10. Thanks or slaps – April 2015
I once brought a patient back from heart stopped without signs of life to sitting up talking. A week later I received a complaint from him against me. Another patient I punched fair and square with a clenched fist and he saw it coming. He sent me a long, handwritten commendation. I’m calling this getting mixed feedback messages.
A paramedic is an occupation where you find yourself surrounded by positive feedback. People walk up to you in the street and say “you people do a wonderful job”. They tell you how your colleagues looked after their gran before she passed on and exude gratitude. The community annually vote paramedics amongst the most highly valued, trusted and respected. You don’t have to look far for good words.
Standing in a shopping centre packing my groceries, a young woman approached me and touched me gently on the arm to get my attention. She looked at me and said “you were wonderful the other night, I just want to say thank you.” Now normally you would take that sort of feedback in a heartbeat. My wife was standing beside me at the time though. My eyes darted between both of them conveying my best ‘I’ve never seen her before in my life’ expression. The woman realised I didn’t recall her. She was the mother of a young asthmatic patient I had attended. My wife is also a paramedic and she, as usual, was well ahead of me and had worked it out already. Also as she usually does she played with the moment for as long as she could with her ‘something you want to tell me’ smile. They both laughed at my albeit brief predicament.
Yet so often we get bogged down in negativity. Sure sometimes we receive complaints about relatively minor things even though we busted a gut to look after the patient. We may not have provided a warm enough blanket or we left nan’s walking stick in the ambulance or lost her pension card. No thank you offered, just little criticisms. Sometimes the complaint might stem from more such as our unsympathetic words, harsh tone or body language being called into question. It is human nature for some to complain and it is our instinct to hear that loudest and take it most personally.
Sometimes the only person complaining is ourselves about some element of our job that we aren’t happy with. Complaining or criticising our own colleagues and workplace allows us to do each others head in much more than any outsider can.
Rarely is any problem simply caused by a deliberately troublesome person. Most ambos and patients mean well and are reasonable. The problem might still be with us. We might feel tired and hungry or rather be at home or maybe we are stressed by study or the last case we attended. We can get frustrated when the patient doesn’t do exactly what we think they should do. We might pass these feelings onto them verbally or more subtly such as by not helping or obliging as much as we might on other occasions.
Other times the difference is the patient wants or expects something and feels we haven’t provided it. I have seen complaints because gran was left in a soiled nightie as ‘the nurses will fix that up’. A complaint because a second family member wasn’t permitted to come even though there was a spare seat in the ambulance being pointed out. That family member had mild dementia and really shouldn’t have been left alone. Or we trapesed muddy boots on pristine carpet when we didn’t really have to. Or we didn’t try to help the patient put on her slippers or bring the wheelchair close enough. Sometimes the complaints are just unreasonable such as the neighbour complaining because we wouldn’t tell him what was happening next door. We shouldn’t tell him.
Whichever the case, it may literally be the patient’s home but the game is on our home ground. We know how to defuse situations and appease people. We should know that people are under stress. This is just another day for us but a huge day for them. The day pop had his stroke will be remembered vividly for years by them, perhaps forgotten within hours by us.
But a minor bit of effort can easily turn most of these into a thank you and there are plenty of thank you’s to be found. The smile, the nod, the handshake, the words said and sometimes even the written letter afterward. The letters come infrequently but the others are almost always there. And how often do we offer them to each other, our colleagues? A bit more of that would be good too.
So how can you save a man’s life then have him complain? He had a cardiac arrest in front of me in the ambulance. By the time I had the defibrillator attached he was unconscious. Four times the device charged and surged electric current through his chest. Four times he bucked in response. On the fourth time his pulse returned. By arrival at the ED he was awake but very unaware of what was happening. Over the next couple of days he found himself being treated, amongst other things, for some mild burns around where the defibrillation pads had been. He complained about those burns as he was told that ‘the ambos’ had done it to him. Nobody mentioned to him that his heart had stopped. This was explained to him and very quickly he felt mortified for complaining.
As for the man I punched, he was a doctor who observed himself go into VF at the same moment I did. In his few seconds of consciousness left he actually called out for me to give him a precordial thump as this was still popular at the time. I did, smack in the middle of his chest. In fact it didn’t work but the subsequent defibrillator shock did. He was unconscious by then so didn’t realise that bit. He was very grateful to wake up and find himself alive and was more than happy to put that on a piece of paper.
Jeff Kenneally – www.prehemt.com