2. They appreciate feedback on their performance – privately! The worst thing that a nurse or ED physician can do is to question the EMS provider’s care in the presence of other staff, patients, or other EMS personnel. When the ED is bursting at the seams and EMS has just brought in the umpteenth patient that day, tempers are frayed and sometimes the EMS providers may get the brunt of the frustration simmering in the department. If there is a true concern on the part of an ED staff member about substandard care a patient received from EMS, that concern should be expressed in private in a professional and productive manner. If things could have been done better, most EMS providers sincerely want to know that information and will receive it well if it is delivered in a confidential setting that allows the individual to avoid being humiliated in the presence of his or her peers. So take the time to perform this exercise discretely and with dignity.

disregarding the value and importance of your local EMS providers does nothing except alienate them and ultimately has an adverse effect on patient care.

3. Understand what they can do and not do in the field. EMS protocols for your local agencies should be available and accessible in your ED. If you receive a patient who had a cricothyrotomy performed and you did not know that your EMS providers could do this procedure, shame on you for not knowing this. EMS protocol should be updated on a regular basis as medications and interventions in EMS are constantly evolving. You may disagree that a certain EMS protocol is allowed, but make your concern known to the EMS Medical Director instead of yelling at the medics about it. Be ready to share scientific data on why you feel the EMS protocol is inappropriate instead of just saying “you don’t think it is right.” Constructive and productive criticism is welcomed by EMS if it results in better patient care.

4. Positive comments to them on their care is encouraging. My mother used to say “if you can’t say something nice, don’t say anything at all.” Now if there is a case where the care was egregiously deficient and there really isn’t anything positive to say, that is one thing. But those cases are fortunately rare, so in the vast majority of EMS runs to your ED, you should be able to find something to compliment those EMS providers on. Even just talking to them is a plus, as many times ED staff ignore them and treat them like furniture or “ambulance drivers.” They are health care professionals who perform a very difficult job, and like you and me they enjoy receiving feedback that supports and encourages them.