EMS World

OCT 2018

EMS World Magazine is the most authoritative source in the world for clinical and educational material designed to improve the delivery of prehospital emergency medical care.

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50 OCTOBER 2018 | EMSWORLD.com PROFILES IN EMS "The ethical implications of testimo- nial injustice are pertinent to those with stigmatized identities such as patients with chronic pain and addiction. Indi- viduals with stigmatized identities are often victims of negative attitudes and assumptions, and their testimonies are frequently seen as lacking credibility." 2 The nature of EMS allows us to develop a huge negative bias toward overdose patients, who statistically result more from abuse scenarios than any thing else. For many providers a constricted pupil can mean an entire sequence of deper- sonalization in their head. It is crucial that we regain and promote the perspective of healing versus correcting. There was no ombudsman, no active advocacy. Even when Anne completed a painful detailed "patient experience" sur vey, there was no follow-up of any kind from the facility. That slash of red ink followed Anne home, haunting her family. Her daugh- ter, em otionally ex haus ted, rep or ted the event to a teacher at her school. Not knowing the back ground and acting on school protocols, the teacher notified the school counselor, who felt the girl was being neglected and might not be in a safe environment. This triggered a social ser vices investigation, subjecting Chris and Anne to further scrutiny by the pub- lic safety system. It would even be used against her in child custody discussions. Chris had to return to work, facing an entire department that had by now likely heard some piece or version of events. HIPA A not withstanding, providers are still human and have vivid imaginations. Chris and Anne were private people, and this had ripped a gash in their shield. How much do you share? With Anne's consent Chris decided to be a s transparent a s possible with his staff. He crafted an e-mail that was as factual as possible, detailing Anne's medical struggle and what occurred on the night of the arrest. They felt at least this way they were controlling the flow of information and could better prepare for repercussions. And instead of pushback they found support. Most of the staff had no idea about Anne's histor y and were overall ver y supportive of the couple. It had been the right call. Back under the care of her primar y physician, Anne labored to rework her plan and get things back under control. Sleep was scarce for both of them. Anne lay awake at night, writhing quietly with pain and hot fla shes, afraid if she fell asleep it might be the last time. Chris' sleep was broken by the need to check on her breathing. A Return to Roots How does the Monteras' experience trans- late to out-of-hospital care? It provides stark reminders that every facet of care, no matter how small, has the capacity to reach much farther into the future than we like to imagine. We are the ghosts, the spe- cial forces, the ninjas that strike with our needles and airways and run away before we can be ensnared into meaningful inter- action with patients—leaving us vulnerable and increasing our emotional risk. Yet every Change can be hard, but when it's this good...is it? Take the First Step. www.ImageTrend.com/Step1 1-888-469-7789 • sales@imagetrend.com Booth #1301 For More Information Circle 44 on Reader Service Card

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