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E.M.S. Decorum: Beyond Protocol

Updated on August 4, 2015

Emergency Medical Services

We live in a fast paced and ever growing world that, in emergency settings, require not only caregivers whom are knowledgeable in their field, but who will take the time to be kind and compassionate. We sometimes take this world - this life - for granted. We like to feel that time will stand still for us upon command and that we will live forever, but the cold hard truth of the matter is is that Father Time’s eternal clock keeps on ticking and waits for no man. “Aging is not a disease” (Dick and Friends 54). “There is no cure for it” (Dick and Friends 54). And, consequently, “we forget how incredibly precious life is” (Dick and Friends 54).

Be Careful...Not Careless

Countless tombstones have known young and old alike and are a constant reminder to us of how grim reality can be. In contrast, the moral choices we make as a people, the random acts of kindness we bestow as individuals, and the courage to smile when there is no one around to do so are the kind of things that make everyday living worth waking up to. To retort, the word kindness is an important word to know and live by. For some, it’s a feeling of drudgery. To others, it’s a sense of duty. But for one breed of special people it’s neither. For them, it’s simply going beyond protocol.

People Care

I would like to address a piece of literature that communicates the act of kindness in such a way that not only would those involved with EMS benefit from it’s message, but also the people they care for. Author Thom Dick (with the help of his co-writers Steve Berry, Jeff Forster, and Mike Smith) demonstrate in their book People Care the importance of showing kindness towards patients in a prehospital atmosphere, the art of listening, and a lesson in the power of words. My wish is for the reader to walk away with, not only a new outlook of those who work in the prehospital field, but to enfold within themselves a renewed sense of compassion for their fellow man.

A simple rule of thumb we should always remember is that kindness is timeless. Whether it be in the course of one’s career or in day to day living, how one treats a patient could very well be the determining factor in how that person will remember them. Theodore Roosevelt once said, “The most important single ingredient in the formula of success is knowing how to get along with people” ( This truth is ever present for an EMT.

In a subjective manner of speaking, one could say the secret of success for an Emergency Medical Technician (EMT) is to gain the trust of their patients. For instance, gaining the trust of a patient could be what decides the success or failure in the agreeance of an alert patient for transport. This meaning that it would reflect poorly on an EMT's work if their partner had to constantly cover for them because of their continual poor behavior and lack of enthusiasm, self confidence, and respect; whether their actions are witnessed by the general public or be it in a private setting.

Walking A Day In Their Shoes

“One cannot say enough about the importance of treating people with respect” (Dick and Friends 69). There was once a time in feudal Japan when honor was the code of the day. The word honor could be further defined as trust and respect. Though it is seemingly becoming more difficult in this day and age to find much of either of the two, respect, or the lack thereof, is the one thing people will judge you over despite of everything else.

Respect is the first thing people expect to gain and the last thing they want to lose. If you have some one’s trust then you have their respect. Or, it could also be said that if a medical professional respects their patient then they will gain their patient's trust. In any case, one must keep in mind, too, that although trust and respect must be earned they can quickly be lost.

From the mentally incompetent geriatric to the obese teen, all patients deserve to be treated with the same respect and fairness as any other patient. If we put ourselves in their shoes then we would discover there is “great power in humility” (Dick and Friends 17). Some people are just “unlucky” (Dick and Friends 38) and may not be able to help their situation. Such are the most common patients EMS may receive a call from; e.g. the homeless, troubled or runaway teens, geriatric patients, and so forth. As the caregiver, it is the EMT’s responsibility to be the advocate for those patients. It is not their job to discriminate a patient because of their looks and/or living conditions. The EMT’s job is that of “a caregiver, not a judge” (Dick and Friends 17) and should therefore keep an open mind. “You never know who you’re dealing with” (Dick and Friends 48) when you come to a patient, and should acknowledge that “the patient is often an expert in his own right” (Dick and Friends 32); i.e. the patient could be a retiree from a higher level medical profession.

It should go without fail of mention that the acts of kindness and respect go far beyond the limitations of the patient arena. An EMT will meet numerous people throughout their career. In addition to the countless number of patients that will be encountered there are the myriad of bystanders, law enforcement officers, First Responders, firefighters, doctors, nurses, CNAs, paramedics, EMTs, and so on. Because of this, the EMT should always ere on the side of caution and perform as though every call is carried out in the eye of the public and therefore be on constant awareness of their demeanor.

There is an art to being a good listener. An EMT tending to an alert patient will have no trouble in getting that patient to listen to them. They may very well be experiencing one of “the worst days of their lives” (Dick & Friends 22). It is the responsibility of the EMT to not just hear what the patient is saying, but to “listen to people when they say something to you” (Dick and Friends 31). The patient may have some bit of information that could be valuable to his or her care. They may also need to pass on something to a friend or family member and this opportunity could be their last. “No matter how much of a hurry you’re in, remember you’re no more important than anyone else” (Dick and Friends 31).

There are times when the call an ambulance station gets will be a familiar one. Or in other words, they have been repetitively called to this particular patient for one reason or another. But why? Why do these people keep calling? Are they in that much distress that they should take up a permanent residence in a hospital? No. “They call us because they know we’ll always respond, because they know we’ll probably listen to them, and because they simply don’t know whom else to call. That’s not system abuse. It’s just how some people ask for help” (Dick and Friends 41).

“These are people who are so desperate for someone to talk to the only option they can honestly think of is to call 9-1-1“ (Dick and Friends 42). Take for example a teenager. They are “some of the most isolated people in the world” (Dick and Friends 42). It’s easy for us as adults to talk about an issue they are faced with to a friend or loved one. We have been around for awhile. But for the lost teenager who is trying to fit in, they are just starting to see the world for what it really is. It’s big, it’s scary, and the hardest part is going to be for that teenager to find his or her place in that big "out there". It’s during this time in life they will find talking to their own friends and parents difficult. They are developing a sense of pride and self dignity and to feel ashamed or embarrassed will compromise that. Sometimes, it’s an authority figure they need but not one you would expect. They’re looking for someone that will briefly come into their life that can show them compassion and understanding. A stranger that, after the help has been established, can walk away and out of their life. It’s those fleeting moments that matter. The rate of suicide among teenagers is exponential. And if the ambulance crew receives a call to a suicidal teenager then it should be their obligation to listen to what they have to say and to be their friend; even if that friendship is temporary.

Another common type of people who are often lonely are the elderly. “In most cultures, the elderly are revered for their wisdom. Unfortunately, many Americans have forgotten about that.” (Dick and Friends 59). We see the older generation as annoying a lot of the time. We often look upon them with the stereotypical view that the elderly are all senile. That’s most definitely untrue. “You don’t get to be 90 because you’re stupid” (Dick and Friends 57). And when confronting an elderly patient that has called the ambulance out, just so that they feel they have something they need to get off their chest, then for 30 minutes let them talk. The responders are already there. They are still their patient. And the best treatment the responders could provide is to be attentive and listen.

When Every Second Counts...

Everyday heros. Paramedics, E.M.T.'s, and First responders are the first on the scene. Their training may determine if you ever get to see the hospital.
Everyday heros. Paramedics, E.M.T.'s, and First responders are the first on the scene. Their training may determine if you ever get to see the hospital.

Most of us have learned through the years that there is power in words. And in EMS things are no different. On the contrary, this is more true than ever. Words can be many things. They can convey a message. The can give instruction. They have the power to cause action, and they have the power to cause pain. They can be uplifting and comforting. What determines what comes out of our words will be in how we use them. “None of us knows when some insignificant thing we’ve said or some tiny thing we’ve done for someone turns out to be just what they really needed at that moment” (Dick and Friends 8).

“Sometimes people have the simple need to understand what’s happening to them” (Dick and Friends 47). It may be that an EMT has a patient who is seeing their first time in the back of an ambulance. At the same time, they may be experiencing something they have never had happen to them before. To help comfort these patients, prehospital personnel should explain the problem to them. They should inform the patient(s) of every intervention they must perform on them. In doing so, the responders must be aware that not only is there power in the words they use, but there is also power in the manner in which they use them. The tone the patient hears can be the difference between intimidation or relaxation. “Your words can be important to people who are waiting to hear them” (Dick and Friends 47).

Why Do They Do It?

The most important word a patient will need to hear is their name. “Our names are important to us. They’re given to us when we’re born, and they’re all we get to keep when we die” (Dick and Friends 18). It is vital that when talking to a patient to use their name and to not address them “as 'hon,' 'dear,' 'pal,' 'pardner'“ (Dick and Friends 18) as this may come across as “laziness” (Dick and Friends 18). Not only is it rude, but it is also unprofessional. It is better to address the patient as their title and last name and let them “do the defining” (Dick and Friends 18). For some people, using their name may be more than just a formality. “People don’t remember much about our medicine. But they do remember how we make them feel. They remember that for a long time, and that’s almost always what they punish - or thank - us for” (Dick and Friends xi). Using a person’s name is not just a way to show someone respect, but it’s also good medicine.

In conclusion, as technology becomes more advanced, and as the populations of the world continue to grow, the need for caring and sensitive people abound. As representatives of the local EMS system, EMTs and Paramedics are charged with performing medicine in a prehospital setting that require them to work, live, and act in a moral and ethical manner that marks them as professionals. The work they do does not simply begin and end in the care or saving of a person’s life. There is much more to the equation of what they do. EMTs and Paramedics must be respectful to those they are called to help and to the people around them. They should keep in mind that their patients have an opinion, and they must take the time to listen to what they have to say. Prehospital personnel must be constantly mindful that the words they use can have a profound impact on a person’s feelings and on their own image as caregivers. In the words of Theodore Roosevelt, “Nobody cares how much you know, until they know how much you care” (

A Tribute To The Men And Women Of E.M.S.


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