EMS Study: Shut the F–k Up.

When “Quiet Please” Just Isn’t Working.

West Midlands

West Midlands

We’ve all been there before: that patient who is making the proper provision of care all but impossible because of their yammering on.

Loud, obstructive and verbose, they refuse to cooperate.

Apparently faced with just such a patient, UK West Midlands Paramedic Richard Playford employed the crucially important but rarely used “shut the f–k up” (STFU) technique on his 25-year-old patient complaining of severe stomach pain.

STFU Basics

STFU can only be used on persons old enough to have a driver’s license.

Also, they must not be older than you.

Thus, children and the elderly are exempt from STFU deployment.

STFU candidates must be judged to be of sound, if temporarily impaired, minds.

STFU can only be employed in the language the patient is speaking.

No doubt some are shaking their heads or expressing various degrees of  incipient professional umbrage.

In fact, there is an EMS patient demographic that both appreciates and responds quite well to the frank approach of  STFU and its variations.

STFU Variations

The stand-alone STFU is often successful especially when a brief pause is allowed between each word with the emphasis placed on “up.”

“Shut (brief pause) the (brief pause) f–k (brief pause) UP.”

However, field studies have shown that the variant:

“I told you to shut the f–k up.”

is rarely successful if, in fact, you already told them to shut the f–k up since it obviously did not work the first time.

Further, studies have indicated that:

“Would you please just shut the f–k up?”

enjoys an 80% success rate in random trials.

The rate jumped to 93% when the word “please'” was clearly emphasized as in:

“Would you PLEASE just shut the f–k up?”

Researchers surmise that it is more than the use of “please” that is responsible for its effectiveness.  Making STFU into a question apparently sets up a “win/win” dynamic where patient and paramedic share a sense of equality which results in compromise.

But, more field studies are clearly needed.

Field research has also shown that extremely subtle variations can demonstrably effect STFU efficacy.

For example, adding “Oh” at the beginning of STFU can lead to catastrophic results including introducing a sense of confusion into the caregiver/patient relationship:

“Oh, shut the f–k up.”

Apparently the “oh” acts to cancel out or negate the force of STFU entirely.

This is especially true if the “oh” is drawn out as in:

“Ohhhhh, shut the f–k up.”

Conversely, and inexplicably, adding “just” after a drawn out “oh” as in:

“Ohhhhh, just shut the f–k up.”

garners an 87% success rate but only if there is a pronounced pause after the drawn out “oh” as in:

“Ohhhhh, (pause) just shut the f–k up.”

The longer the pause, the better the success rate as it implies that you have thought the matter over very carefully and you still conclude that they should just STFU.

Practice Makes Perfect

Like all critical field skills STFU must be practiced in a non-emergency setting.

Try STFU in front of a mirror first.

Direct eye contact with the patient is very important as is a slight nodding of the head with each word.

Once you think you have it, tried it out on your co-workers.


Our case study paramedic Richard Playford not only employed STFU he also went on to say, “That is it, I’ve had enough…” whereupon he exited the transport unit and was found a mile away by colleagues.

This, we do not recommend.

Sources:  Daily Mail







  • RJ in florida says:

    I use the “are you finished” question for ranting patients. I do what i gotta do to get the treatment done and the info i need then i simply sit back cross my arms and ask “are you finished?” After a while they get tired of the question and become cooprotive but if they dont, i got what i need to treat them and when they get to the hospital and complain i whip out the cellphone and say “lets see what the cameraphone caught” (i really dont but the prospect of having been taped being an asshole usually makes them docile

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