Whilst there are opportunities where we can listen to great music and even elevate our feet by resting them up on the dash (as long as we wipe it down afterwards of course), those opportunities must be limited to the times that we’re parked up away from the public eye.
Humble Protestation v Disrespectful Diatribe
Our next call comes across the radio, to an elderly lady with chest pain. Once we reach our destination, the patient’s daughter has already arrived and calmed her mother. This gives us plenty of time to build rapport and reassure our patient whilst we’re assessing, treating and preparing for transport.
During their general chatter with our attending partner whilst we’re driving, en route to hospital, we hear the patient praising the hard work of paramedics and expressing her thanks for the “tireless efforts” she describes. It feels good to be appreciated, doesn’t it? Our partner, however, responds with “it’s just a job” and dismisses her thanks. Going on to describe a lazy profession who get to lounge around and sleep between calls.
The patient cannot believe this and hopes that her gratitude is being dismissed with modesty and humility. She wants, and possibly needs, to believe that her perception of paramedics is as professional, hardworking, caring members of society. If this is not the case, how can she feel confident that we want to provide that professionalism and care?
Her daughter joins in and describes how paramedics have always been so cheery, and reassuringly calm, during treatment of her mother in the past. Our partner, however, is keen to emphasise their casual, cool demeanour. They go on to quote “You call, we haul!” type phrases, stating that we only work for half of the year. Omitting the fact that a good chunk of that time is spent working long shifts, or sleeping to catch up afterwards. As we listen, we cringe with shame.
Public perception of our role is generally extremely positive. Simply acknowledging this positive praise with polite thanks can help patients to maintain their sense of safety, security and confidence in the service that we provide. Educating any misconception is obviously an important factor, when necessary, if managed appropriately, but shutting down positive feedback and describing an entire profession in such negative terms is unfair. To the patients, to our colleagues and to our entire industry.
If we wish to describe ourselves personally as lazy, slack, or any other negative term, that’s entirely up to the individual. We can easily convince the general public of this with our words, body language and attitude, without even realising it. In doing this, however, we may irreparably damage the hard earned reputation and respect that paramedics have gained over one hundred years.
The Ugly
We may have forgotten most of our reasons for becoming a paramedic, because we’re tired and it’s been a long, long time in the making. We may be suffering from stressors that make it difficult to even want to do the right thing. We may be new to the role, and think that we fit in better if we can portray a cool and casual attitude. We may have been drawn to paramedicine purely for its image, therefore self-image is our focus.
Whatever the reason, sometimes paramedics, just like all other professions, can behave in ugly ways without even realising it.
Driving Our Team v Ditching Our Duties
It’s our turn to drive for the next job or the current shift, so, whilst transporting a patient to the emergency department, we put in our headphones and make a phone call to a friend or colleague throughout the entire journey.
Meanwhile, our partner is in the back of the ambulance, attending to the patient. They can both hear the conversation, and they both know that they’re in the hands of an inattentive driver as well as an inattentive clinician.
Throughout treatment, we can’t hear our partner calling out updates regarding vitals assessed or medications given, therefore we’re not working as part of that team other than in a driving capacity. If our partner receives a complaint regarding an accusation of mistreatment, errors in medication, inappropriate behaviour, or if their safety is compromised, we can’t confirm or deny any part of that, as we were not aware of any aspect.
Should the patient have a complicated presentation, we cannot support our crewmate in making decisions regarding clinical care, should they wish to discuss the case en route or afterwards. Most importantly, we are driving distracted with a colleague and patient in the vehicle. In some jurisdictions, this may be illegal and, in many, it may be considered enough of a distraction to warrant prosecution in the case of an accident.
Did we ever imagine, when we submitted our initial job application, that we would choose to be the type of paramedic to wear headphones and completely switch off from their partner and from patient care? We can almost guarantee that the patient will be quick to share their disappointment and loss of respect for paramedics with family members, friends, nursing staff and potentially, our managers and/or governing registration bodies.
Appreciating Privilege v Inflating Importance
Back to the good old food break example, and we find ourselves between calls once again. It’s now almost dark and we’re hungry, so we decide to sit in, rather than eat takeaway in the ambulance for a change.
We park in a nearby disability spot, lock the vehicle, and, as we’re walking towards the restaurant, we notice passers by watching, in that naturally curious way that occurs whenever an ambulance pulls up. As we enter, we’re unaware of the distaste on the faces of those who have noticed that we’re about to get comfortable. Public perception drops to an all-time low. Not only have we taken one of the only parking spaces available for patrons with mobility issues, but we are doing so purely for our own needs, and it’s not appreciated at all.
This may cause a huge loss of respect, and is potentially damaging for the next time we are forced to park awkwardly in order to attend to a life threatening emergency. Social media often depicts images and video footage of public hostility. This occasionally includes violent acts towards ambulances blocking in parked cars, or traffic attendants who refuse to back down on issuing a ticket.
As a profession, we are often frustrated and confronted by such behaviour, but it begs the question of how thoughtfully our decisions are made when parking an ambulance or response car purely for personal needs. Yes, paramedics have to eat, but there are ways around this. We can park nearby, if possible, and walk just a little further. Should the closest available space be far enough to affect response times, we always have the option of one crewmember staying with the vehicle.
If we make ugly or thoughtless choices, however, we can guarantee that they will be noticed and they will ultimately affect public perception. How can we expect members of the public to differentiate between this, and true necessity, during access and egress for emergency calls?
Maintaining Safe Distance v An Unacceptable Approach
Once we’ve eaten, it’s still early on a Saturday night in the city, but we are called to our third unconscious and potentially intoxicated patient for the shift. We’re getting tired, it’s cold, and the pavements are crowded with noisy, bustling groups of partygoers. As we step out of the ambulance, we walk over to the patient on the ground, lying face down, with hands comfortably forming a pillow under their head. They are snoring gently and smell strongly of alcohol.
Before our partner does anything else, they nudge the patient with the toe of their boot, so that they don’t have to lean over and risk the patient striking out violently. In the eyes of the general public, this will likely appear to be the utmost level of unacceptable behaviour from a paramedic. Whilst the training we have in approaching a patient safely may be minimal in many ambulance services, we all know of tried and tested ways in which we can approach the situation with professionalism, as well as caution.
The patient may be alcohol or drug affected