his partner came into the ED in full body length contamination garb, including Hepa-masks and face shields. His tale, complete with Darth Vader behind the mask breathing, had me in hysterics, and unfortunately may have precipitated a new registrar to transfer out of the ED and turned a triage nurse into an obsessive-compulsive handwasher.

Humor is almost always good. Whining never is.

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I read an awesome book many years ago called Talking Trauma: Paramedics and Their Stories by a guy named Timothy R. Tangherlini, who is a sociologist. His book is a collection of tales told by paramedics, and an analysis of what the tales mean from an anthropological social perspective. I thought it was fascinating reading.

One of his best insights is into tales where the paramedic is the “sly hero.” The paramedic as sly hero is a very common form of paramedic tale. The bottom line is that paramedics use these tales as sort of a rebellion against the medical caste system where they are often considered to be lesser people than the caste of the villain. The tales serve to validate the paramedic’s self worth.

Here are two examples from some of my earlier posts:

Left Lateral Femoral Condoyle

Stud or Idiot?

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The nationally syndicated radio guy who was replaced on the local station by the annoying local guy actually used to talk about things that pissed him off too, but he did it in such a funny outrageous way that I enjoyed listening. He also had a sidekick or alter ego who would temper his comments, and so after absolutely skewering somebody, he would admit to his sidekick that maybe he had gone too far, and he would apologize and say he loves everybody. That’s just the kind of guy he is. Sending love out to all his listeners.

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For me now, I’m about getting along. I try to treat everyone with respect, avoid confrontations, and do whatever is best for the patient. We’re all in this together and you have to love and respect everyone in the medical field. And I’m all about showing them love.

That doesn’t mean I don’t like a good story told well skwering a deserving villian and spreading the fame far and wide of sly paramedic or EMT heros, of which there are countless many.

3 Comments

  • TOTWTYTR says:

    Regarding Triage Nurses, I refer your larger than mine audience to my postAdvice for Triage NursesI know that EMTs that work for commercial ambulance companies risk their bosses wrath if they annoy the nurses, but I think an anonymous phone call to the risk management people at a hospital hinting that a complaint might be filed with the feds just might result in an attitude adjustment in the ED.It’s not the job of EMS to register patients, do VS in the hospital, make up beds, or anything else that is the ED staff’s responsibility.

  • davisemt says:

    Holy crap. This is the exact post I needed. My partner is a supervisor also, so all of the stress and whining of coworkers gets unloaded onto our day. I have found myself going from a strong “do my job, do it well” keep my head up person to a very cranky, get my nose in everyones drama. I am exhausted and disgusted with myself.Definitely have to read that book. Too funny.

  • Rogue Medic says:

    This is one of the reasons I avoid listening to talk radio, unless it is something that is supposed to be an informative exploration of a topic. Too often, even this is done with such a bias that it is annoying.The talk radio seems to be so much about winding people up that I would rather listen to music. Fortunately, I have more choices than the local Clear Channel station.If my patient is being treated appropriately, I am good about keeping room available for people to pass and making up a bed to get the patient into the right bed – triage nurses have bad days, too.If my patient is being ignored or my patient has a condition that needs attention, but is being ignored, then it becomes impossible to keep the hallway open, and I am commenting about the inability to find the Press Ganey survey forms, and I will by-pass the nurse to get the doctor involved, if necessary. Should I need to do a bit more I can call Press Ganey – (800)232-8032 and complain directly. Or the JCAHO complaint line (The Joint Commission, now) – (800)994-6610. Handy numbers to keep in your phone. Doctors and nurses initially think that you would not have these numbers. I put my phone on speaker and when they hear the person answer “This is the Press Ganey office, all of our operators are busy right now, . . . or whatever it is that they say, well things change. 🙂

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