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Original Contribution

Simple Things

June 2004

A glance at my planner as I got ready for work confirmed that I pretty much had back-to-back meetings all day. Another meeting Monday, I thought. Given that I was already running late, I could see that I was left with only two choices: drive-up window time or skip breakfast. Like any true EMSer, I really hate to miss a meal, so fast food it was.

A short while later, I was at the drive-up. I scanned the menu and made my choices as a pleasant voice greeted me and asked what I wanted. My first reply was “Good morning,” and then I went ahead and placed my order. I pulled around to the window and handed the young woman my money. As she took it, she told me, “I’m pretty new here and have been working the morning shift for the last six weeks. You are the first customer to say good morning to me.” I must admit, her comment caught me off guard, but I replied, “Gee, I’m sorry to hear that,” and I truly meant what I said. As I drove off with my order, I thought how odd this exchange had been, when such a simple thing as a pleasant greeting was worth noting.

Only a week or so later, I was doing field observations with one of my medic students, Sarah Engdahl, who was riding with Pierce County Fire District #21 in Graham, WA. Late in the morning, we finally got our first call and rolled out on a diabetic emergency. Once on scene, Sarah introduced herself to the patient and began working him up as her preceptor, Steve Richards, looked on. In the background, there was a barely audible chirp. One of Graham’s firefighter/EMTs, Dan Bamford, turned to the patient’s wife and asked, “Do you have a smoke detector beeping?” “Why yes, I do,” came her reply. “Would you like me to change that battery for you?” he asked. Along with the surprised look on her face came the reply, “Yes, I would. That would be very nice of you.” With that, firefighter Bamford went out to the rig, grabbed a new battery and, in short order, had swapped out the old one.

Back at the station, I asked him if this was just a random event, and he explained to me that they did this anytime they heard a smoke detector chirping in a patient’s home. I told him I thought that was great customer service and that he should be proud to work for an agency that would go that extra customer service mile. The smile on his face told me that he clearly was proud to work for Graham FD.

As I drove home later that afternoon, I thought about both my exchange at the drive-up window and the battery swap, and I realized that both events involved really simple things. With minimal effort, I had brightened someone’s day, and Dan had made one family’s home safer.

Out there in EMS land, we frequently find ourselves dealing with people having some of the worst days of their lives—maybe even THE worst day of their life. Along with providing care, how hard is it to take another step to make someone’s day just a little bit better?

Take, for example, the elderly grandmother whom you are transferring from the extended-care facility to the ED for a bowel problem. Obviously not a red-lights-and-siren, time-intensive, lifesaving event. She’s wearing her pink bathrobe, but doesn’t want to leave without her pink slippers. Is it really that difficult or time-consuming to look for the slippers? Consider things from her perspective: Society has taken her driver’s license and she is dependent on others to get around. She’s lost her home and lives in a nursing home. One of the last things she has is her dignity, and she doesn’t want to go to the hospital barefoot.

Or how about the young woman who has been in a car crash and is complaining of neck pain. As you are en route to the hospital, she suddenly gets this stricken look on her face as she realizes that her young daughter is getting off the school bus in 20 minutes and she won’t be there to pick her up like she promised. No parent I know wants their child left standing alone at a bus stop with no one to pick them up. Asking her, “Is there anyone we can call for you?” and then making the call to get someone to pick up her daughter isn’t that big a deal in effort, but it’s huge to that mom. Having the person call back to confirm the child has been picked up and is safe closes the loop, and may well do more for that young mom than any other single thing you could do.

Try this: How about making it standard practice, once you’ve met the patient’s primary care needs, to ask, “Is there anything I can do to make you more comfortable?” Whether that means an extra pillow, or turning up the heat a notch, or loosening an overly tight strap, you’ve just made your patient’s bad day a little less so.

In times when common courtesy seems increasingly uncommon, it seems to me that we should think a little more holistically about how we care for our patients. Sure, I realize the items above aren’t in your job description. But then again, in truth, they are simple things. Until next month…

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