Thursday, October 17, 2013

Professionalism in EMS and why the lack of it is hurting us all

                Oh no, this one is going to hurt. See there is no EMT or Paramedic that is professional all of the time. So in posting this one, I had to look at this from a very introspective point of view as opposed to the usual looking at problems that I see others needing to solve. See, despite my personal crusade to end the lack of information and poor patient care modalities, I have personal flaws. While I am aware of them, it isn’t always easy to fix them. So when you read this, understand that I am working on mine as well.

Professionalism as an EMT or Paramedic

                I have described getting EMS personnel to get on one page to be like herding cats. We are the guys and girls that walk into chaos with the determination that it will conform to our desires. It breeds arrogance and cynicism. We often speak of a patient complaining of neck pain as being a drug seeker. We become irritated when we pick up a diabetic patient regularly with hypoglycemia. The drunk with psych issues that we treat with contempt as being below us. The welfare mom with five children who is pregnant with the sixth, and she calls because her water broke.
We become immune to human suffering and consider ourselves better than these people. Our contempt often bleeds through in our communication with these people. I mean they are just abusing the system right. The person with neck pain should go to his local doctor, pain never hurt anybody. The diabetic should just eat a sandwich. The drunk is worth a couple of laughs at his expense. The welfare mom should have her damn tubes tied. I know you think this. So does the rest of the word. You post it online for the world to see. Then you wonder why people look at you with no respect.
Facebook pages like Paramedics on Facebook and The Most Interesting Ambulance Crew in the World have individuals that post on there in ways that are detrimental to the profession. We put cocky stickers on our vehicles. We wear T-Shirts that advertize our lack of empathy and caring. When people refer to us in terms that we consider derogatory, despite the fact the speaker may have no knowledge of what we do, we often flip out and act like they initiated a hate crime. Never mind that the person has no clue about your ability to recognize a posterior MI and act accordingly, or that you can make a snap decision that can improve their life, the know that you and your partner are coming in an ambulance and one of you are going to drive them to the hospital.
Then there is the condescending attitude we take with coworkers. We all know what we feel like when a new EMT walks in the door. We fear taking them out on the street the first time. We treat them as if they have communicable disease. We laugh when they hold a little old ladies hand or they have trouble working the suction. These people are coming in looking for mentors and they get bullied. I remember starting a job, walking in wearing my new white shirt and BDU pants and the first thing I heard was “Who the Hell are you”. Nice way to start a new job. This was two days after being suspended because I had to be so I could pay for my EMT-I class.  That is enough to make someone not want to work in the career field.
                The only person that catches as much crap as the newbie is the person who actually reads EMS research. The guy who was pointing out that 12 Lead EKG’s were going to be the standard in 1998. You know the guy who gives out pain medication to “obvious” drug seekers, then explains himself by talking about patho-physiology of pain. That nerdy guy who “can’t hack it on the streets” as opposed to the street medic who “knows” what to do.
                Carrying yourself in this way shows the world that you are not a professional. You allow the gallows humor that we use at the station or in the ambulance to cope with the stress bleed out into of pain. That nerdy guy who “can’t hack it on the streets” as opposed to the street medic who “knows” what to do.
                Carrying yourself in this way shows the world that you are not a professional. You allow the gallows humor that we use at the station or in the ambulance to cope with the stress bleed out into your dealing with the public. We also forget to shave and neglect our personal appearance. We yell at our coworkers and management. We look and act like we don’t give a damn. We have reaped what we have sown. We need to fix this. Now, that’s enough on ripping on crews
Professionalism and management

                Supervisors, managers, and dispatchers, this one is for you. We will start with dispatchers because while they are not actual management, you are part of the office staff and the initial point of contact for both employees and the public. A hateful or panicked voice portrays nothing more than you are too good or incapable dealing with the situation. The public and the crews know that you are their lifeline. If a crew needs help, you are the first person they are going to tell. If there is an emergency and the public calls you, they are going to expect you to keep calm. Be honest with them, and try to help them. When a hospital calls do not give them an unreasonable time that your crew will be there. Remember that whatever is going on is that person’s emergency not yours, and you have the ability to think clearly.
                Supervisors, you are in a precarious position. When your crew messes up, you have to be able to discipline them while maintaining your composure. Yelling and screaming at people proves that you are not in control. The fact is, whatever the person has done that is wrong has already happened. You cannot make it not happen. But yelling and insulting the person is not a solution. Your crew may also come to you with a problem with a patient, hospital, or other customer. The problem may actually be with the customer. Keeping an open mind will allow you to adjust for this. No matter what, no disciplinary action should take place in a public forum. This leads to belittlement and can lead to a loss of morale, even among the employees that act the manner you want to encourage. Be free with praise and encouragement. It never causes problems to tell someone they did a good job.
                Management, you are the ones that truly worry. You know how much operations cost. Losing a contract might cause you to have to fire people. You have to make the decision whether to purchase new or refurbished equipment. You deal with billing. You know what these people’s actions cause. Everything stated about supervisors applies to you. You should also never seem flustered. Rant and rave behind closed doors, but never let the employees see that side of you. You have to be cool, calm and collected. See from an employee’s stand point our livelihood depends on you. Often employees do not understand that your job depends on them as well. You have to be firm, fair and consistent with employees. You should not reward employees for not doing the requirements of the job. It might make things easier, but rewarding people for not doing the right things sends a message that being a problem is what gets rewarded. This leads to good employees being more likely to turn into bad employees.

Professionalism conclusion

                If this sounds like I am preaching, I am not. I have done most of these things wrong. I probably will again. That being said, I am trying to act in a manner more befitting of my profession. See most of the people reading this are my brothers and sisters. I want people to look at them as the people that come into their lives and make them a little better. I promise you I am trying, and maybe you will as well.

As always, I welcome your comments,

Lone Medic.


  1. Well said.

    Unfortunately, the ones that most need to read it are the ones least likely to read it.

    Perhaps if you could distill it into a tee shirt slogan of ten words or less...

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