Sunday, February 15, 2015

The Butler Did it

There are any number of different ways to give a verbal handover report at the ED. All sorts of mnemonics. What form you use may depend on what your hospital expects. I try to tell a story. But I don’t tell a story in the same way I would write one. A written story takes you from point A to point Z with all the twists and turns, ending with the Da Dumm! The Butler Did it.

The other day I was listening to a new paramedic tell a triage nurse a great story of a very interesting call. Lots of the above mentioned twists and turns. It started with "We were called for..." It could just as well have started with "It was a dark and stormy night..." The problem was even though it was a great story the triage nurse was getting very impatient, not to mention she was interrupted by other nurses, doctors and her phone during the course of the medic's novella.

My suggestion to the paramedic was when giving an EMS report to a triage nurse, you have to start with the last line. Begin with “The butler did it,” and then you can explain why you think so. If you are uncertain, you can say, "Either the Butler did it or Miss Scarlet did it."

Here are some great opening lines:

Hip fracture. Asthma. Seizure. Epistaxis. Hypoglycemia. ETOH. You can fill in the blanks from there.

The bottom line is the nurse needs the bottom line first.