Thursday, November 18, 2010

Never too smart to learn

I've said before that pride is the one thing that gets in the way of learning, and I was forced to remember it again tonight.

Arriving at a routine medical call for a laceration on the back of a hand, I was first in the door and took patient contact.  Checked the wound (top of the left hand), not too deep, roughly an inch long, I'd definitely seen worse.  Smiling reassuringly I asked the patient to move her fingers for me, which she did without issue, and then I made sure that she had feeling throughout her hand and a strong distal pulse.  Good on all counts, I asked if she wanted to go to the hospital, and she gave me an adamant "no", which I understood because I would have done the same if I were her.

Glancing back at one of the more experienced firefighters there on scene, I called out "she's refusing transport, we can return the ambulance".  He looked uncertain, and after glancing at her hand, asked me "has she had a tetanus shot?".  Realizing the thought hadn't even crossed my mind, I looked back at the woman and she said no.  Furthermore he pointed out that she might need stitches anyway and that the best chance of not getting an infection was to have it cleaned well by a professional.

Keep in mind, on the whole I'm a very confidant person.  I don't doubt myself easily, and that has it's advantages, but it also means that when someone else demonstrates better knowledge or skills than me I have to force myself to contain my pride well enough to learn from them.  My instinct in this kind of situation, as it is for many people, is to think "oh, come on man, it's a little cut, she's going to be fine, would you just return the ambulance?".

Why is that?  Is it because I'm sure that's the right thing to do, or is it because that's what I'd already decided we should do and I don't like being overruled?

I think the answer is obvious.  We aren't in this job to play the numbers, however favorable they may be.  Our job in patient care, past immediate stabilization, is to provide the patient with ALL the information necessary to make an educated decision about their treatment, and to always encourage treatment (liability is a mother, ain't it?).

The older firefighter was giving her the facts: you have a cut from a metal object, that means you can get tetanus, or another infection, and there could even be damage that we can't see just from looking at the surface. You're probably ok statistically speaking, but we recommend you get it looked at by a doctor.  And next time, that's the information I'll give too.  It's a little thing, but a habit of improving in all areas, every chance you get, has a cumulative effect over time in making you into a better and better firefighter, and once it's a habit you hardly even have to work at it anymore.

The best lesson to take from this, in my opinion, is that you're never so good that you can't get better.

No comments:

Post a Comment