Ride Along Etiquette?

[ClutzyEMT]

Hi Caduceus, nice to meet you

I'm going to be the one irresponsible adult in this bunch who walks over, shakes your hand, and hands you the code to access my ambulance shed door.....

Then we are going to sit down together and have an in depth visit. In some of your previous posts you've alluded to having witnessed or possibly having been a part of some traumatic events, or maybe some medical events. I'm going to ask you further about them, what they were, what your part of them consisted of, how it affected you in the following days, weeks, etc.

During our chat, I'm also going to give it to you straight. We see things in EMS that most people can't even begin to imagine. Things that we carry with us for the rest of our lives. I only have three decades in this business and I'm sure I haven't seen it all and there are probably more things I have yet to see, but honestly, I still have a few accident scenes and traumatically abused young patients come and visit me in my dreams.........but I also have some wonderful memories of being the first person to hold a newborn baby in my hands and can still feel the arms of a mother who's son we revived after he plunged into an ice cold lake hugging me and thanking me for not giving up on him.

So we are going to talk about those things together. We are going to talk about the good, the bad, and the boring. We are going to talk about how a profession in EMS can either make or break a person. Then I'm going to ask you to go home and take 24 hours to really think about whether or not you want to come along with me in my ambulance.

24 hrs later...............you show up at my bay and say "I thought about it and I still want to do it."

And then I'm going to give you a pager which you will carry with you at all times.

He probably will be quiet for the first few days that you carry him and you'll probably push down on the little protruding button on the on/off knob a couple of times a day "just to be sure" it hasn't gone off and you've missed it......

And then finally, when we least expect it, (most likely at 0600 hours) Mr. Pager is going to scream/beep/tone at the top of his lungs to tell you that "Old Mr. Creeky Hips down the road has fallen and can't get up." and your going to jump out of your nice warm bed, throw on that set of clothing that you have had nicely laid out for just this occasion for three days now, wipe the sleep out of your eyes and try to calm your shaking hands while waiting for me to swing by and pick you up for the ride to the ambulance bay.

I'm going to pick you up outside your house and on the way to the ambulance bay I'm going to coach you to slow down your breathing and shake out the tremors running thru your body and just relax. I'm going to calmly remind you that this is Mr. Creeky Hips emergency and not ours. And we're going to talk about what we might be heading into as we get to the bay and transfer into the ambulance with the rest of the crew. I'm also going to remind you that this is the time of day that heart attacks happen and that we can't always rely on what "Mr. Pager" tells us so we need to be mentally prepared for the "worst case" scenario as well as a simple fall.

As we pull up to the front door of Mr. Creeky Hip's house I'm going to ask you again if you are ready and if you want to come in. If you don't, that's fine with me and I really won't mind if you decide to sit this one out in the front seat of the rig and just wait for my partner and I. I will not hold it against you either, so don't be afraid to tell me that you've changed your mind. I'd rather know now than have you come in against your better self judgement.

But if you do decide to go in, then you need to know that I can't hold your hand. I can keep an eye on you and guide you if needed, but once we step foot into Mr. Creeky Hip's house, my focus and my attention need to be on him and what is happening with him. If we get in the house and it is a simple fall, great! We can do a rapid trauma assessment while we question Mr. Creeky Hip and try to find out what caused him to fall and get him all packaged up and ready to transport (if needed) or if he doesn't want to go in, do a thorough assessment both medical and trauma, call medical control then help him up off the floor and be on our merry way. Most likely the entire time I am going to be observing you and how you handle yourself, how you interact with Mr. Creeky Hips and his family, and how you interact with myself and my crew and hopefully you will be wonderful at it.

But if we walk in the door and Mr. Creeky Hip is exhibiting agonal respirations and his family is hysterically screaming at us to "do something" then I may even forget for a few minutes that we brought you along because we will be in full "code" mode and you may have to fend for yourself for a few minutes until we get CPR started, the AED on, get IV's going, etc....so I hope you are okay with that and secretly I am probably hoping that you jump right in and ask if you can help with CPR. Whether I need you to help or not doesn't matter, but your offer to help will be immeasurable in the amount of faith I put into helping you continue along your chosen path should you choose it after this call.

And when it is all said and done, and the call is over, we are going to talk about it. And we are going to talk about you. And should you decide you want to continue on this path I will urge you to first get your Emergency Medical Responder patch.... And I will probably give you my personal cell phone number and tell you that any time you want to talk about it to call me. Any time.

I will be honest with you and tell you that I would much rather you get your EMR patch before your EMT patch because of your age. I'm not trying to downgrade you or say that you aren't ready for an EMT patch but rather just saying that "at your age" the logical step is to get an EMR patch which will allow you to ride on the rig but the ultimate responsibility for a patient's life will never lay in your hands. That's a huge responsibility to have at 15.

As a side note, my son, who is 12, has his EMR patch and it might be a shock to some, but he is allowed to ride on the ambulance with me on certain calls. Granted he has grown up in EMS and has practically lived in an EMS classroom since he was about five years old, not to mention been witness to several car accidents that we have come upon while traveling and watched from afar as I've treated the patients. The last class that I taught he decided he wanted to take the State final and practicals..........and he passed......he passed all the skill stations and the written so "legally" he can practice as an EMR but legally and mentally are not always the same. I am fortunate that I work full time for a small service and I can pick and choose which calls I allow him to go on, but I always know in the back of my mind that at some point we could be called to something I know he shouldn't be involved in because it will be totally different on scene than what the call came out as. Thankfully my town is small enough that if he isn't able to stay in the rig, there will most likely be two or three extra people on scene that can take him home again and I can talk to him later about the call and why he wasn't allowed on scene.

But in your case, it will be a totally different deal and I worry a little bit that you may get in over your head by mistake.....especially if you are running with a bunch of guys who maybe won't think twice about how something may or may not affect you....but on the other hand, I applaud you on the research that you have been doing and how you found this site. Your maturity level speaks to me of far older than 15 and I may be worrying for naught...

Please keep us posted and let us know how you are doing....and never be afraid to talk to us about stuff..........good luck!!

[island emt]

+ 100 for that great post Clutzy Girl

That may be the best post I've read all year.

Good to hear from you

[scubanurse]

Best post ever.

[uglyEMT]

Awesome post Clutzy

Hello Caduceus welcome to the City. I see your welcome has been a warm one.

Let me add a little to the discussion. As a former Captain of a squad I see a lot of liability issues but depending on your area (things change from area to area) might be able to get a waiver. One thing I would suggest is maybe not a ride along but more of an auxiliary. Help out around the bays, work those football games, pitch in at events. This way you get the experience of working with the EMTs but in a more controlled environment. As Clutzy said, if the scene goes wonky I may forget about you for a minute, in that minute a whole world of bad can happen. At a football game the chances of that happening are less. Plus helping around the bays helps you get a feeling for the crews and how they interact. Maybe crew 1 is crass and obnoxious maybe crew 2 is more laid back and receptive, ect ect.

Not saying don't do the ride along just saying maybe wait a little. Get to know the crews a little. It may even make the ride along more enjoyable because those awkward silence moments would be fewer and farther between.

As I think about it a little more let me ask you this, you said you have experienced bad in your young life already, are you ready to have that experience again but with the added weight of everyone wanting you, personally, to fix it? Even though you are just riding along and not being an active participant you came through the door with us so those around the scene assume you are "with" us and may expect action. Sometimes the hardest part of our job isn't so much what we do but what others seem to expect us to do. Call it the Hollywood Medic curse, people assume we show up and fix everything like they do in the movies and TV when in actuality it is far different.

I'm glad to see someone so young willing to take the step and join our ranks, we need more motivated young participants. By all means stick around here and pick our brains.

[Just Plain Ruff]

As Clutzy said, if the scene goes wonky I may forget about you for a minute, in that minute a whole world of bad can happen.

Ok, let me give you a real life example of the above.

I'm precepting a very gung ho new emt. We get a call to an overdose. On arrival we cannot find the guy. Police are looking, myself and my emt partner are looking and we are thinking that our new guy is right behind us. Well he wasn't. He went down in the basement looking for the patient, didn't tell us where he went. Next thing we know we hear screaming and yelling and the five of us, three cops and me and my partner are rushing downstairs. We find the overdose patient and our new guy in a wrestling match with the new guy holding the overdose patients hand which has a 6 inch bladed knife. My new guy has already been cut on the arm and he's screaming "help help help".

We are able to subdue the patient and then treat both patients until a 2nd ambulance gets there.

I have a long talk with my new guy including the part where I told him emphatically at the beginning of our shift together "NOT TO F'ing leave on scene without telling me" and then I transported him to the ER. Once done, we had to go to the supervisor's office and we both got a ass chewing that actually still hurts if I think about it too long.

This is what can happen on scene if we forget you. And with you being 16, your safety is tantamount. Can you see the headlines in the papers and Facebook "EMS Agency allows 16 year old to ride-along which resulted in injury to said 16 year old" That would be bad. I for one would not really want the added responsibility of having to watch you and take care of my patients. BUT--------------- Why not ask if you can ride with a supervisor, that way you get to go to all the best calls and can bypass the routine calls that are a dime a dozen.

[ERDoc]

I've got to play devil's advocate here. I started in EMS at 16y/o. My volley allowed us to ride the ambulance at 16. We could not drive and obviously could not be an EMT. I think it was a good experience and is what turned me on to medicine (on second thought maybe that wasn't such a good thing).

[Just Plain Ruff]

I'm all for letting Cad, get out on the trucks but strictly speaking liability wise, I'm not sure it's a wise idea but my alternative suggestion of having her ride with a supervisor would be a very viable alternative.

There are so many things that happen on scene that having a medic watch a teenager (who I believe to be mature but we only see what we see in her forum posts) as well as control the scene puts just another variable in a very fluid situation. The medic will have the distraction of keeping her in his view finder constantly which might in the end compromise patient care.

I have full faith that Cad will do what she is told but that is NOT a guarantee and to have to control a teenager, who may or may not be beyond her years in maturity, is not something that should be thrown into the mix.

So if the option is there, why not allow her on with the supervisor, I mean really , they don't actually do anything on scene except try to steal tubes and just get in the way, having a teenager to babysit(no offense) would take the supervisoritis out of the mix.

Of course my barbs at supervisors is just that, Barbs because at one time I was one of em and I welcomed ride-alongs of 16 year olds up to 80 year olds. Plus the riders can go to the BEST restaurants out there to eat at.

[ERDoc]

We didn't have supervisors since we were a VAC, it was pretty much whoever responded for the call. The student program has been going on for about 30 years with very minimal problems. I can guarantee you, we were in no way mature beyond our years and our advisors have the gray hairs to prove it.

[Just Plain Ruff]

We didn't have supervisors since we were a VAC, it was pretty much whoever responded for the call. The student program has been going on for about 30 years with very minimal problems. I can guarantee you, we were in no way mature beyond our years and our advisors have the gray hairs to prove it.

My parents keep telling me that my childrens giving me gray hair is just payback for my giving me theirs.

The supervisor ride is only good as long as there is a supervisor to ride with.

If no supervisor, then the medic/emt crew really needs to be on the top of their game to make sure that this rider comes home safe and sound, not like the dumb ass who was riding with us as a new employee. He didn't last long at our service. He was a problem child from the get go. Needless to say, he was put with another FTO and did some other stupid crap too.

[uglyEMT]

Ruff that sounded like a bad day for everyone. Definitely what I was thinking about when I said what I said. Well maybe not that drastic but still the headlines would be no less as bad. Looking at it strictly from a liability issue.

I think the supervisory ride along would be great. Like you said get all the good calls leave the stubbed toe alone LOL If the super ride isn't available I still think helping around the building, participating with them at sporting events ect will garner some great knowledge and experience but in a more controlled environment. I was always looking for help for events.

I was thinking of another thing between posts, see if you can come by for a rig check. OK I know it doesn't sound fun or exciting but you can learn a lot. I know with all the new recruits I made sure they did rig checks constantly. Who knows by going this route might make it easier to get a ride along once they see how you are around them.