Don't Treat the Monitor

I spent several years as a volunteer paramedic. And one of the first things I learned after deciding to upgrade my knowledge from EMT-I to EMT-P was, "Treat the patient. Don't treat the monitor."

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I also recently became obsessed by my Klout score. A few months ago, I had no idea it even existed. Then, suddenly, it became very important to me to have one as high as I possibly could.

Why? I have no idea. Because bigger is better. That must be it.

Just the other day, I checked my score to find that it had dropped precipitously, like by 7 or 8 points. I had no idea why. But just as puzzling, a few days ago, it leapt back up almost to its original value.

Did I do anything different? Not that I'm aware of.

So what happened?

Who cares? I lost sight of the patient and homed in on the monitor.

Brand-new medics love their cardiac monitors. They're shiny. They're new, at least to the new medics. They are symbols of the advanced training paramedics receive. They tell us all about what's going on inside the patient in ways the patient can't, espcially when they're unconscious.

But in the rush to treatment, it's tempting to forget that the flashing screen and paddles are just one tool, and often not the best, or most reliable. If the monitor shows a heartbeat but you can't feel a pulse, then your patient is in bad shape regardless of what the monitor says. If the monitor shows flatline but your patient is alert and conscious, you have a problem outside the patient.

And if the patient's problem doesn't involve their heart, then the cardiac monitor isn't going to be much use.

When you're treating a human, and you're using technology to evaluate their condition, many things can go wrong. Leads can become dislodged. The movement of an ambulance can cause readings to shift. The technology can simply fail. Machinery breaks.

This is true in my post-paramedic life as well. I often spend too much time trying to "game" the metrics. Even in school, I found ways to ensure I could ace tests without really mastering the material. Has this served me well? Nope.

I'm not saying you shouldn't measure things. "What gets measured gets improved," said Robin S. Sharma. EMTs focus on blood pressure, pulse rate, and respiratory rate as measurements that can directly be affected to improve patient outcomes.

So the next time you find yourself worrying about follower count, or subscriber numbers, or department profitability, or yes, your Klout score, just remember -- don't treat the monitor. Keep doing the right things and leave the metrics to themselves. Focus on the numbers you can affect and spend your energy there.