On Defense

[Sandog]

On this subject of defense, I think the best defense is to not need one.

By that I mean, when one approaches a possible hostile patient, approach with a mindset that your there to help, your demeanor should convey that. Attempt to get into the patients mindset if you can, humor them if you must. Anxiety, illness, and the fear of the unknown is going through the patients mind. Knowing this, as a provider your best tool is to alleviate these fears and to bring calm to the situation.

When all else fails, and things do break loose, stay cool, and remember the techniques DT4 has been posting.

 

[DT4EMS]

On this subject of defense, I think the best defense is to not need one.

By that I mean, when one approaches a possible hostile patient, approach with a mindset that your there to help, your demeanor should convey that. Attempt to get into the patients mindset if you can, humor them if you must. Anxiety, illness, and the fear of the unknown is going through the patients mind. Knowing this, as a provider your best tool is to alleviate these fears and to bring calm to the situation.

When all else fails, and things do break loose, stay cool, and remember the techniques DT4 has been posting.

Thanks. I second that. We actually spend the majority of our time learning to de-escalate, prevent and avoid conflict. The physical stuff we teach was for if everything else failed.

This is why we have the backing of two different state EMS associations and dozens of agencies now teaching our material.

The EMS arena, or patient care arena for that matter, is so unique when it comes to the dynamics of human conflict. It is unlike an attack in your home, or by a mugger or thug...... there are many more things that come into play.

 

[bahnrokt]

One of the least talked about subjects in EMS is provider - patient communications. I've spent the last 13 years of my life as a salesman / manufacturers rep and have been through endless salesman training seminars, workshops, books and now pod casts. They all harp on the same tenants of interpersonal communication that many EMTs lack. How many EMTs been trained to read body language or how to present themselves? Police go through training on how to display themselves as an authority figure and we get "BSI Scene is Safe!".

Everytime you come across a pt you become a salesman / woman. The person needs medical help and you are tasked with selling them on the idea of letting you transport them. No different than if you were selling any other product. You recognize the customer/pt has a need for your product, you visit them and evaluate their needs. Based on their needs you recommend one/multiple services and then educate them on the features and benefits of them useing your service. If they refuse you ask why and start to pick apart their objections.

It's the same formula almost every "Sales for Dummies" book will give you. Treating PTs more like customers, learning how to listen and acting less like we are one removed from LE would go a long way toward solving many of the conflicts we see.

 

[DT4EMS]

One of the least talked about subjects in EMS is provider - patient communications. I've spent the last 13 years of my life as a salesman / manufacturers rep and have been through endless salesman training seminars, workshops, books and now pod casts. They all harp on the same tenants of interpersonal communication that many EMTs lack. How many EMTs been trained to read body language or how to present themselves? Police go through training on how to display themselves as an authority figure and we get "BSI Scene is Safe!".

Everytime you come across a pt you become a salesman / woman. The person needs medical help and you are tasked with selling them on the idea of letting you transport them. No different than if you were selling any other product. You recognize the customer/pt has a need for your product, you visit them and evaluate their needs. Based on their needs you recommend one/multiple services and then educate them on the features and benefits of them useing your service. If they refuse you ask why and start to pick apart their objections.

It's the same formula almost every "Sales for Dummies" book will give you. Treating PTs more like customers, learning how to listen and acting less like we are one removed from LE would go a long way toward solving many of the conflicts we see.

Beautifully put!

I have said it a hundred times........ Good Customer Service IS a scene safety "tactic".

 

[DT4EMS]

Good Customer Service
A tactic for scene safety
© 2006 DT4EMS L.L.C.

I was sitting in the ambulance base after teaching DT4EMS a class not too long ago, when a medic began to tell me about how he controlled an “uncooperative drunk”. This seasoned medic began to describe how he placed his knee across the throat of this intoxicated patient. To make matter worse this guy was a supervisor.

I asked “why” he used his knee and he replied the patient was cursing at him and wasn’t allowing treatment to take place. Several thoughts rushed through my mind at the time…… First was “why” did the medic feel he needed to use deadly force upon an “uncooperative” patient? I think the answer there was two fold.

First and probably the most deadly was machismo. I think machismo was getting to him because he wanted to show his male side, that he was tough. The second was a lack of training and/or preparation. He apparently had no training on the levels of force and didn’t’ realize putting something (a knee) across the throat of a person was considered, in a lot of places, to be deadly force.

Lets’ take a step back to why most people enter into EMS. The overwhelming majority entered because they have a true desire to help others. People start as either a First Responder or an EMT. Some move onto becoming a paramedic because they want to be able to “help” even more.

Something that gets lost in the training and the street experience is Good Customer Service. You remember, the Golden Rule…… the whole “Do unto others”, well where does it go? The crazy schedules of EMS providers, the poor diet, rough on the family life lifestyle sometimes leads us to forget “why” we got into the business to begin with.

It seems to leave a lot of providers for an undetermined amount of time, surfacing again with those who seem to outlive the average career span in EMS. It is some of the old-dogs that start to show compassion and understanding again. They find their “bedside manner” all over again.

Simple words like “I’m sorry” or “Excuse Me” said with sincerity can calm an escalating situation. Using “please” we need to….. can help move a person toward allowing treatment or transport to take place. We joke a lot about “Sign here” but that should not be tolerated as a standard in EMS.

Good customer service means doing more than what is expected. It is to go that extra step to make patients and their family feel important. During PALS classes I like teaching the “Coping with Death” station. I can give good customer service tips to the participants.

I can share my experiences with the participants. As a medic I received very, very little training on telling a family member their loved one was dead. As a police officer I had to deliver death notifications and received …. Yep you guessed it……. little training on “how” or “what” to say. I ask you……. in a code with a prolonged down time….. who is you real patient? Who needs good customer service too?

I write this for several reasons. Many assaults that occur in EMS are preventable. One of the absolute best ways is to remove machismo. You know, the whole “I control the scene” attitude and get back to caring. EMS shouldn’t be about how people look at you as an individual, but how well the patients “perceive” our treatment of them.

Sometimes we get so fixed into “what” physically we must do during a call, we forget it is EMOTION that people remember.

Think about it like this. Have you ever gone to a restaurant and the food was OK, but the service was outstanding? You went back didn’t you? The reason was someone made you “feel” important, like they really cared about YOU. That is good customer service in EMS. Making the patient and their family believe you care.

I can tell you from personal experience, when I learned to apply good customer service both as a paramedic and as a police officer I was in a lot less fights. So in other words I found good customer service to be a great “tactic” in my self-defense jump-kit.

I still believe a person should train in Defensive Tactics for those situations that do unfortunately arise, but good customer service can help many bad ones from ever happening.

 

[Sandog]

On the theme of customer service...

I have read on a few occasions where it has been said that the patient is not my customer. This could never be more wrong, for indeed they are a customer. Whether you work for a private agency or the city, either way you are being payed to provide a service and that service is to your customers the patient. Tax dollars or insurance money, your salary is a direct result of need by the public who in fact do pay your salary in a indirect way.

The idea that I am doing you a favor mentality is bad business, bad for your company, bad for the end customer.