If you’ve been listening to recent news then you are aware of incidents where EMS personnel have been called to task because of an alleged delayed or half-hearted response. The EMS community is in an uproar because the bulk of the criticism seems to come from folks who have no experience in emergency response. Meanwhile, we, and many of the critics, have not been present at a scene to see firsthand what actually transpired and eye witness accounts may be tainted by emotions. Allegations of wrong-doings affects all of us, we feel that everything we do is subject to inspection, we worry that outsiders are waiting to “catch us” doing something stupid, foolish or wrong.
…actually blaming first responders (police, ems, and fire) is nothing new.
Family members will often look to place blame when they lose a loved one - maybe it’s just a stage of grief – there is denial that the deceased was sick enough or injured enough to actually die. They look to rationalize; maybe anger even helps them avoid their pain. Sometimes, thankfully on the rare occasion, there was a MISTAKE made… the definition of a mistake is “an action or judgment that is misguided or wrong”. Mistakes are not done purposely or vindictively, they are not planned and no one started their shift deciding to cause harm. Sometimes the more chaotic the scene and possibly the more services involved, each with different responsibilities, the more possibility things will not happen systematically and mistakes may be made.
Rarely, VERY RARELY, there is carelessness or personal triggers that bring about human reactions that may, in the long run, cause harm or worse. In our litigious society, cases such as this are scrutinized intensely. Whether or not the scrutiny and blame are justified, and hopefully the inquiry will be fair and impartial, such events cast suspicion over all EMS workers. Even if the investigation later declares innocence of wrong doing, no one really gets out un-scarred. There will always be doubt and rushes to judgment from others and by the EMT/Paramedic himself.
When a person dies first responders may feel guilty. EMTs and Paramedics will second guess themselves and wonder what they could have done differently in the treatment that might have made a difference. Rescuers who “fail” to save a patient will begin to believe they are a failure – they haven’t fulfilled their purpose to save people, all of the training they took means nothing, there is a lot of self blame. The EMS responder who loses a patient experiences a form of survivor guilt. When that guilt simmers, the rescuer continues to doubt their training and their skills; they become afraid to forget the patient and “fail” them again by moving on. This continued guilt can snowball into depression, burnout and sometimes the use of crutches like alcohol or drugs – a “recipe for disaster”.
Every EMT, paramedic and first responder has experienced bad calls, every health provider has experienced the loss of a patient, it’s impossible to be in this business for any length of time and escape the tragedies and recriminations.
Responding crews may want to talk about the call among themselves (remember HIPPA). Remember to be realistic in your memories, don’t second-guess your actions based on what you did not know at the time things were happening. It’s important to acknowledge that you are human and not all-powerful, things can happen that are beyond your control. Don’t allow the angry, tearful and grieving comments made by family or friends of the patient to be taken out of context. Do not personalize the analysis of other EMS responder actions especially when guilt has been implied in unrelated situations. Learn from the events of your call and be sure that you are always doing the best based on your training and the tools you have available. Be sure to accurately document all findings, treatment and circumstances in case you are required to defend yourself. And never hesitate to make use of CISD if you are “haunted” by the outcome of a call.