By Dan Limmer
When I train new people in EMS or police work, I tell them about the “CNN Test” I apply to every call. The test is simple. I ask myself if this particular call could now, or in the future, have the potential to be on CNN. If the answer is yes, I go into a different mode. My response on the EMS or police side remains the same quality I try to provide everyone, but my response to the environment is different.
The recent shooting on the film set in New Mexico caused me to think about the EMS providers who responded there and were likely filmed in one way or another. It isn’t always the calls involving celebrities, although this is a great example. Assisting the police with chemical restraint, caring for patients involved in protests, and EMS at mass shootings are just a few more that will put you in the spotlight. Even local issues get you on the local news and social media channels. “Local” isn’t local anymore.
Note that I used the term “caring for patients” in the paragraph above. If you care for the patient and appear to bystanders and their cameras that you care for the patient, you begin in a great place. The difference between a well-meaning and caring EMS provider and one who appears gruff, indifferent, or uncaring is one with deep implications for ongoing legal and career success.
If the “CNN test” applies to a call, follow these recommendations.
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- Be aware when your call is—or may be—the “big one.” Awareness is key. Don’t be surprised. You know that there are certain types of calls that will attract attention. Get in the mindset to succeed—clinically and in public perception—early.
- Remember you will be on video. That is guaranteed. And that video will be on social media and/or the news. We can’t stop people from filming in public areas. The police can’t stop people from filming in public places. Don’t fight a fight you can’t win despite how distasteful, or intrusive you consider it. Plus, trying to shut down cameras makes you look like a defensive bully and distracts you from patient care. If people are interfering with patient care (access to the scene, hindering use of equipment, etc.), then there is more of a case to act. Otherwise, follow the following three steps on scene.
- Focus. Then focus more. Big calls can throw you. Stay on your game. Your focus is essential. If you feel you are losing it, stop. Count to 3 (or quietly recite A…B…C to yourself), so you don’t lose focus. You’d be surprised how beneficial this is and how no one will notice a quick pause. Codes and serious trauma are enough to cause distraction and loss of focus. Add a frenetic public scene, and the potential to lose focus is greater.
- Remember the basics of patient care and perform them. This is the ideal thing to focus on. Whether you are being viewed by the public or second-guessed by your alleged colleagues on social media, you will always win if you get the basics done first. Life-saving things like the A – B – Cs, done promptly and properly, play well for the cameras—and the QI committee.
- Make good decisions. Don’t get swept into action or inaction by false clues or urgent situations. You may face pressure to perform a skill to support the police (e.g., chemical restraint). You may be faced with bystanders shouting for you to take a particular action (“Why are you wasting time? Get him to the hospital!”). When personal and patient safety and solid clinical decisions prevail, you can weather the storm.
- Get into the truck as soon as clinically and practically possible. Don’t rush off the scene if life-saving care is necessary first. But don’t linger either. The ambulance is your office, your safety, and your shelter. All your tools are there. It is good medicine to get a critical patient off the scene quickly.
- Stay off social media after the call. There are two reasons for this advice. Any comments you make on social media can later be used against you legally and in the court of public opinion. No matter what you say, no matter how well-intended, a troll will turn it against you. Avoid the temptation. It is also believed that disconnecting after an incident and not becoming embroiled in social media may be better for long-term emotional recovery.
- Remember that you were just in a pressure cooker. Take care of yourself. And that leads to the last point. The public has a short attention span. It may seem like an eternity to you, but people move on to the next incident, issue, or tragedy. The memories and emotional carnage from a challenging incident will last for a while in you. I’m not saying that every big call causes damage, but the ultra-big one will stick around in your head for a while. Be sure to take care of yourself, talk to someone you trust and/or a professional, and stay in the game for the long haul.
Our reactions to calls with large-scale public visibility are very individual and personal. In no way am I implying that emotional damage is inevitable or guaranteed on any call. In a video-based and social media-driven society, it seems reasonable to follow the age-old adage of expecting the best but planning for the worst.
Stay safe and well. Always.
