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Patient Advocate

Late one evening, we responded to a man who wounded his hand after a night of heavy drinking. While splinting his possibly broken hand, we attempted to unravel the details of how and why. The man was vague, said he punched something because he was angry. After seeing the wedding ring, one of the paramedics put two and two together; he asked the man where his wife was. We found her face down on the floor in an upstairs bedroom.

Medical professionals are not required to like every patient. We're simply required to give every patient an equally exceptional level of care, regardless of individual situation. Whether they are a kindly old lady or our personal worst enemy, every patient is entitled to the same quality care. Ensuring that every patient is treated equally is one aspect of patient advocacy.

A patient advocate must act in the best interest of the patient. Each medical professional needs to access state of mind in decision making situations, ensure safety, ensure that proper information is relayed regarding the patient’s condition and history, and protect the patient’s privacy.

As an EMT, patient advocacy is one of my primary directives. While vital, it is not always easy. Transporting a patient with flu symptoms that is stable and can be safely transported by car is draining (and not just on us, but Medicare too). Often a patient’s attitude can be one of hostility or anxiety. They may be drunk or high. Still other times, you may have a patient that makes it very hard to focus on putting their needs to the forefront. 

I was posed a question before I started working. “What do you do if you show up on scene and your patient just finished beating up his wife? The police want to take him someplace private to 'question' him, do you allow it?”

Of course not. As a patient advocate, you never leave the patient’s side. You can’t let any harm come to the patient. He is in your care regardless of his actions or who he is. 

My conviction has been tested. I’ve treated and transported assailants, addicts, vagrants, child abusers, spousal abusers, and diagnosed psychotics. I’ve seen people at their very worst. Not just their weakest, but at their most vicious and cruel. I've had the same man spit on me, kick me in the face breaking a very nice pair of Oakley sunglasses, and call my mother an assortment of derogatory terms; he received the same level of care as Grandma Nicey McHuggington. I would give every other patient. After he kicked me in the face, I did however, opt to drive the ambulance rather than ride in back.

You ignore your emotions whatever way you can. Some try to know as little about their personal history as you can, or block the image of them hitting their child from your mind. Some pretend the patient is someone else with a different history. You also tell yourself that when they get to the hospital, they’ll have an opportunity to change. Whatever you do, you do your job. 

Deep down there’s a part of you that wishes the child abuser resisted arrest. You think of what they do to rapists in prison. You hope the man who beat his wife goes to jail. You hope justice is done. But it never shows. They are your patient and you their advocate. And when necessary, and it can be, you offer care and safety without discrimination or prejudice.

five comments

The treating of people of all stripes, regardless of background, is the real test in this case. I think there is one similarity in counter-insurgency in that a lot of the people you have to deal with aren’t good people, but sometimes doing your job requires working with them.


From Dispatches: They tried to bring in Vietnamese here, and I couldn’t treat them.” “Jesus man, what about the hippocratic Oath.” “I took that oath in America.”


Great comments, both. Thanks.


Hey, something just got me though. The OC Weekly has a story this week about a jail house beating that killed a man waiting trial for child pornography crimes. This is what “what they do to rapists in jail” means. Death. Death before a trial. No more legal system with witnesses and rights and juries. Vigilante-style justice. In my opinion, nothing is worth that.


Nice Red, it got to be tough trying to help people who just don’t seem worth helping. Keep trying. They’ll get what they have coming like Eric said.