You Communicate Well

A critical patient, a short ride, and the compliment that stayed with me.

The patient was critical, but the moment that stayed with me came after the handoff.

I was sitting in the office with my morning coffee, watching a sunny spring morning reveal itself through the window, when my Minitor VI pager shattered the quiet.

The call was for an ALS intercept.

In EMS, an intercept means a BLS ambulance is already on the way to the hospital and asks ALS to meet up with them. Sometimes the patient is critical. Sometimes they need treatment above the EMTs’ scope of practice. Sometimes the call is already moving before you ever step into it.

This was one of those calls.

A BLS crew from a neighboring town was passing through my area on the way to Good Samaritan Hospital. They pulled into my building to pick me up.

I grabbed my gear and climbed into the back.

The first thing I noticed was the 12-lead.

That impressed me.

Their agency had adopted the state’s policy on training and allowing EMTs to perform 12-lead ECGs. That may sound like a small thing, but it told me something right away. This crew had already done more than wait for ALS to show up.

The patient was lying supine on the stretcher with a non-rebreather mask in place. Oxygen was flowing at 15 liters per minute, and I could hear the steady hiss of it in the back of the ambulance.

The EMT gave me the story.

There wasn’t much.

The patient had not been feeling well. Then came a series of seizures. The crew had gathered what they could from the family, started care, and made the right decision to request ALS.

I opened her eyes with my gloved hand to assess her pupils. They were fixed in an upward gaze to the left.

I kept listening while I was getting ready to start an 18g IV in her left arm. I asked clarifying questions, trying to dig a little deeper into what we knew, what we thought we knew, and what still did not make sense.

There was also one clinical detail that made me think a little harder before moving too fast.

The driver stepped into the side door and watched for a moment.

“Do you need anything else?” she asked.

Then she asked how I wanted her to proceed to the hospital.

“Use the lights and sirens sparingly,” I told her. “Keep us moving through the traffic and the red lights, but don’t speed and don’t weave in and out. She’s critical, but she’s stable. There’s no reason to put anyone at risk.”

She nodded and went back up front.

I started the IV, drew up the Midazolam, and administered it. We checked her blood glucose to make sure that was not part of the problem. We placed her on nasal capnography. The EMT and I kept working through the call, narrowing things down as best we could with what we had. We kept reassessing her blood pressure to make sure it wasn’t climbing. It was fine.

As the medication did what it was supposed to do, the patient began to come around.

That was when the story got a little clearer.

What the family had described as “she didn’t feel well” turned out to be more specific once the patient could answer for herself. A migraine. A bad one. Lingering over the past couple of days.

That was important

Not because it changed everything.

Because it filled in the blanks.

EMS is like that sometimes, like a giant jigsaw puzzle. You start with fragments. A family gives you what they know. The crew gives you what they found. The patient cannot always speak for themselves at first. So, you work with the puzzle pieces in front of you and keep updating the picture as new information appears.

Most of my interaction was with the EMT in the back. We worked through the call together.

Questions.

Assessment.

Treatment.

Reassessment.

A little direction where it was needed.

A little reassurance where it fit.

Nothing loud.

Nothing dramatic.

Just steady.

What I did not realize was how much the driver heard.

She heard the beginning when she stepped into the back. Then, while she was driving, she continued hearing us through the intercom system tied to the rear-facing onboard camera.

The conversation carried farther than I knew.

We arrived at Good Samaritan and brought the patient inside.

The emergency department was busy. Not surprising. It had been a busy morning for everyone in the area.

We were standing just outside the patient’s room while I waited for the nurse to come out of another patient’s room so I could give her the handoff report. The driver was there for a moment before heading down the hallway to clean the stretcher and get the linens ready for the next call.

That was when she looked at me.

“Are you an instructor?”

The question did not feel random. It felt like something she had been holding onto for a few minutes.

Not casual.

Curious.

Almost like she had seen something during the ride and was trying to place it.

I remember thinking, “Where did that come from?”

It piqued my interest more than anything else. Why would she want to know that?

“I used to be,” I said. “Why?”

She said, “You communicate well.”

Three words.

You communicate well.

Then she turned and headed down the hallway.

That was it.

No long conversation.

No follow-up.

She got her answer and was gone.

I smiled anyway.

For a few seconds, I was on cloud nine.

Then the nurse stepped out of the room next door and asked, “What did you bring in?”

And just like that, the moment was over.

I gave the report the same way I had worked the call.

“We didn’t have much at first. Here’s what the crew found. Here’s what we did. She started coming around. This is what we learned after that. And here’s where she is now.”

It wasn’t fancy.

It was the truth in order.

Afterward, once things settled, I texted the president of their corps.

Most leaders hear complaints. I think they should hear the positives too.

“Loved your day crew today.”

I used their names in the actual message, but they don’t need to be named here.

They’d done good work. They recognized the need for ALS early. They got a 12-lead. They had oxygen going. They gave me what they knew without pretending they knew more than they did. They stayed involved. The driver asked how I wanted the ride handled instead of assuming.

The whole interaction felt like a crew trying to do right by a critical patient.

His reply came back almost immediately.

“Yes, they spoke highly of you also.”

That stopped me for a second.

It felt good. I won’t pretend it didn’t.

But I kept coming back to the first thing she said.

Not that I moved fast.

Not that I knew what to do.

Not that the report was spot on.

You communicate well.

That stayed with me because on a call like that, effective communication can disappear inside the tasks at hand.

It sits quietly in the questions.

The tone.

The timing.

The way you ask for more information without making someone feel like they missed something.

The way you give direction without taking over the crew or the scene.

The way you explain risk without creating fear.

The way you hand over uncertainty without sounding uncertain or incompetent.

I’ve spent a lot of years teaching, mentoring, and talking about effective communication.

Still, sometimes it takes a person you have never met to show you whether it’s actually showing up where it matters.

Not in a classroom.

Not in a lecture.

Not in a post.

In the back of an ambulance, with a critical patient, a BLS crew doing their job, a driver listening through an intercom, and a short ride to the hospital.

She saw my patient care.

She watched my pace.

She observed the movement.

But what she named was communication.

After nearly four decades in EMS, that still means something to me.

Because people remember more than what we do.

They remember how we sound when the call shifts into overdrive.

And sometimes, without realizing it, that’s what they carry with them.

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About the author

Mike Chanat is a paramedic, leader, and educator with nearly four decades of experience in emergency medical services, fire, and law enforcement. He writes about leadership, presence, and the human moments that shape those who serve.