Making small talk with patients during long transfers

[rhan101277]

I have a hard time talking to people that I don't know, because I don't know enough about them to start up a good conversation. I want to put the patient at ease. I have thought about asking stuff like how has your week been, etc. I just worry about getting to personal since I have a limited time with that person. Anyhow if anyone has any ideas as to how they do it, that would be great.

 

[WuLabsWuTecH]

I mirror them. Oftentimes they just want to sit back and rest. If the make small talk I will too, but usually I'm fine just sitting back and getting up to take vitals every 15-20 minutes. Generally I'll just enjoy the scenery going by or if I have a book, read it as most patients like to get some rest.

 

[Hal9000]

I routinely make two to four hour transfers when I'm not doing 911. If the patient wants to rest, I let them, but my real life personality is blessedly pretty good, and I usually end up chatting with most of my patients. I've had some of the best conversations on long trips with patients I don't even know. I usually explain my background and inquire as to theirs (Old people have some of THE BEST stories!) and talk about my hobbies, unusual stories, and other things.

As for how to do it, the best thing I can think of is to not be...well, shy. Sometimes I start out asking something boring or stupid, and I usually promptly say, "Wow, that was boring or stupid." How are you around your friends? I treat everyone as a potential friend (Not psych pts, actually.) and I've never had a bad experience. Sure, some crazy whackos that might make me uncomfortable, but I roll with the punches and think of them as one of my crazy uncles. Works every time.

Anyway, it's personality. I personally need my alone time, and I can't stand having more than a few close friends. I still make sure that my patients receive the care and comfort they deserve, so making them comfortable with me as a person is included in the package.

Oh, and avoid being sunshine-sing-along-happy-friendly. While technically nice, it's not very real.

 

[tydek07]

I mirror them. Oftentimes they just want to sit back and rest. If the make small talk I will too, but usually I'm fine just sitting back and getting up to take vitals every 15-20 minutes. Generally I'll just enjoy the scenery going by or if I have a book, read it as most patients like to get some rest.

Perfect answer

 

[rhan101277]

Good thanks so far. The pts. don't get frustrated at you taking their blood pressure 4 times in 60 minutes. After you count respirations do you auscultate? Or only if you think their condition has worsened.

 

[marineman]

I used to have the same problem with being shy around people I don't know. Shyness is nothing a bottle of jack can't fix, errr I mean. The biggest thing to me is 99% of my (limited) patients so far have been really nice and they usually start asking me questions about school and why I want to do this because they know I'm a student. Once you find a good "opener" you can roll with the punches and carry the conversation from there.


P.S. asking how their week has been is generally not the greatest opener because if they're talking to us it's been a pretty crappy week.

 

[KEVD18]

during the early part of the trip(packagin, loading, initial vitals, getting comfortable etc) i'll generally make small talk. nothing major or heavy. weather, sports, etc. if all i get back in monosylabic anwers or another sign of general disinterest, then its quite and peacful time. i'll write my chart up(and get caught up with any others), do my vitals every 15 minutes on the dot without question never missing a set on the perfectly stable and sans complaint va patient thats being discharged home three states away by ambulance becuase of the va's limitless budget and just let the patient chill.

some want to talk. some want to nap. give em waht they want.

 

[LucidResq]

Assisting in D&Es at the OB-GYN office has made me a pro at small talk. The procedure is often pretty unpleasant and painful, so as I'm assisting the doc I do my best to distract the patient. I'm convinced that if you can make small talk with someone while they're in pain and anxious with their legs spread open to the world during minor surgery, you can have small talk with anyone.

I think it's key to realize that some patients, especially those who are feeling really crummy, probably don't want small talk. Be receptive to clues and don't try to force conversation. They may appreciate what feels like an awkward silence to you much more than conversation.

Younger patients - do you go to school or work? You can proceed to ask about their job/school. Try to focus on the positive, and be careful not to come across as judgmental. Once you're warmed up you can ask them about their plans for the future. What do they want to do for a living? Where would they like to live?

Older patients - most parents and grandparents love talking about their children / grandchildren. Many of my most successful patient interactions started with my inquiring the age of their children, and when told they have a teenager or toddler or 3 boys - "Whoa! You really have your hands full then, huh?" lightheartedly - I usually get plenty of interesting stories out of that.

All patients - Do they live in the area? How long? Where are they from? Do they like it here? If they're wearing anything remarkable ie: sports jersey, tattoo, piercing - what's the significance? For female care providers - complimenting a woman's jewelry/clothing/hairstyle/etc is a good way to get started.

To keep the conversation going, avoid interrogating your patient. It is important to ask plenty of questions, but balance it out by revealing some information about yourself.

Most importantly, your goal should be to connect with your patient and make them more comfortable. If you over-think being a great conversationalist, chances are you won't simply listen to your patient, which will set you up for failure.

 

[WuLabsWuTecH]

Good thanks so far. The pts. don't get frustrated at you taking their blood pressure 4 times in 60 minutes. After you count respirations do you auscultate? Or only if you think their condition has worsened.

I do the first set of vitals before we're underway. Can't hear much once we are underway. Immediately after I do BP, I set up the automatic cuff and make sure its reading agree with the manual. If it does, and the patient tolerates it, I set the cuff to inflate every 15 minutes (or 20 minutes depending on how I'm feeling). Take pulse by hand and attach the pulse-oximeter and if it agrees with my reading, I'll leave it on the patient if he tolerates it. Program alarm limits 93-100% since its continuous monitoring and sit back. When I hear the BP Cuff inflate, I write down the pulse-ox readings and count respiration rate. Patients usually can sleep through this so it doesn't really bother them, but if i notice its waking them up, I just set the screen to flash when the bp cuff inflates instead of making the "ding!". If you can asculatate in the back of a truck running down the highway, more power to you.

Also, generally patients are stable before transport, but if they become unstable, its time to have your partner find a diversion hospital and to take vitals every 5 minutes.

(...)

Younger patients - do you go to school or work? You can proceed to ask about their job/school. Try to focus on the positive, and be careful not to come across as judgmental. Once you're warmed up you can ask them about their plans for the future. What do they want to do for a living? Where would they like to live?

I've never done a long distance on a child, but I would assume if they didn't want to rest they would want someone to keep them entertained and talking. I would also assume they might have a toy or gameboy?

 

[DT4EMS]

I have a hard time talking to people that I don't know, because I don't know enough about them to start up a good conversation. I want to put the patient at ease. I have thought about asking stuff like how has your week been, etc. I just worry about getting to personal since I have a limited time with that person. Anyhow if anyone has any ideas as to how they do it, that would be great.

I have used a little "Ice Breaker" for years to get a conversation started.......................

Once the back doors close and I sit on the bench seat............. I look right in the patient's eyes and ask "Is this your first time in an ambulance?" When the reply is "Yes"............

I smile and say................ "Mine too."

It has worked well for me over the years.

Kip

 

[rhan101277]

We don't have automatic cuffs on our trucks, they do seem pretty reliable though. But anything electronic or mechanical can break.

 

[marineman]

We don't have automatic cuffs on our trucks, they do seem pretty reliable though. But anything electronic or mechanical can break.

I'd tread lightly there, it's likely to cause a hellstorm of people coming in with half saying they work well and the other half saying they're crap and you should always do manual with a few in the middle that do half and half.

 

[WuLabsWuTecH]

its completely a personal choice. I like to think I can trust what I feel and see so that's why I do a manual before going to the auto. Also, our monitor has in the past been wrong before. The reason for the auto is that it measures systolic and diastolic where as in a moving vehicle, i can't hear so I can only get a systolic/palp.

 

[FFEMT1A]

Ive been lucky I guess.... Ive never had any really long transfers. Blessing of living in a Metro area. Now that I am living in a rural area and the "big hospital" is 45 minutes away... that may change.

 

[traumateam1]

Oye... lets not turn this into an automatic vs. manual thread again, there have been many.. and they just turn into mess fest.

As far as the original topic goes.. I, like joking with the patient, will feel them out. If they are in the mood to talk lots, or they have been chatty the whole time, I will keep the conversations going. However, if they are really only into answer medically relevant questions, and other than that, they just wanna lay there.. than I wont start gabbing away. Remember, theres a time and place for everything.

 

[pumper12fireman]

I work in a small town of about 8,000 so that really helps. The older people love talking small town gossip and politics and if I don't know them, they usually know someone on the fire dept or I know the area in which they live. I usually like to ask what they do/did. Some people have/had some really cool jobs. And I like to show interest in that because most are very interested in what it's like to be an EMT/firefighter...

To the OP, I used to be the same way..kinda shy. But, this job has defintely gotten me over that, and meeting new people is one of my favorite parts of the job.

 

[41 Duck]

Guess I'm lucky--I'm within a half-hour of three hospitals--two of which are Level II's. I've never taken a PT anywhere other than those three. I couldn't imagine having to bring them via ground to places further away.


Later!

--Coop

 

[pumper12fireman]

Guess I'm lucky--I'm within a half-hour of three hospitals--two of which are Level II's. I've never taken a PT anywhere other than those three. I couldn't imagine having to bring them via ground to places further away.


Later!

--Coop

I work in a system where the hospital is no more than 10 minutes away..yet, it's a 5 bed ER, with the only capability of labs and CT. No trauma, no surg, no cath lab etc. So, a lot of times pt.'s come in POV or by us for stabilization then they get transferred out ALS or BLS, emergent or non-emergent to the city (depending on which hospital a 45min-1 hr 15min drive). We may only run 4 or 5 calls a day, but when some or most of those are 3 hour round trips, it makes for a long day.

 

[marineman]

Guess I'm lucky--I'm within a half-hour of three hospitals--two of which are Level II's. I've never taken a PT anywhere other than those three. I couldn't imagine having to bring them via ground to places further away.


Later!

--Coop

I live in a similar area with 5 hospitals within a 15 minute drive one of which is level 2 trauma and it has a peds rating but I forget what it is. Only thing they really don't do is burns but those are flown to milwaukee. We still average 2-3 longer transfers (hour and a half to three hours) daily. That's 2-3 company wide not a single rig. Every now and then we send a rig to the twin cities (5-6 hours one way) on a transport but I honestly have no idea why or what is wrong with the pts.

 

[WuLabsWuTecH]

Guess I'm lucky--I'm within a half-hour of three hospitals--two of which are Level II's. I've never taken a PT anywhere other than those three. I couldn't imagine having to bring them via ground to places further away.


Later!

--Coop

Ha! Yeah, I only do long distrance transfers as discharges!

there are about 12 hospitals in the city and I'm neevr really more than 5 minutes away from one unless tis rush hour in which case it might become 10 or 15.