Posted by: medicblog999 | June 2, 2010

When ‘caring’ becomes a challenge.

I started to write this blog post and realised as I was halfway through it that no matter how much I changed the details, I could not make it anonymous as what happened was fairly unique and so would become identifiable if I spoke about patient details and circumstances surrounding the job.

But there are still some things I want to reflect on, so I am going to handle this a different way and make this all about me and my thoughts instead of anything to do with the patient. Got that? …. Ok….

Recently my good lady wife (@Mrs999 on twitter – if you don’t follow her yet, make sure you do. She is far more entertaining than I am!!) found herself in a situation where she was most definitely placed in harm’s way whilst trying to care for a patient.

Thankfully, both her and her partner managed to escape the situation unharmed, but it really could have been a different story altogether.

Coincidentally, I was sent to this patient a couple of weeks afterwards, not knowing it was him until the police on scene mentioned details about a previous incident a couple of weeks ago which made me realise he was the one that was involved in my wives case.

For the first time in my career I was faced with a situation where I found it difficult to really ‘care’ for a patient, and this has made me think long and hard about my feelings that I had and the way that I conducted myself.

I’m not just saying this for the sake of my employers who may read this, but I can honestly say that I provided him with all of the assessment, interventions and transport decisions that I would have done with any other patient. The treatment he received was thorough, considered and everything was done that should and could have been done.

Was I my normal and usual charming self?………..

I don’t think I was.

There was never anything that he could complain about, because after all, my job is my vocation. It puts food on my families table and provides us a lifestyle which we enjoy (along with Mrs 999`s wage obviously). I love what I do and would never risk that.

But I couldn’t bring myself to go the ‘extra mile’

That left me wondering if I was wrong, or was I just being human?

Or in fact, was I doing better than many others would have done.

I am pleased with how I handled it, but I need to be honest with myself and hope that I am not put in that situation again. It would be waaaaayy to easy for things to get out of hand if he became aggressive and threatening to me or my mate.

Have any of you been in a situation like this?

How did you handle it?

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Responses

  1. Mark, if someone is even tailgating my missus, I get annoyed. I don't think I could ever be remotely gracious (even particularly civil) if someone had threatened her in any way – and this sounds serious.My utmost respect goes to you for handling the situation the way you did. You did the right thing. One hundred percent.

  2. […] This post was mentioned on Twitter by Rhiannon Mae Bluemel and Medic999, Medic999. Medic999 said: New blog post: When 'caring' becomes a challenge. http://999medic.com/2010/06/02/when-caring-becomes-a-challenge/ […]

  3. Mark, if someone is even tailgating my missus, I get annoyed. I don't think I could ever be remotely gracious (even particularly civil) if someone had threatened her in any way – and this sounds serious.My utmost respect goes to you for handling the situation the way you did. You did the right thing. One hundred percent.

  4. I work for a small service and know several of the people I've ran over the years. I've run the people that are pleasent in day-to-day life, and the ones that are a$$e$ in their everyday life. Do the people that are friendly in day-to-day contact with me get better treatment when it's time for business?No. But they may get better bed-side manner.Interestingly, I have never had a complaint from one of the a$$e$. And I've noticed that often, post EMS contact, thier attitude towards me is better. Maybe it's because I know thier secret, or they've learned that I'm not such a bad guy, or whatever their reason is…You “provided him with all of the assessment, interventions and transport decisions that I would have done with any other patient. The treatment he received was thorough, considered and everything was done that should and could have been done.”Just because you didn't smile enough isn't anything to second guess yourself about.And kudos for not slowly starting a 14g IV in the hand while reminding him his last EMS contact was with your bride…Personally, I have no problems with making that very clear to a potentially violent patient that while I'm not going to fight, I will do everything necessary to remove my partner or myself from that situation.

  5. i suppose it depends on what this patient's medical complaint was.but then again, you seem to be a way classier guy than i am.

  6. Sometimes we don't “care” because we've run 10 back-to-back calls without food or sleep or…Sometimes we don't “care” because the patient is belligerent and obnoxious…Sometimes we don't “care” because the only surviving patient is the one that caused the traffic accident through sheer stupid choices…Sometimes we don't “care” because we've seen the same patient over, and over, and over again…for nothing more than “wandering pain syndrome”Sometimes we don't “care” because we have something else on our mind…It's OK, you're human, this is a normal reaction – I'm glad you're writing about it. 30 years ago, if someone had told me what a lifetime of EMS would do to me, I probably wouldn't have listened anyway.

  7. I went to a patient who I recognised as a man who bullied me mercilessly for years when I was at school.This was some five years after I had last seen him at school. I am not proud to say that I was less than gentle. In applying the Thomas Splint (Yup, now I am showing my age) I probably caused significant pain, I probably did not allow the entonox enough time to become effective as it may have before manipulating the limb. It was about then he recognised me, and the look in his eyes dragged me into the reality of what I was doing. I realised that I was in a position of power. I did modify my manner of handling him, but I was still dispassionate. For a fleeting moment, I recall the joy of hurting him, as he had hurt me for years!That moment of joy was fleeting, I had hurt myself more than he ever could have. I had sunk to his level, and probably deeper. I was in a position of trust, and I betrayed him, and myself.I am still ashamed of my actions. I provided him the absolute basic care I had to, and was not as caring as I could have been. That was over twenty years ago. I still feel it keenly, and I still strive to provide the best care to all regardless of the situation. I believe it has made me a better medic and a better person. I still recall the look in his eyes, I cannot forget it, and I wont. Now, if it was someone having a go at my wife… I don't know how I would react. I can only hope your example would be followed.

  8. I went to a patient who I recognised as a man who bullied me mercilessly for years when I was at school.This was some five years after I had last seen him at school. I am not proud to say that I was less than gentle. In applying the Thomas Splint (Yup, now I am showing my age) I probably caused significant pain, I probably did not allow the entonox enough time to become effective as it may have before manipulating the limb. It was about then he recognised me, and the look in his eyes dragged me into the reality of what I was doing. I realised that I was in a position of power. I did modify my manner of handling him, but I was still dispassionate. For a fleeting moment, I recall the joy of hurting him, as he had hurt me for years!That moment of joy was fleeting, I had hurt myself more than he ever could have. I had sunk to his level, and probably deeper. I was in a position of trust, and I betrayed him, and myself.I am still ashamed of my actions. I provided him the absolute basic care I had to, and was not as caring as I could have been. That was over twenty years ago. I still feel it keenly, and I still strive to provide the best care to all regardless of the situation. I believe it has made me a better medic and a better person. I still recall the look in his eyes, I cannot forget it, and I wont. Now, if it was someone having a go at my wife… I don't know how I would react. I can only hope your example would be followed.

  9. Mark,From your description, it appears that the patient survived your encounter and that he even retained a complete set of genitalia. I would call that a successful run.When another person has threatened the safety of a loved one, humanness does come out. By giving complete care and leaving without confrontation, you've done better than most would have. No extra mile necessary; no charm required.

  10. Mark,From your description, it appears that the patient survived your encounter and that he even retained a complete set of genitalia. I would call that a successful run.When another person has threatened the safety of a loved one, humanness does come out. By giving complete care and leaving without confrontation, you've done better than most would have. No extra mile necessary; no charm required.

  11. Thats a rough situation, I commend you for being able to keep your composure and treat the patient. A while back I was called for a man who had been shot as a result of his actions including the rape of a 14yr old, we worked just like any other gun shot patient and truly did the best we could. The individual survived, but I'm going to take full advantage of the internet's anonymity and say that both my partner and I kind of felt that saving the fellow while it being what was expected of us was not necessarily the “right” thing to have done. I think it is a sad fact of life that we will all run into situations where it is a challenge to care.

  12. Thats a rough situation, I commend you for being able to keep your composure and treat the patient. A while back I was called for a man who had been shot as a result of his actions including the rape of a 14yr old, we worked just like any other gun shot patient and truly did the best we could. The individual survived, but I'm going to take full advantage of the internet's anonymity and say that both my partner and I kind of felt that saving the fellow while it being what was expected of us was not necessarily the “right” thing to have done. I think it is a sad fact of life that we will all run into situations where it is a challenge to care.

  13. I might have gone so far as to try to get another crew or service to take the patient, especially if there was the chance that he'd go south during transport. I don't want to give his family/survivors/whoever the opportunity to claim that I (or my partner, in the case that I might be driving this call) allowed a negative outcome or abused him enroute. In the US it would be extraordinarily easy for them to if not win in court, than to get a sizeable settlement just for making the claim. Probably not something you have to worry much about in the UK; it seems far more difficult to “win the lottery” as we say here.

  14. I might have gone so far as to try to get another crew or service to take the patient, especially if there was the chance that he'd go south during transport. I don't want to give his family/survivors/whoever the opportunity to claim that I (or my partner, in the case that I might be driving this call) allowed a negative outcome or abused him enroute. In the US it would be extraordinarily easy for them to if not win in court, than to get a sizeable settlement just for making the claim. Probably not something you have to worry much about in the UK; it seems far more difficult to “win the lottery” as we say here.


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