Moving Day: How Much is Too Much?

“EMS Reruns” is an advice column designed to address dilemmas you may have experienced in EMS that you did not know how to handle. But it offers you a luxury you don’t have on scene: plenty of time to think. If you think of an example like the one that follows, send it to us. If we choose to publish your dilemma, we’ll pay you $50. We don’t know everything, but we do know a lot of smart people. If we need to, we’ll contact just the right experts and share their advice with you. Send ideas c/o emseditor@aol.com.

This comes in from Edmund E. Correa.

Here is a dilemma I am sure has not been covered, but has been faced by many an ambulance crew. It has to do with baggage. My partner and I transported a patient from a hospital to a nursing home. When we arrived at the patient’s room, there were 20 bags/suitcases, flowers and a wheelchair. When we asked the hospital staff if all the items belonged to the patient, they said yes, including the wheelchair. The staff said the patient had no family to take her belongings to the nursing home.

Q. How do you handle this unsafe practice? My company says that if we don’t do it, some other company will. Needless to say, it took my partner three trips to the ambulance to load the bags and the wheelchair. It took us two trips once we delivered the patient to the nursing home, using the ambulance cot as a baggage cart.

A. We all transport patients’ belongings with them; that’s just service. Imagine how you would feel about being separated from everything you own in the world. Chances are it would make you really nervous, right? But there are limits to what a crew can do safely.

Q. Would 19 bags have been more reasonable? Would six bags? Who should decide?

A. Personally, I think the crew always has the right and the responsibility to determine what’s safe and what isn’t. You’ve practiced that throughout your career, in every skills test you’ve ever encountered.

No boss can alter the fact that an EMT’s first job is to come home safe. Your second job is to serve people, in their own time and on their own terms, to the very best of your ability. The situation you’ve described is one that your agency could have handled with a staff vehicle, then billed the patient later for the moving job. (Remember, your organization is a team.) Although it’s not likely they will collect anything for their trouble, you have to admit that 20 bags plus a wheelchair is a very uncommon amount of cargo.

Nursing homes commonly contract with private agencies to transport their patients. I have never heard of a contract that mentioned patient belongings, but patients do accumulate things that matter to them. If you encounter this sort of thing on a regular basis, maybe your boss needs to negotiate it into future contracts. That’s simple foresight.

Q. Easy for you to say. But as EMTs, we don’t tell our bosses how to write contracts. Besides, that doesn’t help us right then and there, when we’re facing the situation up close and personal. And our boss has a point: There are other companies who would just leave it up to their crews.

A. I suspect this is not a routine volume of cargo for you. But even if it is, there is no safe way to transport this much stuff in an ambulance with a patient. One of ambulance crash expert Dr. Nadine Levick’s most persistent themes has always been, anything that goes with you in that patient compartment needs to be secured. Her research indicates there are 8,500 crashes a year in the United States involving emergency vehicles. Those crashes result in one death a week. Care to guess what kills EMSers in ambulances more often than anything else? It’s unsecured equipment and non-use of safety belts in the patient compartment.

Think it would be worth a little trouble to save those lives? I sure do.

As for saying there’s always another agency that will move what you don’t, that’s true. But it’s a lame excuse for not doing a first-class job for this patient. Life is full of people who are willing to accept foolish risks for a buck. So, let ’em. Eventually they end up paying more than they save, and they earn crappy reputations as well.

There’s a rule in EMS that will never fail you in the long term, and it’s this: Never do anything that you know is stupid—no matter who tries to talk you into it. People who ignore that rule are just, well, stupid. They’re like flies who keep crashing into the same window over and over again until they beat their tiny brains out.

You’re better than that. And next time you get yourself into a situation like this one, ask for some extra support from the rest of your team.

You’re worth it.