Some More Help on Writing EMS Narrative Reports

Buried down deep in the 450 or some odd blog posts I have on this site, you’ll find a few that cover how to write an EMS narrative report. It’s a skill that each and every EMT and Paramedic has to practice and perfect over the course of their careers lest they find themselves without a job, or worse.

Writing a good narrative report is arguably one of the most important things an EMS provider does for their patients, their services, and themselves over the course of their career. A good EMS narrative report helps give a glimpse of the patient’s condition at the time of an EMS call to healthcare providers down the line. Healthcare providers from the emergency department, through the inpatient units, through the primary care providers, and to the physical therapists or other rehabilitation providers read the reports and use the information contained within them to glean insights into the patient’s condition when their injury or illness was most acute. They can also learn about the environmental and other factors present during the patient’s initial presentation that only EMS providers are present to observe.

In addition, narrative reports help EMS services improve themselves through QI programs, make the difference in whether or not Medicare and private insurance will pay for an ambulance trip, and are also the deciding factor in most court cases in my observational experience. Trust me, you never want to be in the position of having to go to court to testify about something job-related based upon a shoddy narrative report you wrote one shift when you were too tired to write it well. It’s a terrible feeling and a worse day.

Humans read narrative reports. We skip the canned mumbo jumbo that comes from check boxes and drop-down menus. The canned stuff is used by computers to do math for statistical analysis and data mining. Humans rarely read that.

The narrative report does something else that you might realize. Think of it as the way that most healthcare providers who don’t interact directly with EMS providers learn about what we do, how we do it, and what we’re capable of.

Lots of people read EMS reports. They follow the patient through their care as part of their chart and get seen by lots of pairs of eyes. If they’re well-written then they will be read once and then most probably forgotten about once the useful information has been gleaned by those reading them. However if the reports are stupid… such as if they say stupid things, use stupid grammar, make stupid spelling errors, or don’t make any sense at all… then the reports are dismissed or are ridiculed. So are the EMS providers who write the stupid EMS reports. So are all EMS providers as a whole.

Trust me, the people making fun of the stupid among us don’t have the sensitivity to determine who among our ranks are smart and who are not. One solidly stupid representation by a stupid EMS person can ruin someone’s perception of our whole profession. If you don’t believe me, look at how some EMS providers regard care providers in nursing homes. Nursing home nurses, CNAs, and other staff who are good at their jobs are amazing individuals who cannot receive enough credit as far as I’m concerned, but I’ve seen a lot of them who are willfully not good at their jobs… and I’ve been guilty of condemning them all in the past just because of a few bad apples. Be nice to nursing home workers, and don’t cause other professional groups to regard us as idiots because you didn’t pay attention in 3rd grade Language Arts.

In an older blog post, our friend TOTWTYTR touches on the need for quality EMS reports quite well. He even includes some grammatical examples caught in the wild. Read it.

And if you’re not in the mood to do any searching on my site for my stuff on EMS narrative reporting, here’s a link to get you started: Six Tricks You Can Use Today to Improve Your EMS Narrative Report

Now go 4th and rite good.

See what I did there?

See what I did there?

  • totwtytr

    Thanks for the link. In the several months since I wrote that post I’ve become more deeply embroiled with QA/QI and I run in to this constantly. One of the doctors I work with is beside himself over the quality of the reports we have to review. Since he was a field paramedic for years before he went to medical school, he knows the reality of how important the PCR is to documenting patient care and helping to ensure continuity of care.
    I’ve never been a big fan of the SOAPIE format, but that was because I grew up in EMS using the CHART format. Either way, it’s important to use a format and be organized when you write. The sort of stream of consciousness narrative I see from most medics is almost useless for imparting information along the chain of care.