Family

Sometimes it takes back-to-back calls to help you understand lessons you might not otherwise have thought about.

There are family members on scene of most of all calls and they often ask if they can ride along with us. In most cases, we are not traveling to the hospital lights and sirens so we might suggest that they follow in their own car so they will have a ride home. Some do this, but in other cases when there are more than one family member, one will drive their car and the other will want to travel with us. “Fine,” we say. Out in the driveway, they may wait by the back ambulance doors while we load their relative and then they look a little uncertain about what to do. Some try to step up into the back, and we say, “No, you’ll ride up front.” If they ask why they can’t ride in the back, we usually answer “Safety reasons,” or “Insurance reasons,” or “It’s required.” We rarely get a hassle. If the patient is a pediatric, I usually have the parent ride in back. I have them sit in the seat across from me or if I am in a smaller van ambulance, I have them sit next to me. All I ask is that they put their seat belt on.

Every now and then I have a bad experience with someone in the back, but it is usually pretty rare.

Sometimes I have noticed and thought it odd that a relative will want to ride in the ambulance even if it means leaving their car at a doctor’s office or shopping center or at their home – wherever the call happened. I might ask “How will you get home?” or “How will you get your car?” and they say, “I’ll worry about it later.” “Okay, your choice.” They sit in the front and the patient may ask for them or they may call from the front to the back to ask how they are doing, and I will play the intermediary. “Your wife is sitting up front,” I’ll tell the patient. “Your husband’s doing fine,” I’ll call up to the wife.

This week I had two calls in a row where the family member was either an EMT or a paramedic who I knew. The first was a man who had fallen and broken his shoulder. Since he had also hit his head and had some neck tenderness, in addition to splinting him and we also had to c-spine him. The EMT was very helpful in giving us a full history of the event, and helping us board and collar his father. We stayed on scene quite awhile because the man was in pain, so we made certain to premedicate him with morphine before we moved him on to the board and then out to the ambulance. The son rode in the front, after reassuring his father as we loaded him in.

The very next call was at a doctor’s office for an elderly woman with increased fluid retention. As we approached the room I recognized an area paramedic in street clothes standing by the door to an exam room. She turned out to be the patient’s daughter. While the doctor gave my preceptee a report, the medic filled me in on her mom’s history. We put the mother on the stretcher, gave her a touch of 02 by cannula and went out to the parking lot. The daughter said she’d like to come along. We asked about her car, and she said it wasn’t important, she could get a ride back out to the doctor’s office later. I asked her if she wanted to ride in the back with us, and she deferentially said it was up to me. “Please, it’s no problem,” I said. We had her sit across from us, and we had a nice conversation – all of us with her mother — on the way in while my preceptee did his paramedic thing, putting the woman on the monitor and putting in an IV.

Both the EMT and the medic were very respectful of us as responders with a job to do, and at the same time, we used them not just for history but to help with the care. In both cases, the parent was reassured having their child near them.

It all made me think what I would like if my father were sick. I would certainly be deferential with the responders as long as they weren’t demonstrating gross incompetence. I would hope they would show some respect to me. I have heard other medics tell me of terrible experiences they had had with responders coming for their parents. And I know medics have had bad experiences with relatives with health care backgrounds. It can clearly go both ways.

So what is the lesson? It’s that these two calls made me think for the first time in awhile that we are not just dealing with patients and their relatives, we are dealing with mothers and fathers and sons and daughters just like ourselves, and we should always treat them as we would want to be treated — with respect and courtesy. That doesn’t mean letting everyone ride in the back. It just means treating everyone like family — as you would want your own to be treated. Not a complex lesson, but one that can be easily forgotten in the daily grind of EMS.

6 Comments

  • hilinda says:

    Interesting to me that you are bringing up this topic right now. Twice in the past few weeks, my father has had to be transported, and I was the first EMT on scene, and asked to go with the ambulance. (My agency is non-transporting.)The first time, the paramedic knew me, and openly welcomed me. The second time, it was a paramedic and EMT crew I didn’t know well. The EMT-CC wanted me to ride in front, but the paramedic was okay with me being in the back.In both cases, I wanted to be in the back not so much because it was my Dad, but because I had information about his medical condition that he would not be able to explain to them.In both cases, I was pleased with the care provided by the paramedics, and I believe I was able to contribute to that care, especially the second time, because of the specific knowledge I had.In both cases, it also helped ME to remain calm and more objective that I was able to be an EMT, rather than only a family member.One of the things I was reminded of in both situations is something you mention in your post- about how all patients are family members, for someone. I try to look at each of them and treat each of them as if they are family.Sometimes, in this small town, they are. And often, if they aren’t immediate family, they are people I know, or family of people I know. But even if they aren’t, it’s important to remember to treat them as if they are, and to remember my own experience with my father and how even being an EMT, some of what goes on can be stressful in the moment, so imagine what it’s like for family who don’t have any understanding of the situation.Somewhat amusingly, after he came home from the hospital, I had another experience being a healthcare provider with my father. I helped control some minor bleeding. Interestingly, when he was in the ambulance with paramedics, he was the model of cooperative patient behavior, but when it was just me, he had a very strong need to tell me how to do everything! So if there is another critical incident, I would rather NOT be in charge of his care, even if I ride along in the back of the ambulance. Everyone will be happy to let the paramedics do their jobs, no question.

  • Jarrod 'Ian' Bergsma says:

    Hey Peter, I’m just finishing up reading Rescue 471 and truly want to thank you for it. In september I begin my schooling in Ontario Canada to become a paramedic. It is something that myself and two of my friends are all getting into. My friends are doing their schooling in Quebec. The three of us have each read your books and they taught us more than people might know. So thank you. I’m excited to know I found your new online blog and I will be keeping track of this daily while I count down the days until my schooling begins!If you ever get the chance you can check out my blog I will be updating during school with stories and pictures!paramedicjarrod.blogspot.comThanks for being my inspiration.Jarrod

  • caliems05 says:

    This is a very excellent point. We should always treat every patient with the same amount of respect and kindness that we would want are family members to be treated with. My partner and I always treat are patients with respect especially if they have a Psych History. I have found for myself that when you talk to people like they are people they respect you back. I have had mulitple 5150 patients that could have gone wrong but by talking to them and treating them with respect they to will respect you and answer any questions that you may have for them. Family is also a big thing. Patients familys like to be apart of the care and knowing what is going on. (especailly in the sue happy Cali). The nicer and more respectful you are the less chances you will find someone against you or the company. For moms with pediatrics i think the best place for them is like you said right beside you in the back. It helps calm the baby and the mom gets to see the care given.Overall i totally agree with your blog. This is also is a cool thing that is going on here. My partner told me about this web site and i decided to check it out. Thanks for the helpfull insights.

  • Coffee is my Friend says:

    Thank you very much for taking the time to blog, i am an EMT student in my 2nd month, (i was a EMT 20 years ago, family and military life with frequent moves making it impossible to keep up with) I am enjoying my classes very much and really like having found your blog (and some others) with practical and encouraging stories. i look forward to more 🙂

  • Anonymous says:

    I never let people ride along. I work in a urban environment and it’s just not safe. Too many assaults on my coworkers. Too many problems. It’s a common request particularly on hospice transfers. Sometimes I’ll be more open. For parents, I let them ride in back but their child goes in a child seat and mom or dad goes on the bench with a seatbelt. If the kid is really fubar, mom or dad rides up front.

  • Anonymous says:

    One other addendum. Had a short of breath call once on a pediatric. We’re called to this collection of huts (government housing) that’s crime and bug infested.A cracked out nut answers the door. The crack smoke is thick in the air, she’s high as a 747, and says, “He’s fitting. Make it stop.” Our patient is a little boy, about 3, that is having an asthma attack. He has none of his medicines, mom isn’t around, and this crack head is watching the child. The only thing in the house is a 52″ LCD TV and a bare mattress on the floor.We get a neb treatment going, try to calm the kid. The sitter/crackhead doesn’t even know his name, or how to get in touch with mom. She kind of thinks maybe she knows the first few letters of mom’s name. But that’s about it.My temper was getting a little higher and higher as the call progressed. I was just so disgusted at seeing this happen. A kid with asthma and you’re smoking crack and weed in the house? I start towards the ambulance with the little boy in my arms. He’s crying, I’m mad, and the crackhead jumps in front of me.”You ain’t going nowhere without me. I’m riding with and that’s all it’s going be.”I just told her that I was going to take this sick little boy out to the ambulance and if she followed, she’d be riding to the hospital in her own ambulance, severely injured.When I got to the hospital, I reported it as abuse and neglect. The social worker called back a few days later and said, “Well, it’s not technically abuse or neglect since he did have someone watching him.” I was like, “Yeah, a crackhead.” Well, the lady said, maybe she was just really nervous and unhealthy looking. That’s not really fair.I just hung up.

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