“I am a paramedic, but I do NOT save lives.”

This statement brings questioning looks, not just from my partners and coworkers, but from others outside the field.

A superior once questioned if I was a good hiring decision – after all, he did hire me to save lives. And he was right – the whole concept of EMS is built on the very idea  that we do in fact save lives. I mean, we defibrillate, perform high quality CPR, control bleeding, provide ventilations, give medications, and do many other life-sustaining interventions, and many people survive that otherwise would not.

So therefore, by doing these things, we are in fact saving lives, right?

I suppose there is a certain validity to that argument, but I stand by my opening statement. I DO NOT SAVE LIVES. So how is it that a paramedic in good standing, actively working in EMS caring for patients, does not save lives? 

Being really bad at my job could explain this, and I am sure that if you asked around you’d find someone willing to support that hypothesis, but that’s not what I am getting at. What I am talking about is a shift in perspective.

The fact that we save lives carries a lot of weight. It means we take responsibility for the role we play in the outcomes of our patients. Responsibility is important, and taking ownership of our actions is a key component to our growth as providers. But every coin has two sides.

If I lay claim to saving a life, I also have to own the losses. If patients who would have otherwise died live because of me, then patients that die do so because I may have failed to save them. That is some heavy weight to bear, and we DO bear that weight.

I have taken these losses to heart too many times. I’ve seen my fellow providers do the same. While I enjoy reveling in the satisfaction of saving a life as much as the next person, I’ve seen the toll the weight of losses can take. I’ve heard some variation of the phrase “we lost another one” uttered too many times in this field and it’s too much.

What if the weight of owning our patients outcomes is unnecessary, and what if there was a way to lessen it?

I had this realization after a particularly rough call while struggling to come to grips with yet another loss. My mindset was always the typical “you can’t save them all” and “some people are just too sick or injured and beyond the ability to be saved” mentality. And these are absolutely true statements, but that “what if” question always remained.

What if it was my fault I didn’t save them? That question was the result of me believing that when I did have a save, that I made the save and at the same time taking responsibility for failing to save them when they died.

Then it hit me: I do not save lives, and therefore I do not lose patients. It was like I had this weird epiphany and all of a sudden, things made sense. We do not lose patients! 

We didn’t crash their car, stop their hearts, or bleed them out. We don’t kill them so we don’t get to own what happened to them. We don’t defibrillate and force hearts to beat again, we don’t breathe air into lungs and force life back into them, we don’t stop their bleeding and make it be in time, we don’t give them transfusions and make it be enough.

We do not save their lives! We only give them a chance to live. 

Our patients are drowning, and we did not throw them into the water, so we are not responsible for what happened to them. What we are responsible for is throwing them a rope. We cannot make them grab it, nor can we make them hold on. All we can do is throw them that rope, hope that they can still grab it, hope they hold on while we pull. We don’t get to own the ultimate outcome, only how well we throw the rope. 

Perspective becomes reality, and changing my mindset to this helped me in a couple of very interesting ways. I felt a weight lift from me, the weight of “failing” to save lives. I could still look at a “save” with as much pride and joy as before knowing that I had been able to give this person that chance to live. But on the other side of that coin, when a patient died, I could walk away with a satisfaction that I had given that patient every chance that I could. 

The responsibility didn’t change, it just switched focus. My performance became my focal point, and improving my ability to “throw the rope” was my new priority because that was my new standard. It was no longer about “saving” or “losing” a patient, and with that weight removed, focusing on improvement became much easier, and progress became much more measurable.

So contrary to every EMS slogan, I do not save lives, I only give people a chance to live.