Toxic exposure

Some of my EMS friends refer to the less enlightened of us in EMS as LIV, shorthand for Low Information Voters.  I’m the first to admit that I like the term and use it.  Sadly, I have occasion to use it regularly, especially seeing what some providers post publicly on Facebook.

After some thinking this morning about a couple of discussions I’ve been watching, some LIV providers scare me more than others.  The youthful, overly eager provider who has maxed out their credit line at Galls by buying every piece of equipment known to mankind has the potential to be a diamond in the rough. Those of us who consider prehospital care to be part of medicine owe it to ourselves and our patients to channel said youthful enthusiasm into the art and science of patient care.

Then there’s the other form of LIV.   The so-called “experienced” provider whose only contributions are mindless repetitions of bad information, usually associated with withholding pain medications to those they deem unworthy of their skills.  These older LIVs are also usually the first to scream about the good old days and shame anyone who doesn’t conform to their limited understanding of medicine and operations.  To quote Spiro T. Agnew, these people are the “nattering nabobs of negativism” of EMS.  Their pessimism is toxic, both to other providers and to the advancement of prehospital medicine.

These old-timers run off enthusiastic providers, stagnate development, and generally make work a crappy place.  Their toxicity runs off others and infects the workplace as surely as an outbreak of norovirus.  Heck, at least norovirus runs its course and leaves.  Yet for some reason, these cranky ones are only happy when they can actively discourage others.

Please, if you actively embrace terms like toasted or burnt out, step away from patient care, whether for a sabbatical or permanently.  You owe it to your coworkers and your patients.










  1. You’ve taught me something. Until I read this post, and subsequently googled, I had been under the impression that it was William F. Buckley that gave us the “Nattering Nabobs of Negativism” quote.

    I have been enlightened

  2. Perhaps some of us just embrace those concepts as a way of using these crazy ideas of sarcasm and hyperbole. In the great hope that by being outlandish perhaps some of the things that are actually detrimental to our patients and thus our communities, coworkers, chiefs/leaders/managers/mayors/what have you, will be improved.

    I only say this because thus far being “civilized”, having a “discussion” or going through the approved channels seems to have left us nowhere.

    And if we’re calling out people for having ideas that you don’t deem appropriate, why not those that embrace the idea of being “Rogue”? Neither of them have what one might call a positive connotation or even frankly a definition.

    Some of us have decided jumping up and down and screaming is the only way to be heard. At least by those that have the power to do anything….

  3. 9-ECHO-1 says:

    I am old and cranky. My knees are shot and one ankle is bad. I get frustrated and too often voice it. I get lumped into the second form of LIV you talk about, at least until someone talks to me. My biggest problem is that too many of the younger generation are already too caught up in bad habits, or those that are in positions of being able to affect change are too reluctant to do so for whatever reason.
    And yes, I do long for “the good old days”…a time when me and my up-and-coming EMT and paramedic brethren looked to soak up every bit and piece of knowledge that we could (and that was hard to do when the main publication available to us was “EMERGENCY” . It was never enough to tell us “this is what you do”, but you also had to explain to us “this is why you do it”.
    My first paramedic instructor told us to not get too comfortable with what we were being taught or what our protocols said, because after all, just a short time ago, bloodletting and smoking were considered ‘healthy’.
    Too many of the LIVs are products of a combination of things- trophies for participating, minimal standards teaching, and a high degree of impatience. At the same time, and I have said this before, too many entities have a vested interest in keeping it that way.

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