An alert patient comes into the ER with a deep laceration to the forehead. Seems like a simple enough job. Clean it, IV, maybe inject some local epinephrine, staple the wound, and check for bleeding in the brain. However, what do you do when the doctor can’t make it past step one? This was the scenario and question an old EMT student of mine had for me after their shift.
Now before everyone gets all uppity that I’m “attacking hard working doctors” –this was the real scenario that was given to me and will serve as the scenario I expound upon. If the scenario had to do with a janitor shoving Windex in someone’s line, I’d be talking about janitors. If the scenario involved a nurse, or ER tech, or medic, it’d be them. This one so happens to be a doctor.
This doctor (a resident) came in, nose in chart, and didn’t look up from it for a good 10 minutes. All while blood gushed out of his patient’s forehead. The doctor finally told my former student to apply pressure, but only after being prompted with a,”Hey, uh… should I apply some pressure? Or….”
The patient’s consciousness steadily declined. That is, except for a brief moment when he gave out a shout and an automated swing of the fist. Out of nowhere, Dr. Dingleberry pounded down the first staple in his head. No warning. No “hey this may hurt because I’m not even giving you lidocaine.”
So what do you do? Slap that fool upside the head with that rectal thermometer that’s hanging on the wall? Throw out verbal accusations about his mother? Stay silent out of respect or fear of his position as a superior?
Whether you are the janitor, cook, ER tech, or head of the department, your number one job is to be a patient advocate. It can be intimidating to go toe-to- toe with the big wigs, but just like your very first EMS class taught you: pretend this patient is family. What if your mother was treated this way? What if it was your little niece that was now unconsciousness due to the amount of blood pouring out of her head?
Stop worrying about a person’s pride and stop trying to fly under the radar. Pride and complaisance have no place in medicine. As iron sharpens iron, so too does man sharpen another.
Nerves, fatigue, miscommunication, or inexperience could have played a part in the doctor’s lack of care in this situation. That’s where you come in. Being a part of the team you need to look after your teammates and ultimately win the game of life and death for your patient. There will be times you will need to say something. Whether that is a quick “are you sure doc?”, a one-on- one chat, or saying something in front of everyone, nothing is out of bounds when it comes to your patients safety. Just don’t get your panties in a wad if you find yourself getting yelled at someday.
In addition to three separate associates degrees, Tim became a nationally certified EMT in 2008 and continues to use his certification to this day. His work experience spans from physical therapy and nursing tech to the ER, donor organ procurement, and Search and Rescue.
As a self proclaimed grease monkey and gym rat, Tim enters his self re-built cars into shows and competes in bodybuilding competitions for fun.
Tim has been an instructor for EMS University since 2014, works at the UA as a biosafety officer, and now sets his sights on becoming a Physician Assistant.
