The granite & metal memorial dedicated to flight paramedic Shawn Baker, who passed away unexpectedly in 2010 from medical complications, stands like a sentry at the entrance to MedFlight 3’s base in Pomeroy, Ohio. For me, it is a reminder, and a caution, of the fragility of life. As I enter the base it also serves as a profound incentive to move situational awareness to the forefront of my actions for the coming shift.
When we consider safety in critical care transport, we think of vehicle walk-arounds, safety belts, sterile cockpit, speed limits and more. But do we consider that safety also involves listening, looking, and being aware when our team members are not at the top of their game?
Safety by definition is “the state of being safe, freedom from the occurrence or risk of injury, danger, or loss” (Webster Dictionary, 2019). We complete an individual Risk Assessment (RA) during crew briefing at the beginning of our shift that includes our activity level, restfulness, previous 12 hours’ mission hours, and work days in a row that helps us identify the potential dangers associated with our cognizant and physical needs during our work hours. In addition, we need to listen to our colleagues during our conversations and observe indicators of their physical well-being.
Recently, I came to work with a nagging sinus issue that had not resolved after some home remedies (after all, I AM a seasoned nurse!). I was not in pain or otherwise compromised but was just not feeling 100%. After 20+ years of flying and ground transport, I had adopted “push forward, push forward” as my mantra and I continued my shift. We received a mission request. We responded as usual with our safety walk-arounds and Crew Resource Management (CRM) in all phases of our flight. As we flew back to base following the mission, I experienced a pop in my left ear that quickly turned to intense discomfort. We landed safely at the base, and I continued with the post-mission associated responsibilities even though I had essentially lost the hearing in my left ear by this time. The paramedic I was partnered with for the shift had noticed the change in me and said “you seem a little off today. Are you okay?” That was all I needed to reevaluate my situation and be aware that I was giving less than my usual 100% to not only my team and organization, but perhaps to my patients as well.
The paramedic had acted as the “sentry” to my team member performance, and that brought safety to the forefront of my CRM contribution. I took some time to reevaluate what I was doing to myself and my team in terms of safety and wellness. I announced to the pilot and paramedic that I was going home and needed to care for myself before I could care for our patients.
I suggest transport clinicians not only use risk assessment tools as a numerical identifier of “the risk of danger”, but also as an opportunity of listening, awareness, and observation of each other as well.
As I continue to be part of the MedFlight 3 team and Mobile ICU teams in our organization, I will hold the “sentry of safety” close to my heart. Listen to each other and HEAR each other during your mission conversations and casual conversations, which helps fulfill a “Safety First” mission at your workplace.