The Work Behind the Ride
At the sending hospital, the patient understood the transfer as a trip for more tests. Registered nurse Erin Zink understood it differently. Before moving the patient, she asked a question she often uses when the pace of care suddenly changes: “Can you tell me your understanding of what’s going on?”
The answer gave Zink a place to start. She explained that the crew was responding to a cardiac emergency and needed to move quickly. Around them, equipment was being prepared and the next steps were already underway. The conversation did not stop any of that work. It let the patient know why it was happening.
Zink had been preparing her team since the first call from the hospital. She listened to the report, pressed for details and talked through what might change during the transfer. She shared what she knew with EMTs Kiana Zahedi and Jake Sharp, then laid out the roles and backup plans. If the patient’s condition changed, no one would have to learn the plan for the first time in the back of a moving ambulance.
Zahedi knew she would watch the patient closely and bring Zink updated heart tracings. Sharp would drive and keep in touch with the crew in back. Zink would lead the clinical care. Those assignments gave each person a job, but the crew’s strength lay in how those jobs met. Every new piece of information had somewhere to go.
Once they were underway, the patient asked a question that had not gone away with the symptoms: How could this still be a heart attack if the discomfort had faded? Zahedi talked through what the team was watching and answered the follow-up questions. At the same time, she continued monitoring and handed Zink new tracings without a reminder. Zink was managing the medical decisions. Zahedi kept the patient in the conversation.
“I also spent a lot of time talking to the patient on that call,” Zahedi said. She sees those exchanges as part of what the crew is there to do. In an ambulance filled with monitors, supplies and urgent decisions, someone still needs to notice whether the person on the stretcher understands what is happening. Zahedi put it simply: the team has the people and resources to keep a patient safe and to make that patient comfortable.
Zink noticed both sides of Zahedi’s work. She had asked for repeated tracings, and Zahedi brought each one without prompting while keeping the patient engaged. Zink had encouraged Zahedi to join critical care transport after noticing her work ethic in a previous role. On this call, she saw what that effort had become.
Up front, Sharp faced heavy traffic on an emergency drive. Getting to the receiving hospital quickly mattered, but speed could not come at the expense of the people in back. “You have to be super calm,” he said. “If you’re not calm, you’ll cause an accident or an issue.” As Sharp drove, he checked on the crew behind him and kept the ride as smooth as he could.
The work on that drive happened in several conversations at once. Zink and Zahedi were watching for changes and sharing what they saw. Sharp was listening for what the team needed from him. The patient was being told what the crew knew, what they were doing and why. The explanations were not a pause in the response. They were one of the ways the team stayed connected while it moved.
Zink recalled being told afterward that the atmosphere in the room changed when the crew arrived. The patient had been facing an emergency without a clear sense of what was happening. A plan, spoken aloud, gave them something to follow. The crew’s habits had been built long before this transfer.
Zahedi remembers how intimidating critical care transport felt when she began training. The range of calls was wider than any single training shift could cover. What helped was knowing she could ask questions and learn from the nurse and EMT beside her. Between calls, she said, the crew runs through scenarios and talks through the skills a future call might require. The practice makes it easier to recognize what Zink will need when the next call arrives.
Sharp sees the same approach in Zink. “With Erin, you don’t have to ask her; she’ll ask you,” he said of her willingness to teach. He has seen her make time for EMTs outside her own critical care crew. But Sharp is clear about the other half of that relationship: EMTs have to know their fundamentals, where equipment is kept and how to prepare it within their role. That preparation lets a nurse stay focused on the patient when a call grows more difficult.
After especially hard calls, the team talks through what went well and what could have moved faster or more smoothly. Zahedi says she still asks questions and learns something on shift. Sharp values the debriefs for the same reason. A crew cannot plan for every emergency, but it can keep learning from the last one.
Zink says she uses that same habit of preparation on less urgent transfers. The equipment and pace may change; she still gives the team a full report and talks through what they would do if the situation changed. It is a way of treating every call as worthy of attention before anyone knows how complicated it will become.
Only after the handoff did the crew learn that the patient had an important connection to the receiving hospital. Nothing about that connection had shaped the questions at the bedside, the explanations in the ambulance or the care taken on the road. “You treat them how you treat anybody else,” Sharp said.
The patient had been kept informed. The crew had kept watching, talking and adjusting. The drive had ended safely. By the time anyone learned who the patient was, the team had already done what it came to do.
The work behind the ride is the work of building a team: preparing together, trusting one another, and sharing what you know while staying open to what you can learn.
