Big Brother is Watching

Big Brother is Watching

Nov 3, 2014

I spent some time listening to Chris Cebollero and Kelly Grayson’s show about the presence of cameras being present in the back of an ambulance, and I cannot figure out what everyone is afraid of.  I know what most will say that their fears are, but is there any foundation for those fears?  First of all, let’s throw HIPAA right out the window, or as many on the internet call it, HIPPA.  People who complain about patient privacy issues with cameras and HIPAA laws are people who do not understand HIPAA.

A little more than ten years ago, I had the dubious honor of being my union’s chief steward.  One of the major fights that were dropped on our plates was the arrival of the infamous “black box” driver tracking devices in our ambulances.  If your system does not have them, I will briefly explain their function.

The boxes track the truck’s speed, breaking, use of lights of sirens, use of seatbelts, and use of a spotter while backing up.  All of their information is downloaded to a master computer and is fully accessible if needed for any sort of investigation.  In addition to its, tracking, the boxes used accelerometers and g-force detection devices to give Pavlovian real time feedback to drivers in the form of growls and beeps from an audible speaker to create a safer and smoother ride.

The fear from street personnel was always that “Big Brother” was watching.  People were absolutely petrified that information would be randomly pulled, and people would be disciplined as a result of their driving techniques.  I had to be the mouthpiece for the employee body, and because of a number of factors, we did not get very far with our argument, and the company pushed forward and installed the boxes into the ambulances.

In the two years that followed, the number of disciplinary hearings that I remember taking place as a result of the boxes were few and far between.  Most of them were ones where someone would try to tamper with or fool the box.  The most amusing of them was a crew that was being investigated for “repeatedly slamming the truck into ‘reverse’ and traveling backwards in excess of 35 miles per hour.”  It turns out that the crew was stuck on an ice patch in a posting location and was trying to free their truck up.  The tires were spinning but the truck was not going anywhere.

Once I was promoted I got to see a different side of the black box devices.  Out of all of the accident investigations that I was a part of, I saw the company mandated boxes save more jobs than it cost people.  Sure, people did not always like getting “toned” while driving too fast or taking a corner too hard, but when a crew came to a complete stop before entering an intersection and an accident occurred where the other driver said “they never had their siren on” the crew was thrilled to know that the company had their back and could prove that not only was their siren on, but so was their headlights, their emergency lights, and their turn signal as they crept into the intersection as safely as they could be expected to.

Simply put, Big Brother watched, and he protected his little minions.

When I hear of people possibly installing cameras into the backs of ambulances, my thoughts do not go to the possibility that somebody is out to get me, personally I try to look at it from the side of the argument that says, “if something goes wrong, and I know that I am in the right, I want as much evidence available to prove that.”  A camera is an unbiased witness.  Only one story gets told, and little is left up to interpretation unlike the concept of having crew members sit down and write incident reports that far too often seem to match almost too similarly.  I am not saying that people are lying, but it is easier to poke holes in an incident report than it is in camera footage.

Then there is the clinical side of things.  Let’s take some time and try and figure out how we can care for patients more effectively in the backs of ambulances.  Or, let’s just study the behaviors of paramedics and EMTs in their natural environment so that we can better design ambulances.  The uses for the footage have a much greater upside than their potential downside.

I thought that one interesting point that Chris made during the podcast was throwing out the potential for the provider in the back of the truck to have control over the camera and when it does and does not record.  It does not take much time for EMTs to develop that sixth sense that tells them when things might be going in a more negative direction.  When you need him, Big Brother could just be the flip of a switch away.

Employer policies will differ from service to service and I am sure that there will be somebody out there who is actually out to get someone but I like to try and believe at least that we are all in this for the same mission: to get an ambulance to a scene, and get prehospital care to the public when they need it.  While companies might be looking out for their own liability when installing cameras in the backs of ambulances, the fringe benefit to that is if you have nothing to hide, and you act in the best interest of your patient and something happens resulting in your reputation or employment being called to the carpet, that camera footage will be your best witness.