It`s Care With A Capital "C"

One of the things you learn when you take an EKG is what the descriptive terms for the various cardiac rhythms actually mean. For example, with ventricular tachycardia, the first word identifies the site of the pacemaker (the ventricles) and the second word identifies the rate range of those electrical impulses (tachycardia). In the case of sinus bradycardia, the primary pacemaker—the sinus node—is pacing the heart. Bradycardia indicates that the heart rate is slower than normal for that particular pacemaker.

I believe that we can draw a similar parallel in the descriptive term “prehospital care.” The first word describes the setting where we primarily function (prehospital), and the second word (care) is what we do in that particular setting. Sometimes the care we provide is emergent, when some life-threatening medical emergency or traumatic condition needs addressing. In the majority of cases, we are simply taking care of people’s basic medical needs, e.g., splinting and icing down that nasty ankle sprain until the ED doc can identify whether or not the ankle is fractured; providing oxygen and loosening the constriction in a patient’s lungs until a more permanent solution can be found.

In either case, we are taking care of other human beings: people who trust us and believe in us and our capabilities to care for them or their kids, their mom or dad, or their friends or loved ones. Whatever the specifics, it still boils down to people caring for people, and I see that as a job with incredible responsibility—as care with a capital “C.”

However, in light of some recent events that got lots of airtime and ink from the media, it certainly appears that my understanding of the responsibilities of our job and the weight those responsibilities put on each and every one of us is not shared by all members of our profession.

Apparently, some members thought it was acceptable to take an emergency vehicle out of service and kind of pretend they were on a call so they could check out what I believe was termed a “porn ball.” While there, that emergency vehicle became a kind of carnival ride for the enjoyment of the various members of the adult entertainment business who were in attendance. I wonder how the taxpayers who funded the purchase and maintenance of that vehicle so it would be available in a time of crisis felt about that situation, where it became a personal toy to show and share at a party.

There are also members of our profession who apparently thought it was OK to delay responding to a young woman who was dying because they were in a bathroom doing heroin. Still others think that it is acceptable to drink while on the job and respond to calls while impaired by alcohol.

Oh, in case you are thinking these are isolated incidents that occur once or twice a century, think again. These and other professional travesties are increasingly becoming food for the media. I, for one, find this trend disturbing, to say the least. When members of our profession put their personal pleasures, indulgences and entertainment ahead of the professional job responsibilities that they are paid to provide, they collectively diminish the profession of prehospital care. In that case, it becomes care with a lower-case “c.”

For those supervisors, administrators, union officials or city fathers who dance around these issues, offering up lame excuses as to why these actions aren’t really all that serious, I believe they too diminish our profession by continually looking for the easy solution rather than the right solution. Another case of care with a lower-case “c.”

Help me out here, folks. Have things suddenly changed and I just didn’t see the memo? Is there a new set of professional standards that says you do the job if and when you want to, or if you aren’t too impaired to do it? What happened to responsibility and accountability? I must pick up a dictionary to see if those words have been removed from the English language. It seems pretty clear to me that some members of our profession either don’t know or care what the words mean; certainly they are choosing to ignore their meaning.

To be honest, I am incredibly discouraged by this situation, and I wonder what it’s going to take to get us back on track. Or is this runaway train just going to continue until the people who have long believed in us and paid the bills for our services finally get fed up and find someone else to meet their needs—professionals who accept responsibility and can be held accountable if they don’t meet those responsibilities?

Then again, maybe I just don’t get it. Maybe I’m just old-school and believe that when someone pays me to do a job, I am supposed to do it to the best of my ability, according to the job parameters, in order to earn my wages. In my world, I see that type of arrangement as a formal employment contract. I do the job well and in a timely fashion, and, in return for my services, I get paid. Of course, I also think that when you shake someone’s hand and make a commitment to paint a fence, water their plants while they’re on vacation or whatever, that too is a contract. While it is personal rather than professional, I still see that as a contractual agreement.

In the world of prehospital care that I was brought up in, where we were taught the art and science of prehospital care and the accountability and professional responsibilities that came with it, that would be care with a capital “C.”

Until next month…