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STORY TELLING AS A TEACHER

Have you ever asked a very simple question of one of your patients such as, “So how did you hurt your leg?” and end up with them telling you their life story as a result? I’m sure you have. It’s annoying, isn’t it? But the thing is, you have to listen to it. You have to let them say what they want to say, at least for a short time, before possibly interrupting them to get to a specific answer you are looking for. Why do you need to do this? You need to do this because you just met this person. You need to do this because you have no idea how this person talks normally and what kind of communicator they are. You need to do this because if you, as the questioner, also utilize effective listening skills you may actually end up with half or more of your questions answered before you have to say another word.

In order to learn as much as possible from your patient, you need to find a way to establish a pattern of effective communication. What allowing your patient to tell their story does is it begins to immediately build that bridge between the two of you that will allow this to occur. What is also does is garner co-operation from the patient that maybe you would not have otherwise. When we first make contact with patients their levels of stress and excitability are sometimes at such a level that establishing effective communication between the two of you initially might seem next to impossible. By giving them thirty to sixty seconds to vent their frustrations, whether that be about what is currently happening or about life in general, it allows them to be heard and will in turn allow you to gain some control of the scene. That will only occur however, if you acknowledge what they have said and show them that you are listening and how you can effectively do that is by repeating something that they said during their venting. By mirroring something from within their story, it will show your patient that you have been listening. This will earn you some respect from them and garner further co-operation as you move forward.

 Also, in the time it takes to allow this to happen, your partner has taken one full set of vital signs, completed a 12 lead EKG, and if the patient has continued on for ninety to one hundred twenty seconds, an IV as well. All this while the patient is telling their story, impervious to what your partner is even doing to them. But when my partner did have them distracted for just a moment, I took a glance at the patient’s medications that were right there on the kitchen table before allowing the patient to continue once again. By the time the patient is done with their story, I can have most if not all of the information I need to move forward with a treatment plan. It would all be because I allowed them to be heard.

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Let me tell you a Story

Whenever a student or a newly hired paramedic asks me the question “What is the most interesting call you’ve ever been on?”, my answer is always the same and probably will never change. My answer to this question is not the worst call I’ve ever been on, nor the most challenging call I’ve ever been on. It is however, the most “interesting” call I’ve ever been on.

Guess what? The call I consider to be the most interesting call I’ve ever been on is not what you might think. It is not the high speed MVC with multiple lives lost. It is not one of the multiple suicides that have occurred. It is not one of the criminal cases that I’ve testified in court about. It is not even a call that required my own life to be put in jeopardy.

The most interesting call I have ever been on………………………..was a transfer.

To this day I do not recall his name, but it matters not. What I do recall is his story, and how he told it. I only ever realized many years later what I had actually learned from the encounter with this gentleman. In the short term it was just a very cool call to have been on. Something to tell my peers about when I returned.

He was an elderly gentleman who had been in my town visiting some family. He lived in a nursing home in a different town that was three hours away. While visiting his family he ended up sick and in the hospital. In the end it was decided an ambulance should take him back home.

I’ll be honest, I remember hoping this gentleman would have a long nap during this trip because I had no idea what I might talk to him about for three hours. However, when I first met him, I took note of the fact that he had an old army hat on. That of course lead me to a potential topic of conversation. Maybe this fella is a Veteran. I’ve always been a bit of a history fan. Especially when it comes to all of the different wars that have been fought, whether civil or world. So I asked the question. The answer I received was in the form of a story. It was a story that took nearly two hours to complete. This was in part because the gentleman talked very slowly. It was also in part because of the very fine detail that he outlined while telling it.

He was in fact a WW2 Veteran. He was an infantry soldier who had taken part in Operation Overlord, storming the beaches of Normandy on D-Day. The details given of this battle were enough to hold my attention. I was riveted. He had managed to survive D-Day, but most of his unit did not. He described how this was what happened to most of the units and the aftermath of D-Day was all about finding out who had survived, mold multiple units together to form a new one, and push forward with their plan of attack.

He went on to describe the next few weeks of the war for him with amazing detail and powers of recall until eventually he made his way to the point in his story that he received his injuries. I had not only taken note of his army hat, but also of the obvious bodily injuries he had suffered at some point. There was no point in bringing them up in conversation as it was an obvious thing to point out. I figured if he wanted to talk about them, he would. And he did.

Although I remember everything he described about his final battle in the war, what I remember most is the description of what happened post battle. His moment-by-moment description of how he fought for his life after he was left for dead is what will stick with me forever. This article and outlet is not the proper place to give a complete descriptor of this man’s harrowing journey that day. The one thing I can tell everyone is that the three hours with him passed by as if time stood still.

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The Takeaways

What did this story teach me? First and foremost, war is hell. Absolute hell. From all accounts that would be an obvious thing to say. But without ever being in a war, what would bring me to that conclusion after this encounter? It is not only what this gentleman told me, but how he told his story. As mentioned earlier, this man was elderly at the time and had probably told his story a few hundred times by the time I ever heard it. Is it possible the story had gone through a few alterations to either falsify or exaggerate his plight? Possibly, but I do not think so. What made his storytelling effective is how he delivered it. He was calm. He was precise with his statements and descriptions. He hardly lost eye contact at all with me. That was perhaps the biggest action that held my attention through the entire trip. He was invested in what he was saying and because he was invested, I was too. When we were arriving at his destination, I remember him being reassuring towards me that he was doing just fine and had been in a good place for many years. But it would never leave him. It would never leave me either.

The Transition

I only ever really started writing about thirteen years ago and when I began to research and learn about how to write or tell a story, I quickly realized how much there was to glean from that simple, no active treatment, three plus hour transfer. After thinking about it from a writer’s perspective, I eventually also realized I could and should transfer these skills over into how I practiced as a paramedic.

I did transfer these skills over and I continue to tell myself the following reminders all the time.

  1. Stay Calm – The demeanor of the paramedic will have a direct impact on the demeanor of the patient. If you are calm, they will have a better chance of being calm. If you are excitable and escalate, they will do the same.
  2. Explain and be Precise – It goes along with remaining calm. Speak calmly, precisely and in terms that your patient can understand. Stay away from medical jargon and slang terminology. Adjust your language to with whom you are speaking. How you speak to an elderly person will and should be much different than how you speak to a teenager or child.
  3. Make Eye Contact – Do this both when speaking and listening. This will let your patient know that you are actively invested in what is happening to them. It is a sign of respect.
  4. Be Reassuring and Kind – Go into every call as if the patient you are there to help is a family member. Being kind and acting in a professional manner at all times will help build bridges between the public and the health care system. It cannot be stressed how important this is. This is especially important to any paramedics who might have to visit the same patients in their homes that you have.

Conclusion

Every single person on this Earth has a story and many of them are simply amazing. In many instances, we simply do not have enough time with people to learn their stories as we are busy with patient care. There are of course also times when our patients simply do not wish to talk and are very private or introverted. But if you do have time and the patient is open to talking, dive in. Ask them about themselves. The geriatric population often are the people with stories that are quite interesting. They will have lived during a time when most of us were not even alive and the accounts from life back then can at times both shock and amaze.

Talk and listen to your patients. You might just learn something about not only how to be a better communicator, but perhaps a better person as well.

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