EMS: Is what you do the Best You Can Do?

Not too long ago I was reading an article in Entrepreneur Magazine when I came across an article speaking on negotiating tactics. I wish I could find it, but unfortunately it was long enough ago that Ive disposed of the printed issue (I subscribe) and cannot find it on the web. It was a good article and it taught me some words that Ive since used quite a bit in my own life:

Is that the best you can do?

From the time our parents first put us out there in the world most of us have probably been told to Do our Best when we try to do something. No matter if we win or lose, weve been told that its ok as long as we do the best we can while trying. We seem to feel better at the outcome of almost anything if we feel that weve Given our best shot when we try to accomplish what weve set out to do. We all like to do our best and we hope that our best will be good enough.

This begs the question is what youre doing today in EMS the best you can do? Career wise, operationally, with your services treatments, with your own personal training and education, and with your own attitude is this really the best you can do?

I would like to think that I try my best in my own EMS career and paramedic practice. I would also like to think that I work for an EMS organization that is trying to do the best it can for its people and its collective patients. However, there are quite a few situations where I have felt that I have not done or have been prevented from doing my best for a number of reasons. Some are reasonable and others are not. Id think that all of us would give the answer that we always want to provide every patient with our best possible care. However, Id also guess that everyone reading this can think back to any number of situations where they feel that they didnt give it. Sometimes this reason comes down to the skill set of the individual provider. This could be a situation where the provider didnt have the best possible information or knowledge available to them. They may have provided an ineffective or even harmful treatment modality or might have failed to act upon a missed assessment finding, such as by giving a medication for which a patient has a documented allergy because the provider didnt know or simply forgot that the patient had the allergy. Sometimes the actions of others in the organization can prevent a provider from rendering the best possible care. This could be by failing to check, clean, or restock a needed piece of equipment or by providing inadequate care prior to a provider assuming patient care such as in the case of a first-responder crew failing to place a patient in full c-spine precautions when indicated prior to moving a patient to the transporting ambulance and the transporting EMT not having enough manpower to safely immobilize the patient. Sometimes the organization can hinder an EMS provider from doing his or her best by doing things such as providing inadequate equipment or medical protocols, or by mandating that a provider regularly work past exhaustion-level hours.

People inherently want to do well at whatever they choose to do for their careers as well as at other tasks where they feel stronglyabout the outcome. I may have accepted that Ill never be as good of a basketball player as Michael Jordan, nor the same-level of cartoonist as Scott Adams, nor the best noodler in the world but Im certainly going to try to be the best paramedic I can be.

THIS guy, however, may be The Best Noodler In the World

Sometimes our own personal biases prevent us from doing the best we can do and for this Im not talking about bias regarding any protected classes or topic, rather Im talking about our own version of the status quo. A personal example of this would be my ALS Quick Response Vehicle at work. We went a solid week without having the proper forms available for the daily equipment checks and I didnt have the computer access to print more off. During that week, I got in the habit of not using the forms and simply checked the truck based upon my knowledge of what was supposed to be in there and what was supposed to be checked. The way it played out, I ended up continuing to not use the check sheets when checking the vehicle, even though the forms had been replenished. A few weeks later, someone found that there was equipment missing in the vehicle that had gone unnoticed for some time. At that point, I realized that I had developed my own bias against using the forms for a reason that is even unbeknownst to me. I had gotten in the rhythm of not using the forms, and that caused me to miss that the infrequently-used piece of equipment was missing. I had developed a personal mental bias that prevented me from doing my best and thoroughly checking the truck.

Another preventer of best practices can be organizational politics, both internal and external. As a paramedic who regularly responds to other ambulance services to provide ALS Intercepts, I have observed that the politics between the services we work with can affect patient care for both the negative and the positive. While I am not saying that any of these arrangements result in inadequate patient care, I can say that the services with whom I interface most frequently and most pleasantly get a better provider out of me than do the services with whom my relations are less frequent or are strained due to political turmoil. When I respond to a request for an ALS intercept, I am being called to the house of another group of providers. While I am the highest level of care on the scene, Im also a guest in their house. They have their own internal biases and I have mine. Sometimes the synergy in our working relationship can be strained, which results in a palpable difference in the flow of the scene and the teamwork exhibited at it. While I will ensure that I do my best, its easier to do it when I work well with the team Im working with.

So how do we change things? Were all human and we all have things that prevent our best shot from being the only thing that we give it in our EMS careers. This may be consciously, as in the case of internal politics; Subconsciously, as in the case of my not using the check sheet; or Involuntary, as in our service not providing us with needed equipment or our coworkers failing to replace an item in the ambulance that we did not have an opportunity to check. As in most things, the easiest thing for us to change is ourselves. Changing ourselves is a great place to start and will make serving as an example to others your main tool to use to try and get the best out of them.

Most situations can be made better and almost all of us can try harder. The secret is to attempt to do our best at all times and to try and ingrain our own best practices into our daily routines. This can be as simple as always trying to check the truck in the most thorough way possible or by making sure that you always check and recheck things to ensure that theyre done right. It helps to continuously seek out and recognize ones own personal biases, (remember my check sheet?) to make sure that our own preferences and routines arent leading to suboptimal performance. Consistently ask yourself if what youre doing is the best you can do and then ask yourself what you can do to make it your best. Mentally prepare yourself for your shifts with adequate rest when possible, manage your stress level so you can keep your thoughts focused on your care, and train hard. Ingrain your best efforts into the systematic way you do things and make your best way your normal way of doing things. We cant change everyone around us in an instant, but our quiet positive efforts can pay large dividends in how people around us think, feel, and act. Our best may in turn get the best out of our partner, which may in turn get the best out of the next crew, and so forth. Soon enough deciding to give our best may change your organization, our industry, or our profession.

And I assure you, doing your best will indeed make the difference in someones life. Its just what we do, Folks.

Is that the best you can do??

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For more on doing your best in EMS and in getting the best out of your EMS people read: The Shine Factor”

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Chris Kaiser aka "Ckemtp"

I am a paramedic trying to advance the idea that the Emergency Medical Services can be made into the profession that we all want it, need it, and know it deserves to be.
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  • Comments
    DiverMedic
    Welcome to the Club
    Very well done, Chris.
    2014-09-17 22:15:00
    DiverMedic
    My Blogroll
    One of these days you'll figure out where my blog is... :)
    2014-09-17 22:11:00
    emtterri123
    Six Tricks You Can Use Today to Improve Your EMS Narrative Report
    The first and best way to get people reading you to think that you are an idiot is to pepper your writing with spelling and grammatical errors. It makes you look dumb. - Me thinks this should have been restructured as it does not flow and caused me to reread it several times. lol :)
    2014-09-17 08:27:00
    Алексей Рукин
    So You Think You Can EKG?
    78% accuracy... and I'm not even a medical student, only a blog reader...
    2014-07-12 18:12:00
    Another One Bites the Dust (Part 2) | Medic15
    The Five Second Rule – Six Ways you can Reduce Pauses in Compressions and Save More Lives with CPR
    […] 5,7,9 http://www.lifeunderthelights.com/2014/03/24/the-five-second-rule-six-ways-you-can-reduce-pauses-in-… […]
    2014-07-09 18:39:31

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