Fear Control

Whether I think this is their worst day or not really doesn’t matter. They think it is and that’s what matters. And how I handle myself can have a big effect on the patient and family, regardless of severity. A big part of that is learning how to control my fear. I’m good at not outwardly showing my fear, at staying focused and on task and delivering good patient care through the fright. However, I’m not good at completely controlling fear and sometimes that means I let fear lessen my emotional control, which often manifests itself as anger. There are a lot of things to be afraid of in EMS. My biggest one is the fear of missing something big, of missing something that results in not doing the right thing for the patient, which results in a poor outcome for the patient. There is also the fear of not being perfect. In medicine we are expected to be 100% 100% of the time. It’s just not realistic. But the expectation remains There is always someone coming behind me. When I deliver a patient to the ED, a nurse checks my assessment and treatment, a doctor does the same. Most of my patients are not critical, and most times if I miss something it’s not life threatening. But it is pride threatening. My fear is that my assessment and treatment aren’t right, even on low priority, non-critical patients. I know my skills are good, but still there is that fear of missing something, that fear that results in the always present question will I be good enough, whatever the situation? I can’t hold myself to a standard of perfection, but I can hold myself to a standard of continuous improvement and learning. An instructor I had said he frequently will pull up an ER doctor after working on a puzzling or difficult patient and say “Doc, educate me”. I like that line and I use it. I am not too proud to learn. I don’t want to be that medic with a poor reputation. I want to be the medic people who know me would be happy to entrust the care of their loved ones to. My willingness to learn and be taught has lessened my fear of not being perfect. There is also the ever present fear of personal safety. We get hit by cars. We die in ambulance crashes. We can get the diseases our patients have. And more and more, we get assaulted by our patients, our patients’ families and bystanders. I am always looking around, and over my shoulder. I keep the door to my back, and never let anyone get between my partner and I and the door. Responding alone as I often do as a volunteer heightens all of these fears. I don’t always have a partner to rely on to catch things I miss, to watch the scene as I assess the patient.