A different kind of job**

He's upset, and they can tell. He has good reason to be. The ambulance is there to take his dying wife to a hospice home. She won't be coming back, nothing will ever be the same.

The paramedic expected a frantic family and when they met she could tell that they were only calm on the surface. The call quickly became a bit of a complicated situation as the patient was on the second floor and any movement caused her agony. The husband immediately questioned the quality of a two woman crew and their ability to get his wife out of the house successfully.
Undiscouraged by this common misnomer, the crew weighed the options of different ways to get the patient out of the house. The stair chair was not even a choice, carrying the stretcher in was a bad idea, and it turned out that the movement required to use a scoop stretcher was too much for the patient to handle. Finally, they settled on a long backboard to minimize movement. A bolus of morphine was administered before anything was attempted. Once the patient was secured, it was a difficult climb out of the house and into the ambulance, but the patient seemed comfortable. Although it was not the smoothest moving they had performed, the crew felt relieved that they had not added to the patients distress. It is always best to stop and rest, rather than endanger the patient.

After the patient was carefully moved to the hospice house bed, the husband expressed his displeasure with what he perceived as ineptness of the crew and their inappropriate equipment. What they had seen as reasonable options and careful guess and test, the husband saw as wasted time with tortuous, antiquated techniques and equipment. What the ambulance company saw as a competent crew, the husband saw as two women who were not strong enough or qualified to remove his wife properly and safely. He seemed blinded by his pain, unable to see that the crew had done their job well.
The paramedic tried to explain that they were only trying to do what was best for his wife, but as she spoke, she found it difficult to explain the thought process involved with complicated extrications and almost impossible to explain that a scoop stretcher has practical modern uses, although it looks archaic.

What the husband didn’t know was that the paramedic’s heart was breaking from the moment she realized that this call would not be what she was used to. They weren’t taking the patient to a place to be healed, they were taking the patient to a place where there was no hope. From the moment she read the patients age, from the moment she walked in the door of the house, from the moment she realized that she would play a part in changing their lives forever, her heart broke. Every time she reached for the patients hand to be sure she was doing okay, a heavy feeling in her chest threatened to overwhelm her. The fact that the husband’s mind was not put at ease, that he was unhappy about his wife’s transport, and that she had inadvertently aggravated an already horrible situation that was beyond her control, killed her.
As a paramedic, as an EMS provider, as a human, she had been taught to solve problems. Trained to mediate, to mitigate impact. Training that was failing her now, as she could offer nothing more than an apology, do nothing but to realize that grief was his motivation, and wish that she knew how to comfort him.
In her own mind all she could do was relive the call and know that they did the right thing and that this was simply a problem she couldn’t solve.

** A fair warning: This post is based from an interfacility call I had recently that I can’t get out of my mind completely. And when you can’t seem to forget an interfacility call, it usually means it was very unpleasant.**