Human Kennel Pride

Human Kennel Pride

Police K-9

(image from Google Images)

In my 20 years plus of EMS I have been a witness to, and a victim of, a phenomenon I call Human Kennel Pride within the medical field.

I was first exposed to the term Kennel Pride while training to be a K-9 handler. I was in Oklahoma training with Sabra, my soon to be K-9 Narcotics and Tracking dog. My instructor was teaching me about particular things that I had to learn, most notably there is never a bad dog, just bad handlers.

He began to explain how you could train a nice dog to be mean but you could never train a mean dog to be nice. He explained how if the average police K-9 were to be running at large it usually wouldn’t go looking for people to bite. The K-9 would play like any other family dog. This is why many police officers have their K-9’s around their own personal children. Because they are “nice dogs trained to be mean”.

This rule changes when the dog is on duty, especially when the dog is within the confines of the patrol vehicle.
Anyone that has walked by a patrol vehicle with a K-9 inside recognizes quite quickly how the vehicle will rock from side to side as the K-9 inside barks in a cadence. The person may notice how the K-9 stares directly at the person who is nearest the vehicle. There is no retreat within the K-9. It will only advance while in Kennel Pride. A person could lunge at the car, swing a bat and yell at the K-9 inside with no effect. Well, actually the K-9 may “key-up” a little more on the person.

Now, if the handler were to remove the K-9 from inside the car, the K-9 is ready to listen to commands from the handler and doesn’t usually bark until commanded to do so. Why the sudden change in behavior? What was the difference between being inside of the vehicle versus outside? Why did the dog bark and appear so aggressive inside the vehicle, but wag its tail and look like a big fluffy teddy bear (unless told otherwise) outside of the vehicle? This is what is known as Kennel Pride. This Kennel Pride happens because the area is familiar and personal space if you will of the K-9.

I observed others and had fallen victim to this human type of Kennel Pride within an ambulance or inside a hospital room. These are areas that are known to us in EMS and in the medical field. We are comfortable in them. It is in the Human Kennel Pride stage EMS/Fire and healthcare providers are at the most vulnerable to get into legal, moral and ethical trouble.

In my Good Customer Service article I wrote about how an EMS supervisor bragged about placing his knee across the throat of an uncooperative drunk while in the back of the ambulance. At the time I chalked it up more toward the “machismo” or tough-guy factor. Now that I am more educated and experienced in the field of EMS/Fire and healthcare scene safety, I lean more toward Human Kennel Pride. My reasoning is simple. Would he have done that same thing out in the open or in the patient’s home with other people present? Would he have acted that same way if he knew a video camera was present in the hands of a bystander? I think not.
One of the ways this Human Kennel Pride can get us is in “control” type scenarios or situations. Inside the back of the ambulance or in a hospital room the provider is usually expected to be “in-control” of a given situation. This is true, to an extent. If a person, a patient is in fear for their life due to illness or injury, they look to the provider to show signs of being in control. They look upon the face of the provider to see expressions that may reveal the true levity of their condition. They listen to the way the provider speaks, listening for tone and inflection noting discrepancies in what was said versus how the words were actually spoken.

Now, let’s change the setting. This time the “patient” may or may not be in actual need of medical care. They may be in the hospital because someone, maybe a family member or maybe law enforcement made them “get checked out”. This “patient” may be under the influence of drugs or alcohol. Where the Human Kennel Pride kicks in is when the provider, either in-hospital or in the back of the ambulance begin to feel like the person is not following their directions like they should. The provider is so used to being in control they attempt to “fix” the situation. From the providers perspective, it usually starts with yelling some sort of verbal command (barking). When the yelling fails, the natural progression is to transition in to some form of FORCE to “control” a supposed patient. (But aren’t’ we supposed to have “consent”?) Just like the K-9 within the patrol vehicle the barking begins as a warning and just like the K-9 there is no retreat in the mind of the provider. This is the area we must address.

First recognition of this type of behavior exists. Call it what you will. I have named it Human Kennel Pride. I have felt it firsthand but never really realized “why” I felt it until now.

Georgia Jenkins, Paramedic Instructor at Daytona State College sent me this in an email:
….an abstract published in JEMS in 2003 finding that 59% (of 188 providers randomly sampled from 5 states) of providers reported “seeing a coworker being unnecessarily rough while restraining a patient”, and 55% reported having “observed a partner using a treatment intervention to ‘teach the patient a lesson’”. 9% of these providers also reported having “observed an EMS provider assaulting a patient”.
Have you ever seen a co-worker be “rough” or try to “teach them a lesson”? If you answered “no” what about the 14 gauge needle to the back of the hand type thingy…….?

The headlines below prove the existence of some sort of phenomenon making providers acts in a way not normal for a person delivering healthcare.

One you acknowledge the existence of Human Kennel Pride it can be dealt with. Primarily I believe it can be lessened with training on subjects like verbal skills, legal issues and actual physical skills. Training multiple staff members simultaneously will allow for co-workers to observe the signs more quickly helping stop a situation from escalating.

In law enforcement I experienced Human Kennel Pride while booking an intoxicated male for DWI. During the booking process the guy became more and more belligerent. He would yell and curse. When he yelled, spittle would come across the desk. I had remained calm for quite some time, when finally I expressed my concern for his safety. I must have done it in such a way that as a fellow officer was walking by, he paused, and then asked if he could complete my booking process. The simple act of another person breaking the cycle kept me from getting into trouble.

I learned a valuable lesson about myself that night. I realized how important it was to recognize when I was at a point of losing “control” of my emotions. Too many times in EMS, especially in the back of an ambulance, we attempt to “control” a person when we should be backing away.

The goal I set out for when I started DT4EMS was to prevent at least one person from being the victim of an assault, patient OR provider. That goal has never changed. It is my personal and professional belief that recognizing this Human Kennel Pride does in fact exist; we can reduce assaults on both patients and providers alike when we train to prevent it.