My Love Hate Relationship With EMS Social Media

Sorry for the delay in blogging.  None of my usual pet peeves have inspired me to blog as of late.  The truth is that volunteer EMS still has the same challenges and people still put beans in their chili, so maybe I needed to find something new to write about.  And something I shared last week on social media hit me.

I have a love-hate relationship with the internet, social media, and with EMS social media in particular.  I’ve made some incredible friends all over the world, some of whom I’ve met in real life.  Others I’ve yet to meet in real life, but I feel as if I’ve known them all of my life. But there’s also parts that drive me crazy beyond belief, yet I keep coming back to them like the guilty pleasure of watching Jerry Springer or Cops – or the morbid curiosity of looking at a car wreck.  Namely, I keep coming back to the amount of wrong information and/or dogma being spread online.  I used to try to engage and educate and I’ve stepped back a lot from that.  It’s like most debates with the willfully ignorant online: debating online with a moron is like playing chess with a pigeon —  it knocks the pieces over, craps on the board, and flies back to its flock to claim victory.

Image result for someone is being wrong on the internet

So, as a result, I’ve largely retreated and find my pleasure in sharing the stupid privately with like minded friends.  We largely laugh and bemoan the state of EMS and medicine in that such standards are allowed to exist.

The below average person in EMS (who we regularly mock) copes by making fun of patients, engaging in patient abuse, and the like because it’s their crummy coping mechanism for the things they don’t like, understand, or control about EMS. I think a large part of that comes from seeing the same things over and over.  I get that.

For me and people like me, what bothers us seems to be people repeating dogma, those failing to take personal responsibility for their development, and the general low standards out there. I’m as guilty of this as anyone here, if not more so, but I wonder if seeing that dumb behavior has made us cynical and jaded enough that we automatically assume the worst when we see someone post something that seems dumb as opposed to assuming they have a legit question or need for help? Heck, with the benefit of a bit of hindsight, I wonder how many of my questions as a newer EMT or paramedic came across that way.

I start wondering how many legitimate questions get overlooked because of the amount of chaff (IE dogma and mindless repetition) on EMS social media.   A friend of mine asked the same question and recognized that it’s hard to separate real questions from trolling. And then he asked the most important question, “Where do we draw the line at eating our own versus getting rid of an actual problem?”

I don’t have an answer to that.  What I do know is that the “eating our own” will likely continue as long as EMS education’s entry requirements focus on whether the check bounced and whether educational programs see their obligation as producing qualified clinicians as opposed to maintaining an arbitrary retention rate mandated from on high.

As long as retention remains more important than quality, I don’t think EMS social media will see an end to the “How do I pass National Registry?  I’ve failed four times already.” questions.

The challenge for those of us who want to excel in EMS is how to mentor and guide future clinicians without being jaded.  On a positive note, if it makes you feel any better, the attorney social media groups have enough of the same issues that I regularly wonder how some graduated law school or passed the bar exam.

On Rhode Island

Point of personal privilege here. Because I’m about to rant. And seeing as this is my blog, that’s why you’re here, right?   Sorry, not sorry, that there aren’t any Baby Yoda or cat memes here.

There’s a ton of people posting memes making fun of Rhode Island EMT-Cardiacs and their supposed inability to master advanced airway management.  Most of these memes are being posted by people who like to fashion themselves the fountains of all EMS wisdom and knowledge.  Further, some of these same types believe that their fecal material is non-odorific.

I don’t blame the average Rhode Island EMT-Cardiac for this.  (FYI, for those of you unfamiliar with the certification, the scope is somewhere between Advanced EMT and Paramedic.)  They’re working in a system that they likely didn’t develop.  And at least some, including at least one friend who I’ve literally broken bread with, are competent providers.

I do blame a toxic political culture in Rhode Island where the IAFF, fire chiefs, and politicians hold more sway over the regulation and development of the state’s arguably dated EMS system than do physicians. Rhode Island has its share of EMS issues, including an outsized influence by the fire service, fire chiefs, and fire unions and nowhere near enough involvement from EMS physicians.  Rhode Island’s limited provision of ALS care (EMT-Cardiacs aren’t paramedics.  Sorry, not sorry for that truth.) and it’s relative lack of medical dispatching place Rhode Island severely behind the times in terms of prehospital medical care.

And let’s talk about those snarky edgy social media players criticizing Rhode Island EMS.  They claim to be science-based and evidence-based.  Fine.  I’ll give them that. But what they don’t get is public policy or the political process. Nor do they truly get “just culture,” which is (rightly) supposed to be all the rage in medicine these days.  Nope.  It’s much easier to make memes and make fun of the line-level EMS providers than it is to engage in even superficial analysis and note that Rhode Island’s EMS system and the politics behind it are the problem.

I’ll give Rhode Island credit for one thing.  At least someone in Rhode Island is looking at data.  Granted, the political culture up there is doing what ossified political types do — ducking and distracting, but the data is out there.  I wonder where the data is on actual clinical performance and outcomes for some of these “smarter than you” types posting memes and claiming to be “scientists.”

In summation, for all of y’all who are poking fun at individual EMS providers, I’ll leave you with some lyrics from Ice-T.  “Don’t hate the player, hate the game.”

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