Guest MINDSETTER™ Morse: Dying to Help
Thursday, March 23, 2017
Yadira Arroyo, a FDNY EMT with fourteen years experience was killed last week, run down by a person who stole the vehicle she considered her home away from home. Over the course of her career she treated and transported thousands of people with similar conditions as the man who allegedly killed her. It comes with the territory; EMS is there for humanity, and we do not discriminate.
Yadira did not survive her last patient encounter. Her luck ran out. When EMS responds to emergencies our faith in humanity is the only weapon we have. We do not carry guns like the police, and do not respond with a group like firefighters do. What we say and how we carry ourselves is our best defense against patients who sometimes cannot hear what we say, and see our actions as threats.
The fire department is called for a variety of reasons. Nestled among the building fires, chest pain, intoxicated persons, building collapses, car accidents and other emergencies are a surprising number of calls for psychologically unstable patients. The labels vary, Emotional, Change of Mental Status, Anxious, Suicidal, but all are potentially dangerous.
GET THE LATEST BREAKING NEWS HERE -- SIGN UP FOR GOLOCAL FREE DAILY EBLASTSociety is filled with people suffering from emotional and psychological problems. Many of these folks lead productive lives once helped by remarkably effective treatments; therapy and medication produce tangible results in the mentally ill. Some patients have given up on treatment, choosing to make their own way in the world unimpeded by modern medicine. Most are not successful. Many have no access to the healthcare system. Whether that is their own decision or beyond their control is irrelevant, what matters is there are a lot of untreated mentally ill people living among us.
I spent twenty-five years as a firefighter/EMT in a busy urban city (Providence, RI) splitting my time between firefighting duties and emergency medical response. There were plenty of times that I faced life threatening challenges-most of them happening while on EMS calls. Fire is unpredictable. People are intelligent and unpredictable and have the capability of acting irrationally as well.
Firefighters and police have earned the respect and admiration of most people they serve. EMT’s also earn that respect, but seldom experience any admiration. We find satisfaction by being there for the addicted, the mentally ill, the forgotten elderly and the poor. It is a more personal interaction with the people who live and work in the districts we are responsible for, and our interaction with the residents is what makes the job so satisfying.
The job is as satisfying as it is difficult. The hours are long, the pay relatively low and the risk extremely high. When transporting a person in the back of an ambulance it is a one on one experience. Those intimate encounters have the potential to quickly turn from a simple ride to the hospital into a life and death struggle. Assaults on EMS personnel are commonplace. Many of the assaults are not reported, and considered by both management and medics as “part of the job.”
That needs to stop. During my time on the streets it was an everyday occurrence to be swung at, spit at, kicked, verbally assaulted and abused by the patients I was called to treat. Often, the police on scene cleared as soon as EMS arrived, leaving us with an unruly, mentally ill, impaired person.
EMS professionals cannot restrain, subdue or abduct. Doing so is a violation of a person’s civil rights. There are no men in the white coats. We do not carry straitjackets. All we have is common sense, compassion and a willingness to help a person in need. Often, it is not enough.
A rapid intervention team consisting of a psychiatrist with power to commit a patient, a law enforcement officer with power to restrain a person against their will and a pair of EMT’s to provide support and transportation in a safe environment is what is needed on these type of calls. Until that happens we are sending under trained, unarmed and overwhelmed people into dangerous situations. There needs to be a definitive approach to handling the mentally ill who call for help. The lack of a system currently used is a time bomb. You can hear it ticking if you care to listen.
Captain Michael Morse (ret.), [email protected], is the bestselling author of Rescuing Providence, Rescue 1 Responding, City Life and Mr. Wilson Makes it Home. Michael has been active in EMS since 1991 and offers his views on a variety of EMS and firefighting topics, focusing mainly on the interaction between patient and provider as a well respected columnist and speaker. Captain Morse is a Johnson/Macoll fellow in literature from the Rhode Island Foundation.
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