The first few tabs are for getting enough baseline information to be able to get me to the right situation card. The green cards are for medical situations like allergic reactions and chest pain, while the purple are for traumas, where the patient may be injured rather than sick. Each card will have questions designed to help me decide ALS or BLS response, as well as provide clarifying information to responders so they can have the right tools ready when they arrive on scene. Once I have enough information, I give pre-arrival instructions, which are usually something along the lines of:
"Have the patient stay calm, and do not allow them to exert themselves. Allow them to find a position of comfort. Do not allow them to have anything to eat or drink. If they take medication, have a list of their prescriptions or the bottles ready to show responders."
At this point, if it's a low-stakes situation, I can gather the patient and caller's names, a call-back number (which I ought to have confirmed before now, but sometimes things just move too fast), and the patient's date of birth, and then hang up. I usually advise the caller to call back if anything changes, or I keep them on the line so I can keep an ear on the situation until the ambulance shows up.
Those first few cards, though, the all-callers information, also ask for something else. Different people have different nicknames for it, but I call it "C/A/B" status: is the patient Conscious and Alert, and are they Breathing? This is crucial information, as a 'no' to any of these questions will trigger a "hot" response from responding units. Meanwhile, I jump down to those Time-Life Critical cards. There are tabs for CPR, AED, childbirth, and airway control instructions, and they're the only cards where all I do is read them word for word. The other cards I can skip around a little, depending on the nature of the call.
Today's call would have included CPR, although we never got to the point of giving compressions. By the time the PD had arrived, my caller was trying to get the patient flat on his back on the floor. From what it sounded like, he was struggling to get him out from behind something he was slumped against, possibly a dresser or cabinet.
So, while it was a time-life critical situation, I didn't really do anything helpful except try to keep the caller occupied while we waited for responders. He was, of course, panicked, as a loved one was lying dead in the room next to him and he couldn't even get him out from behind a piece of furniture. The best I could do was keep him too busy thinking about how to help to have time to panic.
From what I heard, I don't think the patient survived. Later, I texted my family group chat to tell them about my first (sort of) CPR call. My brother asked me if I was doing okay, and at first I thought he meant, had I performed well enough? Would my DOR (training evaluation) reflect a competent dispatcher, or would stay on remedial training until I eventually was terminated?
Once I realized that he'd meant, "Are you okay?" as in "That's heavy; are you handling it emotionally?", my reaction was, "Hell yeah. I feel great." I was a bit worried I would freeze up or panic the first time I handled time-life critical. But I performed better than I expected to. The call went into the system quickly and accurately, help arrived in a timely fashion. I did my job well.
"But," I amended, "Ask me again after my shift ends. I might feel differently once I’ve taken off the professional blinders and processed the human emotion side of things."
After work, I went home and really thought through the situation. I really was fine. Did that make me a bad person? Did it say something about my capacity for empathy that I was more focused on my performance than on the reality of the fact that somebody probably died today, and I had just spoken to likely the last person to see him alive? I've always thought of myself as a deeply compassionate person. So what did it mean that I was able to separate myself wholly from the gravity of a situation like that, and view it as nothing more than a day in the office for me?
That's when I realized that I wasn't cold, or unfeeling. The whole reason I wanted this job so badly was that all I wanted to be involved in the process of saving lives. I wanted to take pride in my work, and being the first step in the emergency response process was the way I could do that. It was the place my skills and aptitudes would best serve those in need.
The fact that I could be so distant was a professional skill I've developed rapidly over the last few months. The key to not being "thrown" by calls like this is to break convention: make the situation about yourself.
We as people try to avoid taking another person’s problem and making it about ourselves, because that’s considered selfish and unkind. If your friend confides in you she's been struggling with something, you don't say "hey me too, let me tell you about it!" You can offer your experience to her if doing so will establish a bond between you, but this conversation is about her, and you do your best to keep it that way.
But in this line of work, you have to make it about you. Thoughts like: that guy was in such a hard situation, and man, a human life might’ve been lost tonight, will weigh you down, and the job will swallow you whole.
Instead, you think: how does this affect me? Did I do my job well? What do I stand to gain (experience, perspective, professional acumen)? It goes against social convention, but it keeps you from internalizing the stuff you see (or rather, hear) every day. It’s not about them; it’s about me, and my job, my performance and my success at the situation. Thus, I am no longer emotionally involved in the situation.
It's difficult to override your instincts like that, to subdue for even just short stretches of time the parts of you that feel. But each day I get a little bit better at this job, and though at times I may worry about what that means for my soul, in the end I truly believe the payoff of saving lives will be well worth it.
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