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‘Please, may I see your face?’: Connecting with patients during COVID-19

The pandemic has quite literally masked the social cues that are essential to patients feeling safe and reassured


Eugene Springfield Firefighter-Paramedic Joey Parsons wears a mask in this April 2020 photo.

Photo/Chris Pietsch

For months, COVID-19 has been an overpowering force in the country. We’ve changed our lifestyles to accommodate the need to “flatten the curve” on this pandemic.

And just as it appeared with the re-opening of some businesses that our lives might be getting back to “near-normal,” we’re now facing a new national emergency in the face of the death of George Floyd and the subsequent peaceful protests by many Americans – but also the rioting, looting and burning by a few.

For firefighter-paramedics, the job didn’t change, but it did get tougher.

First came the enhanced PPE. Then came the isolation of station personnel from outside visitors, social distancing even in the station, and the constant decontamination of equipment, apparatus, and the places we eat, sleep, shower and relax.

And now we’re getting out the standard operating procedures (SOPs) on civil unrest and reminding everyone how, when and why we respond in a Rescue Task Force setting, yet hoping that call would never come. For some, it didn’t, but for many, it did.

[Listen: Side Alpha Podcast – Charlotte crews engaged in confined space rescue face hostility from protesters]

COVID-19 limits social cues

What hasn’t changed since the beginning of the human race are basics needs that, during the COVID-19 restrictions, might have been lost – at least temporarily. Psychology Abraham Maslow’s “Hierarchy of Needs” lists basic needs, psychological needs and self-fulfillment needs. Here, we’ll stick to the basic needs.

A new baby bonds almost instantly with their parents, especially the mother, through the five senses: sight, hearing, touch, smell and taste. By these adults, they are nurtured, not just with food, a dry diaper and a warm blanket, but also with a smile, a soothing voice, the safety of a reassuring word and the comfort of a hug.

From the very beginning, we learn the importance of these social cues. But for many, including firefighters, that interaction ceased or lessened because of our constant responses during COVID-19.

The power of first responder-provided reassurance

I had an experience recently that reinforced the need for such social cues.

During the COVID-19 medical restrictions at hospitals and doctors’ offices, my wife, Diana, sought treatment for a serious hip pain. When she could finally see an orthopedic specialist, understandably, the policy was that no one but the patient could enter the office. After X-rays were taken, she met with the gowned and masked doctor who confirmed that she needed a hip replacement, and he would schedule her as soon as the hospitals again opened for elective surgery.

Once the hospitals opened for out-patient elective surgery, Diana was notified of the surgery date and when she needed to come back for pre-surgery testing. Again, only she could enter the facility for this testing. The week prior to her surgery, the hospital partially lifted its ban on visitors or for someone to accompany a patient on the day of their surgery.

In the preparation room, Diana and I were together as several technicians, the anesthesiologist and nurses came and went in the pre-surgery ballet.

Right before going to the operating room, the surgeon came in to see her. As he turned to leave, my wife said, “Please, may I see your face?”

Looking a bit puzzled, the doctor turned back to her and, maintaining social distancing, dropped his mask and smiled at her.

I realized that in all the visits until then, and during those weeks when I couldn’t accompany her, she had never seen the surgeon without his mask, and that this social interaction – seeing his face, his expression and his smile – was important to her, just as it is to anyone needing reassurance and confidence in those we entrust with our care. It’s innate in our DNA as human beings – and it’s a basic need.

I’m not sure if Diana was the first patient to request that of her surgeon, but it got me thinking that as we get back to “normal,” how will we get back to the level of patient care that includes our bedside manner?

Patient connections matter

I have great confidence that our firefighter-paramedics will adjust back to this normal quickly, reassuring patients through their words, facial expressions and actions that they are going to receive the skilled professional prehospital care they deserve. I’m not so sure the same will happen with medical care provided by tele-medicine that was so prevalent during the virus.

I am reminded of an EMS call that I made a few years ago. Our medic units were tied up on previous calls, and one was returning from the hospital when a call was received for a lady with chest pains.

I responded and began to take vitals on an older woman who looked and acted much like everyone’s grandmother. I could tell she was in discomfort and the severity of the pain was a new experience for her. After a quick assessment, she asked me, “Am I going to live?” I answered that she was not only going to live but I would see that she got excellent care.

She looked me straight in the eye and asked, “From your mouth to God’s ears, am I going to live?” I looked at her again, this time directly in her eyes and said, “Yes.” She replied, “I believe you.” And that lady told every neighbor on her block this story when she returned to her home. I know this because I’ve been told this story by residents in her neighborhood for years afterwards.

Show your smiling faces

As we struggle through COVID-19 and the current civil unrest, I hope that for both our patients’ sake and for the sake of our own behavioral health that we can once again achieve the satisfaction that comes when we remember that we are seeing our patients on the worst day of their life, and that they are grateful for both the care we render and for our smiling, caring faces.

Stay safe!

Chief Robert R. Rielage, CFO, EFO, FIFireE, is the former Ohio fire marshal and has been a chief officer in several departments for more than 30 years. A graduate of the Kennedy School’s Program for Senior Executives in State and Local Government at Harvard University, Rielage holds a master’s degree in public administration from Norwich University and is a past-president of the Institution of Fire Engineers – USA Branch. He has served as a subject-matter expert, program coordinator and evaluator, and representative working with national-level organizations, such as FEMA, the USFA and the National Fire Academy. Rielage served as a committee member for NFPA 1250 and NFPA 1201. In 2019, he received the Ohio Fire Service Distinguished Service Award. Rielage is currently working on two books – “On Fire Service Leadership” and “A Practical Guide for Families Dealing with a Fire or Police LODD.” Connect with Rielage via email.