
Steve Valdez only wanted to cash a check. In retrospect it seems so simple. The check was written to him from his wife’s account at Bank of America. He had two forms of ID, both with photos. The address on the drivers license was the same as the ID on the check (printed by Bank of America.) Bank of America thought differently.
Here’s the rub. B of A has a written policy that states if you don’t have an account at their bank you need to leave a thumbprint. You’ve probably seen those by now. Either you dab your thumb in an ink blotter or you use the fancy thumb scanner. But Steve Valdez doesn’t have any arms. And based on his inability to make a mark with his non-existent thumb, B of A refused to cash the check.
Clearly the bank representative thought that following the rules was the safest option. Instead of considering the needs of the customer, interjecting common sense into the matter, taking on a wee bit of personal risk on behalf of the individual being served and making a simple accommodation, the bank manager stuck to her guns. Rules are rules. And now the story has been picked up by the AP news wire and it’s everywhere.
Don’t laugh. It could happen to you. We all operate under multiple sets of rules and regulations from our written protocols to our national scope of practice to our organizations policy manual. We all are expected to apply a set of pre-established rules to our jobs in EMS. The question is how we perceive those rules. Do they trump basic common sense?
Do the prohibit us from acting in the patients best interest? When are we allowed to forgo the rules? If we decide it’s only in emergencies … well, were bound to encounter a lot of those.
- Your patient is seizing in the basement of a building and you can’t make base contact to get your Valium order. Do you give it?
- Your protocol says you can’t give that glucose paste to the patient without a glucometer reading but the battery is dead. Do you give it?
- Your company policy is to splint all unstable femur fractures before moving the patient, but this dude needs a trauma surgeon yesterday. Are you willing to load and go?
- Right now, somewhere in America there’s an EMT working in a medical tent on a wildland fire who is outside of her jurisdiction and not technically authorized to practice her skills. What should she do if one of those firefighters has a medical emergency?
- Or perhaps your protocols contain some of those really ridiculous call-in orders for procedures like cricothyrotomy or dual-lumen airway insertion. Will you follow the rules and make the call or take a stand?
Following the rules is easy. It doesn’t require individual judgment or common sense. It doesn’t require much personal risk. “Hey, I just followed the rules” is a powerful argument. I know of at least one bank manager who’s making that argument as we speak.
What do you think?