In a previous post, we discussed some of the qualities I felt that everyone should know they should have that you don’t get taught in EMT or paramedic school. For today’s post, I decided to elaborate a bit on one of those traits: The Salesperson.
Sometimes, you just need to look at a patient that you know needs to go and say, “What can I do to put you in this ambulance today?” There are lots of tactics that everyone has and uses, and I felt that I would take you through my thought process when dealing with that resistant patient that I know needs to be at the hospital.
“Do it for yourself” — Explain to the patient that there is nothing more important than their health. Why don’t they want to go to the hospital? What are their concerns? Do they not want to wait? Do they think it’s a waste of time? Are they just plain scared? Do what you can to help them get past those fears. Reassure them that if they are worried about their own health that getting evaluated is the best thing. I’ve even gone as far as to challenge patients to prove me wrong, and show me that there is nothing wrong with them.
“Do it for your family” — I’ve asked patients, “What would you wife think about this?” or “How do you think your family would feel if something was to happen to you?” Don’t be afraid to get their family involved as well. Let that scared son or daughter talk to their parent and try to get them to go to the hospital.
Reach out for a higher power — Sometimes law enforcement or a primary care doctor will have an easier time speeding along the process. I had a patient one time that was incredibly resistant and reluctant to go with us. While he was alert, he would have brief periods of unresponsiveness. After debating with him for about a half hour, and having the patient become incredibly agitated with us, we decided to get PD there. Their presence made the difference and helped changed this guy’s mind.
Also, I’ve reached out to a patient’s doctor or my ER doc to speak with the patient and share their concerns as well. Most doctor’s offices you encounter in the US will take the path of least resistance and lowest liability and advise their patients that if they have a medical complaint, they should waste no time and should go to an Emergency Room. If their doctor has any pull with the patient, or if they are willing to side with another medical professional, they can be a handy resource.
With the limited options that we have afforded to us in the current national system in which we operate, sometimes getting someone to go with you is the best thing for them. If you can’t, make sure that they know the disk they are taking. Make sure you confirm that they are alert, oriented, and capable of making such a decision.
Also, be detailed in your documentation. Make note of the steps that you took. Write down who you talked to, whether it be their doctor, a nurse practitioner, your medical control, or your supervisor. Painting a clear and concise picture of the incident will help you down the road if anyone happens to take a look at your run form.
Finally, make sure the patient knows the options they still have. I have a little speech that I give to each and every single patient who is refusing my care. It goes something like this:
“I need you to sign what we call a patient refusal form. Its not a refusal of care, and if you change your mind at any point, we will take you to the hospital of your choice. Remember that even if you don’t go with us right now, you can call us back at any time, or seek treatment on your own, whether it be through your own doctor, or through the Emergency Room.”
I also ask that if the patient does decide to call 9-1-1 for a second time that they go. One call could be an overreaction, but having a situation that is alarming enough to cause one to call 9-1-1 twice could be something more severe.
What other tricks do you use with those more difficult patients who you know need to get to a doctor? Feel free to share them below!