Sometimes it takes back-to-back calls to help you understand lessons you might not otherwise have thought about.
There are family members on scene of most of all calls and they often ask if they can ride along with us. In most cases, we are not traveling to the hospital lights and sirens so we might suggest that they follow in their own car so they will have a ride home. Some do this, but in other cases when there are more than one family member, one will drive their car and the other will want to travel with us. “Fine,” we say. Out in the driveway, they may wait by the back ambulance doors while we load their relative and then they look a little uncertain about what to do. Some try to step up into the back, and we say, “No, you’ll ride up front.” If they ask why they can’t ride in the back, we usually answer “Safety reasons,” or “Insurance reasons,” or “It’s required.” We rarely get a hassle. If the patient is a pediatric, I usually have the parent ride in back. I have them sit in the seat across from me or if I am in a smaller van ambulance, I have them sit next to me. All I ask is that they put their seat belt on.
Every now and then I have a bad experience with someone in the back, but it is usually pretty rare.
Sometimes I have noticed and thought it odd that a relative will want to ride in the ambulance even if it means leaving their car at a doctor’s office or shopping center or at their home – wherever the call happened. I might ask “How will you get home?” or “How will you get your car?” and they say, “I’ll worry about it later.” “Okay, your choice.” They sit in the front and the patient may ask for them or they may call from the front to the back to ask how they are doing, and I will play the intermediary. “Your wife is sitting up front,” I’ll tell the patient. “Your husband’s doing fine,” I’ll call up to the wife.
This week I had two calls in a row where the family member was either an EMT or a paramedic who I knew. The first was a man who had fallen and broken his shoulder. Since he had also hit his head and had some neck tenderness, in addition to splinting him and we also had to c-spine him. The EMT was very helpful in giving us a full history of the event, and helping us board and collar his father. We stayed on scene quite awhile because the man was in pain, so we made certain to premedicate him with morphine before we moved him on to the board and then out to the ambulance. The son rode in the front, after reassuring his father as we loaded him in.
The very next call was at a doctor’s office for an elderly woman with increased fluid retention. As we approached the room I recognized an area paramedic in street clothes standing by the door to an exam room. She turned out to be the patient’s daughter. While the doctor gave my preceptee a report, the medic filled me in on her mom’s history. We put the mother on the stretcher, gave her a touch of 02 by cannula and went out to the parking lot. The daughter said she’d like to come along. We asked about her car, and she said it wasn’t important, she could get a ride back out to the doctor’s office later. I asked her if she wanted to ride in the back with us, and she deferentially said it was up to me. “Please, it's no problem,” I said. We had her sit across from us, and we had a nice conversation – all of us with her mother -- on the way in while my preceptee did his paramedic thing, putting the woman on the monitor and putting in an IV.
Both the EMT and the medic were very respectful of us as responders with a job to do, and at the same time, we used them not just for history but to help with the care. In both cases, the parent was reassured having their child near them.
It all made me think what I would like if my father were sick. I would certainly be deferential with the responders as long as they weren’t demonstrating gross incompetence. I would hope they would show some respect to me. I have heard other medics tell me of terrible experiences they had had with responders coming for their parents. And I know medics have had bad experiences with relatives with health care backgrounds. It can clearly go both ways.
So what is the lesson? It’s that these two calls made me think for the first time in awhile that we are not just dealing with patients and their relatives, we are dealing with mothers and fathers and sons and daughters just like ourselves, and we should always treat them as we would want to be treated -- with respect and courtesy. That doesn’t mean letting everyone ride in the back. It just means treating everyone like family -- as you would want your own to be treated. Not a complex lesson, but one that can be easily forgotten in the daily grind of EMS.
