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.
New EMS students are at the mercy of their instructors unfortunately. That is why I think our minimum age should be 21 period, just like Police Departments. Your average nurse doesn’t practice until they are around 21, and Doctor’s are what? 26 when they hit their internship? Yet we still think it’s okey dokey for an 18 year old who took EMT during Vo-Tech to be first on scene for a pediatric Code or crashing asthmatic? Nonsense. Requiring basic maturity up front would be an easy fix, and would have long term positive impacts down the road. Good QA/QI should fix poor practices in the field for our “experienced” providers. If a system cannot provide good QA/QI they shouldn’t be a system at all. I’m also curious as to what social media sites you visit? You are one of the few that seem to post regularly. Every time I find a good site, they quit posting new content.
I disagree with the notion that those under 21 should not be considered ready for EMS. At 18, you can join the military and be sent to the middle of hell carrying the responsibility for protecting your own life, your fellow soldiers& civilians lives, and tens of thousands of $ worth of equipment. Many collegiate programs offer outstanding care. Darien Ct Post 53 is 100% high school students with adult mentors and is known worldwide for their service and clinical excellence. Maturity is not defined in years. The difference is in the pre-screening for physical and mental suitability for the job, and providing excellent mentoring and leadership. QA is a great tool when it is pro active, not reactive or punitive. CQI is dependent on the focus and quality of both QA and field supervision. The most common problem is that too many of the wrong people are in EMS for the wrong reason (regardless of age), being *led* by people who are at best managers with no experience or leadership training.
I’ve seen people so frustrated and angry that they aren’t “saving lives” on every run. More than once I’ve reminded colleagues that “we are there for the patient, the patient is not there for us.”
It’s not the job of the patient to provide validation, job satisfaction, or ego boost.
It’s not the job of the patient to be medically educated to understand signs, symptoms, treatments, or appropriate use of emergency resources.
It would be nice! (and I certainly admit that I’ve had “those days” and “those patients” that tested my patience).
BTW: I also remind some that if you think that the “grass is greener” in the worlds of Police and Fire, you are sorely mistaken. For every “crime in progress” there are a thousand reports to be taken or posts to stand; for every “working fire” there are a thousand “food on stove” or “outside rubbish” or “strange odor” runs.