I see a lot of people in EMS who want to be heroes. I see a lot of people in EMS who consider us part of the public safety family. Occasionally, there’s some heroism in EMS. And yes, in many places, EMTs and paramedics are part of the public safety team. I also hear the term life-saving bounced around. I can count on one hand the number of EMS calls where a life was immediately saved by EMS interventions. Lives prolonged? Yes. Lives made better? Yes. Lives saved immediately? It’s a rare occasion.
I have a real concern, though. None of those reflect the day-to-day reality of EMS. In my opinion, after a few years in this field in a variety of settings, we rarely get to be heroes. In fact, if we’re at the point of heroism, something’s likely to have gone really wrong in the course of the call. What we really do is deliver unscheduled out-of-hospital medicine. Our definition of “emergency” often varies from the patient’s definition, but the God’s honest truth is that we’re here for our patients. Period.
Over the last couple of days, I’ve been pretty dismayed by some posts I’ve seen in EMS social media groups, whether by new EMS students or experienced providers. I’ve seen posts advocating “punitive medicine” like ammonia caps and dropping the patient’s hand on their face to determine if the patient is “faking” a seizure. I’ve seen other posts asking how to identify “drug seeking” patients so that a provider can hold back pain relief. I’ve seen posts advocating that EMS providers be allowed to decide who gets to go to the emergency department. And I’ve seen posts by supposedly experienced paramedics advocating “just taking the patient to the hospital” rather than performing a complete assessment and providing treatment all because the hospital is close.
I get all of these complaints. I really do. We’ve all been on the shift where the calls keep coming and it seems like no one really has a supposedly legitimate emergency. I’ve complained. I’ve griped to my colleagues. And I try not to let it impact what I’m doing as a medic.
The reality is that we may be public safety heroes who save lives — occasionally. But what we truly always are is professional caregivers. Part of the obligation that you have is to suspend your judgment of the patient in order to CARE for them. Even the most malevolent, challenging psychiatric “frequent flyer” has issues that we’re not going to be able to understand, much less fix as EMS providers. Our duty is to assess the patient, provide care as we’re educated to, and get them to an appropriate destination to address their concerns. When we start embracing the care aspect of the job more, we’re going to have less burnout, better outcomes, and probably some happier EMS professionals. Until that point occurs, I’m concerned — because I’m seeing what people think is acceptable. Ask yourself if that’s how you’d want your family treated or if you’d be proud for the local news media to showcase your last call.
It’s time for all of us in EMS to take a look in the mirror and see what we’re becoming. I, for one, am not sure that this what any of us should accept or condone. We can do better. I know because I’ve seen us do better.