Rose by any other name...

Recently I was given an invitation to become a contributor to paramedicine 101 a great blog resource that I read often, but never linked to in the sidebar for reasons only my alien abductors can tell you (sorry, watched The 4th Kind at the firehouse last night).

So I finally get to start a post this way...

Also posted at Paramedicine101

The title is not a typographical error or omission, I meant it to play on the line from Romeo and Juliet.

In the Shakespeare play, Romeo proclaims that his love for Juliet transcends their family names and political differences by saying

"...That which we call a rose
By any other name would smell as sweet."

And this line certainly conveys that feeling, as does the rest of their exchange, but try calling Rose, your 78 year old patient, by another name and let's see if she stays as sweet.

It can not be repeated enough so I will keep repeating it until I either snap and become un-Happy or until I stop hearing certain words at the scenes of emergency responses.

If you choose to use profanity I have issues with you.

If you use inappropriate terms to describe ethnic groups, I have issues with you.

If you can't learn and use your patient's name then we not only have issues, but you are lazy.

Things I have heard on scenes throughout my travels are terms like Pal, Buddy, Honey, Sweetie and my least favorite, Dear.

Let me assure you I have fallen victim to the occasional frustrated or suddenly confused Buddy or Dear comments, but constantly using such terms only proves you don't care enough to even learn their name.

And another point of clarification, while we're on the topic of names, your patients are not expected to remember yours. Notice I said remember, not learn, because of course we are introducing ourselves to our patients, then using the names they tell us to address them.

Aren't we?

When entering a scene keep in mind what you look like. Uniformed, carrying bags, wearing gloves, possibly even a mask and asking questions. Not to mention all that ruckus outside. That's scary. Not just for the kiddos, but everyone.
Now imagine the confusion when I come racing up the stairs in full turnouts fresh from a fire call doing the same thing.

So when you approach these folks, put them at ease from the first words out of your mouth.
I prefer a simple phrase like, "Hi there" or "Good (afternoon, evening, morning)" just to remind them I'm a human being too.

Now to the tricky stuff that comes from experience, the introduction.
"What's wrong?" is a poor opening line,
"What happened?" can lead down roads not concerning the present Chief Complaint, and
"Why did you call 911?" often leads to people looking away and saying "um..."

Start by offering a hand and simply saying hello, then your name. When they reach to shake in introduction not only do you have an ABC assessment complete, but you make them smile and feel at ease.

Now remember the name they give you.

Repeat it to them.
"Hi Jessica, how did you end up on the floor today?"
Write it on your glove if you must, but remember it. Use it. Call them by it.

If Jessica introduces herself as Mrs Johnson, you call her Mrs Johnson until she tells you otherwise. Not Jessica and certainly not Dear or Sweetie.

Not using a patient's name when speaking to them shows not only disinterest in your patient but disinterest in your profession.
If you lose the trust of your patient then all you are is an expensive ride.
Earn their trust and do it from the beginning with a smile, an offer of a hand, a hello and referring to them by their name.
It's a little step that goes a long way and will not get you noticed when you do it, but will stand out glaringly if you don't.

Imagine if Juliet showed Romeo the amount of interest many in EMS do and called out,
"Buddy, Guy, oh where for art thou Pal?"

I think Romeo would have turned tail and found someone that could at least remember his name.

EDIT - 3/26 - A fellow writer posted a comment about his thoughts on this topic 2 days earlier, which addresses some interesting "rules" in the UK pertaining to addressing clients, citizens and patients.  Read it HERE

Comments

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Amen, and thank you.

This is a personal peeve of mine as well. I try to let the pt drive the conversation at first. "Hi, I'm Grumpy with County Fire Dept", and stop there to see where it goes. Fairly often, a lot of my initial questions get answered without me having to interrupt and keep wrestling the steering wheel of the conversation back. It doesn't always work, but when it does it works well.

And oh my how I hate the dears, sweeties, hons, etc. If you blank on the name, miss, ma'am and sir are the appropriate stand-ins, thank you. The aforementioned terms of endearment start to become acceptable again in opposite proportion to the pt's age, though, as I wouldn't call a 9yo "sir".

Last peripheral peeve...medics and providers (particularly the primary caregiver), lose the damned reflective cool guy sunglasses and let the pt make real eye contact with you. Seriously.

Thanks, HM.
Amen, and thank you.

This is a personal peeve of mine as well. I try to let the pt drive the conversation at first. "Hi, I'm Grumpy with County Fire Dept", and stop there to see where it goes. Fairly often, a lot of my initial questions get answered without me having to interrupt and keep wrestling the steering wheel of the conversation back. It doesn't always work, but when it does it works well.

And oh my how I hate the dears, sweeties, hons, etc. If you blank on the name, miss, ma'am and sir are the appropriate stand-ins, thank you. The aforementioned terms of endearment start to become acceptable again in opposite proportion to the pt's age, though, as I wouldn't call a 9yo "sir".

Last peripheral peeve...medics and providers (particularly the primary caregiver), lose the damned reflective cool guy sunglasses and let the pt make real eye contact with you. Seriously.

Thanks, HM.
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InsomniacMedic said…
Over here in the UK, there has been a recent instruction to one of the police forces about the terms they are allowed to use when they speak to people. It includes NOT saying Good Afternoon, as this may offend certain people who may have a different "afternoon" from the rest of the world. There are also rules in the ambulance services that legislate how to address people, which seems equally as ridiculous to me.
Within the first 10 seconds, just as you wrote, you can have an almost instant raport, ABC assessment, introduction, have the patient at ease and of course the name they wish to be called by, all by just using the right approach.
So don't legislate - just think. And use courtesy and common sense. That's my vote anyway...
Have a recent post about exactly the same subject matter over at my blog too... Must be something in the air :)
InsomniacMedic said…
Over here in the UK, there has been a recent instruction to one of the police forces about the terms they are allowed to use when they speak to people. It includes NOT saying Good Afternoon, as this may offend certain people who may have a different "afternoon" from the rest of the world. There are also rules in the ambulance services that legislate how to address people, which seems equally as ridiculous to me.
Within the first 10 seconds, just as you wrote, you can have an almost instant raport, ABC assessment, introduction, have the patient at ease and of course the name they wish to be called by, all by just using the right approach.
So don't legislate - just think. And use courtesy and common sense. That's my vote anyway...
Have a recent post about exactly the same subject matter over at my blog too... Must be something in the air :)
Theresa Jones said…
Oh, thank you! A true pet peeve of mine as well. Here's another one, do not shorten the persons name either. For example, my name is Theresa, only close friends and family call me Terri. I do not like it, nor care for it, when others whom I do not know, do. Same goes for the names of Michael or Christopher or Joshua etc. Please do not shorten names with out permission or give them a nick name either. Drives folks crazy. Again great post. Thanks!
Theresa Jones said…
Oh, thank you! A true pet peeve of mine as well. Here's another one, do not shorten the persons name either. For example, my name is Theresa, only close friends and family call me Terri. I do not like it, nor care for it, when others whom I do not know, do. Same goes for the names of Michael or Christopher or Joshua etc. Please do not shorten names with out permission or give them a nick name either. Drives folks crazy. Again great post. Thanks!
Theresa Jones said…
Oh, thank you! A true pet peeve of mine as well. Here's another one, do not shorten the persons name either. For example, my name is Theresa, only close friends and family call me Terri. I do not like it, nor care for it, when others whom I do not know, do. Same goes for the names of Michael or Christopher or Joshua etc. Please do not shorten names with out permission or give them a nick name either. Drives folks crazy. Again great post. Thanks!