5 top lessons from Medical Transport professionals that you can apply today!
Let’s say that you need to attend a medical clinic but can’t get there yourself because of your injury or illness.
What are your options?
In places like the UK and Australia, you would probably be offered medical transport.
Medical Transport (MT) staff are uniformed and are fully trained in first aid and transport operations. Often, they will use a type of fully liveried ambulance vehicle of the non-emergency variety.
Mostly, they transport elderly patients or people with physical challenges, sometimes in wheelchairs, sometimes in stretchers. It can be a very physically demanding job having to carry or at least support patients while travelling. For this reason, MTs mostly work in pairs.
Most importantly, MTs are dealing with people at their most vulnerable.
And it is that point that brings out certain aspects of their professionalism, from which we can all learn.
Here are 5 Lessons in Professionalism from Medical Transporters.
1. The importance of trust and dealing with vulnerable people
Professionalism element – (ethical) Standards
“I think of it as a great privilege being invited in to people’s home to help them” says Dave, one of the most experienced MTs.
Part of the MT’s job is to help people from their homes in to a vehicle and back again after a medical appointment.
A professional MT won’t simply drop an elderly person at their door, he or she will make sure that the patient can unlock the door, turn on the heating and the lights and that the door is suitably locked behind them when he or she leaves.
“We (Dave and his colleagues) know that it would too easy to take advantage of these people if we wanted to. I’m not saying that we think how easy it would be to pinch money but resist the urge, all I am saying is that it’s just that we are really aware of it. We want these people to trust us – mainly because we are genuinely there to help, but also because it makes our job easier and safer. If a vulnerable person trusts us, we don’t have to convince them to leave their house or use their safety harnesses next time.”
“Our purpose is to transport these patients safely to their medical appointments and then home safely too, ensuring their safety while in our care.”
Trust is vital and it only comes with consistently ethical and principled performance over time.
2. The unseen value of wearing a uniform with pride
Professionalism Element – Presence
We think of uniforms as being something that workers wear with pride and that helps them to identify with their occupation and organisation.
But uniforms also have the impact that they help people identify the uniform wearer as someone who is trustworthy, who is there to help them. If they are vulnerable, they may well be scared of people arriving on their doorstep – how do they know to trust this person?
With a uniform, vulnerable people feel a confidence in the person on their doorstep offering to help them. They feel that the person is indeed who they say they are and that they will be safe and protected in the uniform-wearer’s care.
Unseen, but important.
It’s the unseen value of a uniform to one’s professional presence.
3. When things go wrong – what’s not in the Operations Manual
“I won’t go in to the details, but not all that long ago, a patient passed away during transport”. Sinead, a senior manager, tells me.
“We don’t provide emergency medical transport so this doesn’t happen often – I don’t know actually that it has happened ever in (my organisation). If the Operations Manual covers what to do, it’s so rare that I don’t blame our uniformed staff not knowing what procedure to follow.
“You know, mainly, when it happened, my staff were simply human beings who were dealing with the death of another human being in their workplace. They aren’t trained paramedics who see death all the time – who wouldn’t be upset and distressed?”
But Sinead’s staff did an amazing job. They were initially taken aback as to what to do but quickly came to their senses. They advised Home Base by radio, covered the poor patient in a dignified manner and tended to the (thankfully few) other patients still in the vehicle.
They called on another vehicle to collect the remaining patients and take them home, while keeping Home Base informed of their actions and movements.
They brought the body of the deceased patient back to the hospital as soon as possible. Sinead is as pains to add that it was too late for first aid procedures which is why the Transporters did not try resuscitation.
Being professional till the end, the crew completed a detailed report on what happened, with intelligent and considered recommendations as to how to manage such situations in future. They appreciated the offer of access to a counsellor but felt that this wasn’t needed.
The crew were two people who were confronted by a sad and frightening experience in their workplace but kept their wits about them and dealt both with the care of their remaining patients while also dealing with the implications of a person dying on their vehicle.
They fulfilled their purpose by performing their role with dignity and pride.
4. Context is King; Break the Vacuum!
Professionalism element – Purpose
Working in a knowledge vacuum. You go through the motions of your job, not really knowing if you are adding real value. And if you are adding value, it’s probably only by coincidence, because you simply don’t know!
MTs are skilled at what they do and are committed to helping the patients in their care. Unfortunately, they are often the last to be shown information about how they and their organisation are performing.
This is a true and all-too-common organisational vacuum.
Imagine being told to go about your daily job but not told why or any context. If you come across a problem, you might not know how to respond, or what to look for. And certainly not what to advise management – if they’ll even listen.
Typically, Transport crews are given a list of patients to pick up and take from clinic to home.
Sounds reasonable and unproblematic.
But one year, they often found that they were leaving the clinic with only a few patients rather than a usual capacity of up to twelve.
What might the consequences of that be? It meant that virtually empty vehicles were leaving clinics but the same number of patients had to be transported. Which meant backlogs of vulnerable patients being transported home. Which means that more vehicles and crews were required. Which meant more cost to the client clinic. Which meant anger and frustration. Which meant an extremely unhappy customer (the clinic). And ultimately, it meant the threat of losing that customer.
IN NO WAY WAS THIS THE CREWS’ FAULTS! They were never told this information and were working in a vacuum.
“I cringed when I heard a colleague manager complain that the crews acted like children so that’s how she would treat them” says Nick, one of the senior managers.
His reaction was that the colleague has it the wrong way round – even if crews were indeed ‘behaving like children’, it was because that’s how they were being treated. Treat them like responsible adults, like colleagues, like PROFESSIONALS and start by giving them the information they need to do their jobs and all the required context.
“This is where we had a great success” says Nick. “Once we started sharing this information with crews, they realised it was a problem and, most importantly, why it was a problem.
“They could also see that there might be a danger to their jobs if action was not taken and that they had the chance to make a difference.”
Information, not vacuum. It meant that instead of solely doing their jobs, they were also co-owners (with management) of a problem and of a solution.
“The crew collected data about empty vehicles which we were able to use with the clinics to understand what was causing the problem. We found a solution and set a new standard for service delivery.
“Best of all, the crews went from working in a vacuum to being interested in MI (management information) to using the MI to ask important questions in meetings about operations and ultimately to changing their behaviours and practices without instruction from management.”
They broke out of the vacuum themselves!
5. Repetition, repetition and, oh yes, repetition
Don’t let boredom undermine your personal commitment to performance standards
Ok, things do go wrong and this is a good example of that happening, in this case due to unprofessional performance.
A Transporter vehicle was involved in a near-miss with another vehicle and had to come to an emergency stop. A regular wheelchair-bound patient was thrown forward in her wheelchair. Thankfully she was unhurt, but was left frightened and, worst of all, let down by the crew.
You see, the patient’s wheelchair had not been properly secured. The fittings were not broken or worn, and all evidence pointed to crew error.
It transpired that the Transporter responsible for securing the wheelchair did not do his job properly. He had secured so many wheelchairs so many times that he knew all the ‘short cuts’ and ceased following procedure. Now, procedure isn’t infallible, but it you are being investigated for negligence, it can be an acceptable defence to say that procedure was followed.
This crew member got it wrong.
Repetition and boredom had got the better of him.
Professionalism takes over when the boredom of repetition threatens. Professionalism means taking personal pride in each and every performance, from first till last.
Thankfully the patient was not injured, through luck alone. The consequence was that she lost trust in the service, the crew member suffered the stress and embarrassment of an avoidable disciplinary investigation, and the service had to spend money on investigations, re-training and supporting the victim.
All that from being bored of repetition!