Not Everyone Gets a Trophy — or a Patch

No matter what your view is on what constitutes a “legitimate” request for an EMS response, we all agree (or in theory, should agree) that a patient calling 911 is experiencing a bad day. Even the lowest acuity call deserves a response from an educated, competent, and ideally, compassionate, caregiver, regardless of certification level.

As I look at some of the Internet and Facebook forums devoted and dedicated to EMS, I see a lot of posts full of spelling errors.  I see a lot of posts asking questions that either shouldn’t be asked in a public forum or should be considered common knowledge in emergency medicine.  And of course, I see posts begging for help on passing the National Registry exam on the student’s sixth and final attempt. Many times, I ignore these posts and shake my head.  Sometimes, I let my snarky humor emerge.  My good friend and fellow blogger, EMS Artifact, used to give these shining exemplars of the future of EMS a Mickey D’s job application as a helpful hint.

Why do I not always encourage little Johnny or Susie to “be all they can be” and be a real lifesaver?  Simple.

Emergency medicine is too important to lower our standards to the point that everyone gets a trophy — or a gold colored National Registry patch.  This is why I refuse to coddle students, tolerate poor patient care, or be supportive to the person who asks for help on passing Registry on their sixth attempt.   We’re in the business of caring for the weakest and most vulnerable of society.  That demands high standards.  And if you’re complaining about the lack of professional respect or financial stability in EMS, then we should be setting the standards for excellence — not minimal competence.

If this makes me a paragod or an arrogant prick, then so be it.  Maybe we need just a few more paragods or arrogant pricks in EMS.

Ten years in

This month celebrates my tenth year in EMS, first as an EMT and now as a paramedic.  (This doesn’t count for the several years I spent as an untrained observer annoying the living daylights out of Lubbock EMS and Austin/Travis County EMS.  Nor does it account for the several years annoying the EMS groups on Yahoo Groups.)

I’m an anomaly.  I’ve passed the average career duration in EMS for most providers.  However, I’m not sure that’s truly the case as my EMS career has been primarily as a “weekend warrior,” doing EMS on the weekends when I’m not practicing law.  So, I probably really haven’t really reached burnout level yet.   Think how bitter, cynical, sarcastic, and jaded I’ll be by then.

I owe EMS a lot.  It’s given me a useful outlet to unwind when I’m not practicing law. It’s given me knowledge that I’ve used for the benefit of family and friends.  It’s given me the confidence to walk into the unknown and care for someone who I’ve never met before and take care of them in the most important moment of that day for them.  I’ve watched someone die in the back of my ambulance.  I’ve hugged family members.  I’ve cried more than once.  Fortunately, I’ve laughed more than I’ve cried.

I’ve learned a great deal as well.   I’ve kept up with the science.  I’ve kept up with evidence-based medicine.  I’ve watched our methods, our treatments, our medications, and our paradigms changed.   There remains one constant, though.  This is the practice of medicine, not merely the science of medicine.  Current treatments matter.   What matters even more is how you treat your patient.

Most importantly, I’ve made some incredible friendships in this field.  I count several prominent EMS “celebrities” as friends.  I’ve had dinner with Randy Mantooth and Bryan Bledsoe at the same time.  (The statute of limitations prevents me from saying any more on that topic.)  I’m also friends with a lot of the “rest of us” as well.  I cannot even begin to measure how my life has improved from having EMS in my life and from having so many of us in the public safety and healthcare worlds in my life.

What I do know is that, when this is no longer fun, I’ll hang the stethoscope and duty belt.  Despite some changes in my EMS affiliations and activities, it continues to be fun and I hope that I have many years left.

I always say that I’m the medic I am because I’m also a lawyer and that I’m the lawyer I am because I’m also a medic.

Thanks for letting me into your world.  I hope I’ve been — and remain — a worthy visitor.

(Another) reason why EMS isn’t taken seriously

EMS providers love to claim that "EMS isn't taken seriously" by you-name-the-other-healthcare-profession.  And we're right.  We rarely are taken seriously.  I've complained before about some of the reasons why.  (See also: T-shirts with flaming … [Continue reading]

Things that make no sense in EMS

1) EMTs and paramedics are constantly told "We don't want you to know how billing works because we don't want you to let finances influence a decision to transport a patient."  Makes sense.  But then we're told, "If you don't document this chart … [Continue reading]

Monday morning thoughts

Just a couple of random thoughts to get your Monday morning started.   1) In EMS, we're constantly making noise about going beyond blindly parroting and following protocols, but we continually apply the cookie cutter mindset to any legal … [Continue reading]

Some reasoned justifications in favor of jet fuel and flight suits

In the EMS world, it's become almost fashionable to question the need for helicopter-based EMS (HEMS).   I personally believe that HEMS has been overutilized on occasion, probably even by me.  (I have a lovely snark-gram from the QA gremlin about … [Continue reading]

Ice Buckets

As a conservative/libertarian type, I'm in favor of individual charity rather than the enforced charity that the IRS collects every April 15.   As such, any giving to charity should be encouraged and celebrated, both for individual self-worth and the … [Continue reading]

Core Maxims of EMS

Here are a few of my core observations and beliefs about EMS. 1) You can never go wrong catering to the lowest common denominator of EMS.  The success of Facebook groups like The Most Interesting Ambulance Crew In The World and t-shirts with … [Continue reading]

Thinking outside the box on community paramedicine

I've been discussing pain management options with a friend of mine who's got an anesthesia background prior to entering the EMS world.  We were both bemoaning how EMS doesn't always excel at managing chronic pain and how our options are, in most … [Continue reading]

It’s not always THAT call

Last night, I had a challenging call.  The specifics don't matter all that much, but suffice it to say that a rodeo cowboy had an isolated extremity injury where he wasn't responding to much of the analgesia options I had for him.  The real issue … [Continue reading]