A Smile and a Positive Attitude

I have a friend who works at a local espresso stand as a barista. As an avid coffee drinker, I get to interact with her on a regular basis. By our society’s current standards, she would not be considered “beautiful”—she is not 5’8”, 100 pounds and wearing a size 4 dress. Thankfully, not all subscribe to those beauty benchmarks.

Every time I pull up to the window to order, I am greeted by one of the most stunning smiles I’ve ever seen. Whether I see her early in the morning or later in the day, she is always in a great mood. I find both to be absolutely infectious qualities, and I can’t help but notice that when I pull away from the window, I’m also smiling and in a better mood. By my standards, she is one of the most beautiful people I know, and I'm certain my life is better having someone like her in it.

A smile is arguably one of the most powerful nonverbal communication tools at anyone’s disposal, yet, strangely enough, a smile has no value whatsoever unless it is given away. The barista's smile has incredible value, because she gives it away over and over, customer by customer, throughout her shift. Now, I happen to know she’s a single mom with a couple of kids, and I know she has good days and bad days, as we all do. But when she shows up at the espresso stand, she leaves her personal baggage behind and goes to work.

By comparison, when we show up at someone’s door, they may well be having one of the worst days of their life. While the care we provide is arguably the most important facet of the call, there are clearly other factors that impact how we deliver the care, as well as how the patient receives it. Irrespective of whether we come through their door at oh-dark-thirty or some other time, our demeanor will greatly impact the overall outcome of the call. A smile on your face says “I’m glad to be here to help you, and I like what I do.” That truly greases the skids for getting any call moving in the right direction.

As Dr. James Adams, one of my most important teachers, mentors and friends, used to say, “The most horrible, dismal patient care scenario improves immediately upon the arrival of EMS. Even when all seems hopeless, EMS brings hope and the possibility of success to the table.” Over the years, I found one thing to be true time and time again: If you can get your patient to smile, things are starting to improve. For really frightened patients, one of my favorite phrases was: “Look at me, ma'am. This is not my worried face. Until I look worried, you have nothing to worry about.” I delivered that message with a smile, and 95 times out of a 100, I got a smile in return. While the message was clearly intended to elicit a smile, it was also 100% truthful, because it represented an honest statement about my positive attitude toward them and the care I was going to deliver.

When you bring a positive attitude to each call, it also shows you are confident in your medicine. Whether the problem is “I can’t breathe,” “I just can’t think straight,” “My heart feels like it’s going to jump out of my chest,” or whatever is troubling your patient, if the patient is confident that you are both capable and willing to solve his problem, the entire scenario begins to move in a different direction and starts to improve.

As with double-blind drug studies where 10% to 20% of the patients improve with only a placebo, that clearly is one example of the power of positive thinking. The more strongly they believe the drug is going to work, the more likely the patient will get a positive result, even when it’s the placebo. And for those patients who hover somewhere between giving up and dying or hanging tough and fighting to live, your positive attitude may well be the deal-breaker that pushes your patient in one direction or another.

A second benefit of smiles and positive attitudes is not just the impact on calls, but also the impact in the workplace. Being surrounded by happy, motivated colleagues contributes to a positive work environment as well. In my mind, whatever job you have to do, that job gets much easier when you are working in a positive setting with positive-thinking people.

Just as a gambler wants to hedge his bets and do whatever he can to produce a positive outcome, so should we embrace a similar philosophy as we work to deliver quality patient care. Giving a smile and getting a smile in return, as well as bringing a positive attitude with you, has no downside whatsoever in regard to patient care. As far as the workplace, the exact same statement holds true.

Until next month…

Mike Smith, BS, MICP, is program chair for the Emergency Medical Services program at Tacoma Community College in Tacoma, WA, and a member of the EMS World editorial advisory board.