The greatest Commandant the United States Marine Corps has had since World War II was General Al Gray. General Gray, channeling the spirit of every Marine, famously stated, “Every Marine is, first and foremost, a rifleman.” He captured the essential nature of being a Marine. Every other role that a Marine has or is trained for is secondary to and a condition of being a rifleman.
Wait, Wes. How does that quote relate to EMS, which is what you mostly blog about? Elementary, my dear Watson. EMS is, whether you’re an Emergency Medical Responder, an Emergency Medical Technician of the varying levels and flavors found in these fifty amazing states, or a paramedic, fundamentally based on responding to emergency calls for assistance, regardless of the platform that you’re responding on. Whether it’s the 1966 NHTSA White Paper, Dr. Pantridge in Belfast, Freedom House in Pittsburgh, or the fictional (BUT so influential) Squad 51 in Los Angeles County, EMS was created on the basis of its very name. Emergency. Medical. Services.
And the reality is that EMS education, whatever flaws it has, is fundamentally based on producing a safe, entry level provider theoretically capable to providing initial emergency medical care, whether it’s CPR, bleeding control, advanced airway management, or the management of an acutely ill patient with medications. That’s what EMS education produces. And that’s what EMS professionals are trained for and should be doing.
Yet, for some reason, there’s a crap ton of EMS people who think the role of a 911 provider is somehow beneath them. I have an update for you. It’s not. It’s literally who you are and what you were educated (or trained) to do.
Both in real life and online, I’ve observed what seems to be a constant. The people who talk the biggest game about their clinical acumen and are the most certain of their answers, whether correct or incorrect are among the biggest frauds to hold an EMS patch. They almost always have one common trait. Namely, virtually none of them have significant tenure in a 911 EMS system – or have experience somewhere where the wheels turn only a few times a day.
I’ve met a long list of these people online and more than a few in person. They eventually get found out. I can remember one of these people who some of us on social media referred to as “Doctor Google.” This guy could recite facts about the most obscure conditions and the related pharmacology, but couldn’t hold down an actual 911 job because of his innate arrogance and off-putting tone. I’ve known others who think that a 911 job is beneath them so they can work in an emergency department or in some vague notion of “critical care” in the hopes that the collective wisdom of the physicians, advanced practitioners, and nurses will rub off on them. And perhaps the biggest fraud I’ve ever met had experience as a transfer medic, then an overseas contractor. They flexed that experience into several PRN flight gigs, then wormed their way into a leadership position in rural EMS, where they eventually were exposed. After several stints in freestanding emergency departments, they ended up in EMS education full time before seeming to gradually move on from EMS. After working with that person for a while and even trying to help them find an actual opportunity in 911 EMS working for a service that, at the time, offered some of the highest call volume and acuity in the Lone Star State along with aggressive protocols, I finally figured it out. They were afraid of actually being on an ambulance, let alone being around people who might recognize their shortcomings. Ironically, despite the tough talk and rough attitudes, that service was known for never giving up on someone who had the drive to improve. (And for what it’s worth, I owe much of whatever success I have in EMS to that department.)
In conclusion, just as every Marine is fundamentally a rifleman, every EMS professional is fundamentally a 911 provider. Those are what the initial goal and the foundations of our education are about.
911 EMS isn’t a distraction from whatever path you’re on. It’s how you got on this path. And it’s, by and large, where EMS professionals belong.
It’s not an insult to be on an ambulance (or a fly car or even a fire truck). It’s why you’re here. It’s what you do. And it’s what your patch says. Emergency. Medical. Services.
Don’t be the fraud. Be the medic you wanted to be when you first found this field. And, if you can, leave this field just a little better than you found it when you came in. On that note, you don’t have to fix EMS as a whole. You can fix one system at a time. Or even one student, colleague, or patient at a time.
