Compassion is competence: the key to successful patient care

compassion in medicine
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As a field training officer and adjunct EMS lecturer, I have the opportunity to work with both rookies and seasoned professionals.  While their levels of expertise are obviously different, there is something that matters to both groups: competence.  Those who are new to the field are so focused on demonstrating their practical skills to themselves, their colleagues, and their patients that they forget the urgency of bedside manner.  Experienced providers, no longer feeling the need to prove themselves, often work quickly and diligently as they easily navigate their protocols and algorithms yet they forget to explain procedures to the patient or to communicate their expectations of how a scene should be managed to their lesser experienced partners.  EMS professionals on both ends of the spectrum have forgotten that competency alone will not guarantee success.

Psychologists and sociologists have learned that professional success is not solely determined by competence, but also warmth.[1]  In only milliseconds, our patients (and also, our partners) will develop their impressions of us and those impressions are based upon the warmth we demonstrate to others.[2]  Our concerns may be scene safety, proper performance of our skills, rapid transportation, and ending our shifts on time, but our patients are concerned about how they are being treated and the outcome of their care.  When citizens call 911, they believe that the government has dispatched providers who are highly qualified.  Our uniforms, emergency vehicles, and equipment already imply competence.  If we want our patients to have a positive experience during our care and simultaneously display our proficiency, we must first integrate warmth.  When we are perceived as pleasant, polite, and concerned, we open the door for others to trust that we are competent.

What are three steps that we can take to introduce warmth to our care?  Firstly, practice active listening.  When we are able to reflect upon what others have said, ask open ended questions and then respond to specific answers, summarize our patients’ concerns, and affirm their needs and desires, we will be much more effective practitioners.  Secondly, we need to start smiling.[3]  Many of us arrive on scene as if we’ve arrived at a funeral, but our patients are not dead yet.  Even if the patient’s condition is critical, we can still offer a smile.  Their situation may be serious, but we can bring calm dignity during grave moments.  Thirdly, explain the procedures and processes that are about to happen.  I cannot tell you how many unsettled faces I’ve seen when the electric stretcher starts going up in the air without warning.  Minimize surprises and clarify what may be unknown to the patient.  If we can do these three things on our calls, our competency will rarely be called into question.

Dr. House may be great entertainment, but in the real world of medicine he would have been assigned to the lab a long time ago.

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[1] Christine Horvath, Mastering Civility: A Manifesto for the Work Place (New York: Grand Central, 2016), 71.

[2] Ibid., 72.

[3] Ibid., 72-73.

The truth about finding your calling

I vacillated through many ministerial preferences throughout my early twenties, believing I may be called to serve the church as an evangelist to the unchurched, a mentor to new believers, or as a pastor to pastors.  I navigated the choppy waters where both the salt water of pride and the fresh water of calling seem to intermingle in brackish, lukewarm waves of mediocrity and hypocrisy only to find myself shipwrecked and bitter.  In obedience, I attended seminary but I was still tossed by the winds of each class.  In my New Testament class I considered becoming a New Testament scholar, in my Apologetics class I contemplated a ministry of preparing believers to defend the faith, and in Doctrine of God I was certain I was called to be a seminary professor.  I never did desire to be an Old Testament scholar, though I once tossed around the idea of becoming an expert in Ecclesiastes.  Even to this day, there is a part of my heart that loves each of those roles (and still loves the book of Ecclesiastes), but my calling emerged not from my personal ambitions, but from my obedience.

It was during my second year of seminary that I was approached by a volunteer firefighter at the fire department where I was an overnight dispatcher.  As seminary texts (and vocational preferences) were scattered around the room and academic journal articles piled high, this lieutenant in a volunteer fire company said to me, “We haven’t had a chaplain in 30 years, but we were wondering if you would serve as our chaplain.”  I had no idea what I was agreeing to do, but after some thought and prayer, I accepted his offer and prepared to serve as chaplain to a fire department.  Four years later, I provide pastoral care to two emergency medical services agencies, a police department, and the very same fire department.  I teach first responders how to manage stress, train recruits in emergency medical technician courses, pray for those who are hurting, and offer pastoral guidance and spiritual direction to men and women who observe the worst of human evil and suffering.  And I do all of this while working as a full time dispatcher and a part time advanced emergency medical technician.  This is all done for the glory of God, so that he may receive praise and honor due his holy name.

I did not find my vocational calling by exploring my options or taking spiritual gifts surveys, though those two things were somewhat helpful.  I never desired to be a emergency services chaplain (because I wanted to be the next Billy Graham), but during my times of prayer and contemplation I remembered the powerful truth taught by Jesus: “If you love me you will keep my commands” (John 14:15).  I read the Scriptures, asked God for the willing heart to obey them and the strength to endure, and I asked the Lord to open opportunities for me.  I came to understand my calling as it was revealed to me by the Holy Spirit as he highlighted the area where my education, professional training, passions, talents, and opportunities all came together.  The Lord revealed one step at a time and by his grace and strength, ever depending on Christ, I followed his promptings and have had opportunities that I would never have planned.  Surely, if we are faithful in each of those steps, we will see things we never dreamed of seeing and hear things we never imagined hearing.  Many of us long for a moment where the Spirit of God descends like a dove and lands upon us and gives us a job description, a name of a company, or a ministry in our local church.  Such hopes are typically unrealistic and exclude the possibility that day to day obedience and gradual ascent to positions of favor are equally as miraculous.

If we have a desire to achieve greatness for ourselves, we may temporarily succeed but ultimately we will find ourselves on the wrong side of success and wellness later on in life.  Genuine greatness is found in making God great, making others great, and helping others make God great in their lives.  If we actively seek his kingdom and his righteousness, truly all the other things will come (Matt. 6:33).  Ask God to direct you to an area where your education, training, passions, talents, and opportunities intersect.  God will place you just right where you’re called to work.