For those of you who know me outside of this blog, you may know that I run several EMS groups on Facebook. Several are private groups for friends and colleagues, but one group has grown well beyond expectations.
Running an EMS page on social media is a constant challenge. I like to compare it to Goldilocks and her porridge tasting. Some porridge is too hot. Some is too cold. She had to try to find the right porridge.
EMS social media is the same way. There’s one extreme where we always have to be supportive. Everyone should follow their dream and passion to be in EMS, even if you’ve failed the National Registry exam three times. These people recite the dogma quotes we all cringe at. “BLS before ALS.” “EMTs save paramedics.” “Race the reaper.” Their sources of information include “my instructor told me” and “our protocols said.” If you challenge these folks, you’re automatically unsupportive and get called a “paragod.”
There’s an opposite extreme as well. These are the people who obsess and drone on about arcane clinical topics. No minutiae of biochemistry or pharmacology is too obscure for these pedants to emphasize that you’re “dangerous” if you don’t understand. These people, or their companions, like to post random EKGs with subtle findings that even cardiologists would debate. They will post these EKGs without any patient presentation and expect any EMS provider to find the zebra or risk their scorn and ridicule. It’s as if Sheldon and the rest of the cast of The Big Bang Theory started working on an ambulance and/or as EMS educators.
So, there’s a balance. The truth is, it shouldn’t be that hard to pass an entry level EMS exam which measures minimal competency. Mere certification determines entry level competency. We must always strive to be better, each and every day. It’s my personal belief that EMTs should be reading paramedic level material for continuing education and/or possibly considering pursing AEMT/Intermediate or paramedic certification. It’s my belief that paramedics should be reading physician-level educational material to supplement their knowledge. With the advent of open learning sources such as FOAMed and the like, the material is accessible. However, it’s also important that we remember our fundamental role in the world of medicine. In most cases, we are the entry into the healthcare system. If we can get the right patients to the right level of care the vast majority of the time, then EMS is a success. Don’t worry about the Krebs cycle nearly as much as you worry about taking care of your patient. I don’t expect the average EMS provider to provide physician level care or have a PhD’s understanding of the underlying science. I expect competent, compassionate care where a clinician recognizes their limits, but challenges themselves to expand those limits daily.
Medicine is a parallel to engineering. While both are based on the sciences, they are the application of pure science to solve human problems. Never forget that what we do is about people.
Having said my peace for now, I make one promise to you. I’ll try to be a better clinician, caregiver, and person today than I was yesterday. I merely ask that if you share a passion for EMS that you make the same commitment.