Licensed Texas attorney. Licensed Texas paramedic. Unlicensed BBQ critic.

Licensed Texas attorney. Licensed Texas paramedic. Unlicensed BBQ critic. And yes, I went to law school first. Got to learn how to chase the ambulance before you can drive it. Politically incorrect infidel who's very conservative. . Oh, and also a big fan of country music, firearms, and, as of late, cars.

So, You Want To Be An EMS Writer?

Posted on May 31, 2016 Written by

Everyone wants fame and notoriety.  Some even find it. A few find fortune with that fame. I may not be able to promise fortune, but I can sure tell you the keys to becoming famous by writing another EMS social media clickbait posting. If you just follow my simple steps, you too can be internet famous!

First, you need to say something controversial. Next, throw in some data, preferably about cardiac arrest survival.  Add one glowing reference to some current EMS fad, perhaps community paramedicine or bystander Narcan. You will get bonus points for mentioning a “respected” EMS organization.  Instant credibility will be awarded for mentioning Seattle or King County Medic One or Wake County EMS. (Note: DC Fire/EMS does not count….)

If you’re feeling especially creative and want even more instant credibility, you should be sure to mention The Gathering Of The Eagles.  As we all know, no EMS innovation is complete without it being the subject of a speech or PowerPoint at the Eagles conference.  (In all seriousness, I would again note that the Eagles are the medical directors of some of the largest EMS systems, not necessarily the best EMS systems.)

Here’s a winning example of a great topic guaranteed to get you likes and shares on EMS social media. “EMS Community Paramedics should embark on a pilot program to train police officers and bystanders to administer Narcan in cardiac arrest to boost survival rates. We are looking forward to having Wake County EMS present on the community paramedicine aspect of this program at the next Gathering of the Eagles and King County Medic One has some very promising cardiac arrest survival rates to present as well.”

If none of this works for you, another sure-fire winner is to write about how EMS doesn’t get the respect it deserves, but also say that the educational standards are set too high.

If you get an article like this going, you’ll surely become infamous.  And just like in the movie The Three Amigos, “Infamous is when you’re MORE than famous!”

 

Filed Under: EMS, Humor, Rants

We Deserve Respect?

Posted on May 23, 2016 Written by

At every gathering of EMS providers, whether in person or in the online world, we constantly bemoan the perceived lack of respect that the “ambulance drivers” get from the rest of the medical community, from other public safety providers, and from the public that we serve.  So, to answer the question as to “when will we get the respect that we deserve,” I present the following answers.

When doing the right thing for the patient becomes more important than doing something, no matter what it is.

When we embrace education and science-based medicine rather than dogma because “our instructor said so” or “I’ve seen it work.”

When we work constantly to raise the minimum standards for entry into EMS rather than continually watering down standards while using “the volunteer crisis” as an excuse.

When we spend as much on continuing education and pursuing knowledge as we do on getting another set of LED lights for our personal vehicle.

When we embrace professional self-regulation rather than being an afterthought in most states’ health and human services bureaucracies where the same people inspecting ambulances are inspecting tattoo parlors and tanning beds.

When the term “semester” replaces “clock hours” for ALL levels of EMS education.

When we recognize that patient advocacy and customer service are part of the job rather than something to be ridiculed with a t-shirt slogan.

When we realize that completion of a 120-180 hour EMT course and passing a test of minimal competency is but the beginning rather than the pinnacle of a medical career.

When we recognize that heroism consists of significantly more than merely working in the emergency medical field and doing your job.

When punitive medicine like selecting IV catheter size based on your annoyance factor with the patient or joking about rapid sequence intubation of a patient without adequate sedation is no longer accepted on your ambulance. (At the very least, can we not make these comments in a setting where the public can hear them?)

When shop-worn slogans denigrating advanced practice in favor of “BLS before ALS” are recognized as the anti-intellectual attitudes that they are.

When EMS education reaches a point where one can become a paramedic without first having EMT certification.  Doctors didn’t go to physicians’ assistant school first and lawyers don’t have to become a paralegal first.

When we recognize that “street experience” may actually be meaningless if it was three years of working a BLS transfer truck and learning nothing but bad habits, shortcuts, dogma, and who gives free coffee to EMS.

When we realize that the most important thing that any EMS provider can do is to provide a thorough, competent assessment rather than some “sexy” skill.

When we stop using “the lawyers” as a mythical bogeyman and start understanding the laws and regulations that impact the practice of prehospital medicine.

When we as EMS providers have a voice at both the US Capitol and each and every state capitol.

When our goal is that we leave every patient at least as well as we found them.

When we stop defining EMS by “what we can do.”

When we realize that we DO diagnose and that diagnosis is not illegal, but rather, is expected.

When we recognize that what’s not an emergency to us is still the most important thing that’s happened to the patient today.

When we realize that the most important person in the room is the patient.

When we cease to define clinical competency by parroting a skills sheet.

When EMS managers cease to define success by response time and cardiac arrest survival.

When every EMS provider in every EMS system knows who their medical director is and how to reach them.

When we realize that continuing education is designed to teach new concepts rather than just merely repeating the same dogma on a two year basis.

When we recognize that lowest common denominator medicine means that providers will sink to the lowest common denominator.

When we finally realize that the biggest obstacle to EMS advancement is the average EMS provider.

When we recognize that it’s not our job to judge our patient, but it is our job to treat our patient.

 

When we can hit even fifty percent of these goals, the respect will be earned.  And so will the salary.

Filed Under: EMS, EMS 2.0, Rants

Closing Out EMS Week

Posted on May 20, 2016 Written by

As we close out EMS Week 2016, I thought I’d share some more thoughts and observations as you digest your snacks from the break room and enjoy your party favors with the pre-printed motivational saying on it.

Yesterday, on Facebook, a good friend shared a post that I modified and shared.  I think it’s worth sharing here as well.  I’d like to thank the people who’ve made EMS Week possible for me. Thank to the instructors who made it possible for me to get my EMT and then paramedic certification. Thank you to the mentors who’ve inspired me over the years. Thank you to the coworkers who’ve partnered with me over the years. Thank you to the managers, supervisors, and medical directors who’ve put up with way more from me that you should have. Thank you to my family and friends who’ve always supported my passion for EMS. A special thank you to my non-EMS employers who’ve been supportive of my extracurricular EMS activities and given me the time off to pursue them. And finally, thank you to each and every patient who’s trusted me to care for them. There’s too many of you to mention by name and I wouldn’t want to overlook everyone, so please know that each of you has made it possible for me to enjoy both EMS Week and every shift I get to work.

To top yesterday off, I came home and found the latest edition of Dr. Bryan Bledsoe’s paramedic text waiting for me, courtesy of UPS. Spoiler alert: the medical-legal chapter is co-written by yours truly. The biggest thing that we can do in any profession is to pay back the mentoring we’ve received along the way.  I don’t get out on an ambulance nearly as much as I’d like, but I make it a goal to leave EMS better than I found it.  And the biggest impact I can make is to improve EMS education.  In my case in particular, I’d like for EMS students of all levels to have an understanding of the law relating to prehospital care as opposed to myths and urban legends about EMS legal issues.

I’ll leave you with two thoughts as we close out EMS Week 2016. One, the perfect EMS system is much like the Loch Ness Monster. Everyone is looking for it and no one has found it. Strive to make your EMS system the best it can be and find out what you can live with for the pay. (It’s never about the pay.  It’s ALWAYS about what people will put up with for the pay they’re given.)  Thought number two:  If we’d spend 25% of the time that we spend complaining about being called “ambulance drivers” on actually improving EMS, we’d find that, in a very short time, we wouldn’t be called ambulance drivers.

Filed Under: EMS, EMS 2.0

Google Let Me Down.

Posted on May 19, 2016 Written by

The following is an email that I sent to Google in response to them choosing artist/activist Yuri Kochiyama for today’s Google Doodle on the main Google page.

I realize that Google Doodles are sometimes meant to cause us to think.  That’s a good thing.   But today’s Google Doodle honoring Yuri Kochiyama was way too much.  I “Googled” her and found this in Wikipedia:

In response to the United States’ actions following the September 11 attacks in 2001, Kochiyama stated that “it’s important we all understand that the main terrorist and the main enemy of the world’s people is the U.S. government” and that “the goal of the war [on terrorism] is more than just getting oil and fuel. The United States is intent on taking over the world.”

While the United States has certainly made mistakes and there are certainly different views about our role in the world, I consider honoring this “activist” to be a grave dishonor and a slap in the face to those who died on 9/11, first responders, and those who serve in our United States armed forces.

Over the last two weeks, there has been extensive media coverage about an anti-conservative bias in the tech world. While I had been somewhat skeptical of this, your decision to “honor” this far-left, anti-American activist is certainly evidence of at least a cognitive disconnect with many Americans, especially those who hold conservative or libertarian values.

To me, Google is a source of information.  I expect an information source to be an honest broker of such information or, at the very least, to disclose its biases.  Today, Google let me down.  And that’s something that’s let me down.

Very truly yours,

Wes Ogilvie

I could go on and on here, but suffice it to say that I think it’s bad business to take an unnecessary political stand that pokes many of your customers right in the eye. Rather than an attempt to be hip, edgy, or thought-provoking, this decision shows the disdain that many in the cultural left have for anyone in “flyover country.” These tech hipsters share their progressive views where the tech industry gets government subsidies while wearing a Che Guevara t-shirt and “Feeling the Bern.” It always strikes me that many of the people who are the loudest about the wrongs in America are among those who benefit the most from what makes America great — namely free enterprise supported by the values enshrined in our United States Constitution.

In summation, you’d never have a Google, Apple, Facebook, Dell, the New York Times, or even the movie industry in anyplace but America.  And as the late great Merle Haggard sang, “If you don’t love it, leave it.  Let this song I’m singing be your warning.”

Filed Under: Politics

Another EMS Week Post

Posted on May 16, 2016 Written by

Well, it’s Monday and it’s the annual commemoration of EMS Week.  This is the week where you’ll likely get some sort of junk food at the local ER, assuming the staff doesn’t eat it first. Your employer may give you some sort of trinkets and there will probably be a couple of extra motivational posters around the station.  All of those are the traditional ways of celebrating our week and honoring what we do for our respective communities.

But I wanted to go a little past that.   I saw something last week that got me to thinking.  Last week, I saw pictures of a bunch of paramedics from a large EMS system undergoing boot-camp style training to become “rescue” paramedics, skilled in rope and water rescue.  And that led to another thought – namely, how many of us add something else to modify the term EMT or paramedic.  Firefighter/EMT.  Special Operations Paramedic.  Critical Care Paramedic. Firefighter/Paramedic. Flight Paramedic. Dive Medic. Community Paramedic. Firefighter Paramedic. Tactical Medic.

It’s absolutely great — and essential — to expand our knowledge and, in some cases, to expand what EMS does to meet our respective communities’ needs. However, the reality is that each and all of those roles fill limited needs.   There are relatively few patients that need advanced life support provided by paramedics rappelling down a cliff or that need care under fire (at least in the civilian world).  The chances of needing to intubate a patient in a radioactive environment are pretty close to nil.

Let’s go back to the famed “White Paper” issued by the National Academy of Sciences in 1966.  That’s the paper that gave the impetus for modern EMS.  It addressed accidental death and disability in the out of hospital setting. From that, EMS has evolved into the practice of prehospital medicine.  To me, what EMS is delivering the practice of medicine, outside the clinical setting, incorporating some aspects of the public safety disciplines to do so.

There’s nothing wrong whatsoever with these additional skill sets.  What is wrong is the explanation that I’ve heard from some of these providers as to why they pursue those skill sets. Time and time again, I’ve heard, “I wanted the additional challenge.”  My continuing belief is that if you do the medicine right, there’s plenty of challenge. Medicine is constantly evolving.  The clinical practice of medicine has changed dramatically in the twelve years I’ve been in EMS.  More and more EMS systems have embraced selective spinal motion restriction, rapid sequence intubation, 12-lead EKG interpretation, and standing orders for pain management.  When I first entered EMS, I’d never heard of ketamine or sepsis, yet both of these are now routine terms I use in my practice of medicine.

On this EMS Week, let’s each make the commitment to each and every one of our patients by doing the core mission that unites us all — providing the best medicine possible. On this EMS Week, commit to being a clinician first and foremost.

Filed Under: EMS, EMS 2.0
Posted on May 9, 2016 Written by
This is a collaborative post by Too Old To Work, Too Young To Retire (TOTWTYTR) and me. It started from an email exchange and then we decided write a post that will appear on both blogs. I’m not sure exactly how this will work out, but it’s worth a try.
TOTWTYTR: I will say that I’m not sure how much Presidential election blogging I will do this time around. Neither of the “presumptive” candidates are ideal by any definition of the word. One is a brash entrepreneur and reality TV show host with no political experience. The other is the epitome of the political insider. Who also happens to have little in the way of achievement that isn’t tied to her former President husband. Trump is (or was) hated by the GOP establishment, while Clinton is the darling of the Donkey set.
Those are my preliminary thoughts outside of the collaborative portion of the post. The parts in regular fonts are from the original email from The Ambulance Chaser. My comments are in red interspersed.
ME: So, since we’re among friends and for the most part, relatively like-minded
ones at that, I figure I’ll share my insights as to how we’ve ended up with
Donald Trump as the presumptive Republican nominee.
Let me first say that, in the words of Marc Antony, I come to bury Trump,
not praise him.  I cast my vote for Cruz not out of support
of him, but at least knowing who he is and what he stands for.   Like some
of us here, I too share the disgust at the Republican Party’s current
fascination with bedroom and bathroom habits.  It’s unseemly,
narrow-minded, and especially hypocritical coming from a party that
supposedly is the champion of limited government.
TOTWTYTR: Which is the common perception, but the Democrats seem far more interested of
late in peoples’ sex lives and bathroom habits. After all, it’s they that are proposing “affirmative consent” laws
on campuses and trying to change the public bathroom habits of the American public.
Trump has for the most part totally ignored those issues and the pressure to discuss them. Wise move.
My major complaint with the Republican Party, which I share with you, is that they aren’t acting like conservatives.
This despite the fact that most Americans are politically center-right, not left.
ME: So, how’d we get to Trump?  Well, for one thing, I do think that social
conservatism has a limited appeal.  There’s only so many voters out there
for whom homosexuality, abortion, and school prayer are their core,
fundamental issues.  Bluntly, if it was me, I wouldn’t even make an effort
to appeal to them.  And by and large, Trump really hasn’t.
TOTWTYTR: See? We agree.
ME: What has Trump done?  He’s appealed to blue collar Reagan Democrats.  The
comments about foreign trade and “making America great again” appeal to
blue collar, Rust Belt voters.  For all of the talk about the Republicans
being “politically incorrect,” the Republicans really aren’t all that
willing to offend or speak painful truths.  Trump has said what many people
are afraid to say in “polite company” about immigration and Islamic
terrorism. And in that “everyman” appeal, he scores more points with
voters.  While I don’t have the statistical analysis, I’d hazard a guess
that Trump is doing especially well with independent and previously
unengaged voters.
TOTWTYTR: This is one point on which we disagree.
Trump is drawing support from broad segments of the population. For the
most part it’s people who are fed up with the establishments of both
parties. That was part of the appeal of Ted Cruz and is a large part of
the appeal of Bernie Sanders.
My sister, who is at least on the surface a liberal Democrat, is a self
described “Bernie Girl”. I’m not sure what his appeal to her is, because
chances are she’ll be negatively impacted by his communist financial
policies.
My son has a MBA and is a Trump supporter. Trump is hugely popular in
the southern state in which he lives. My daughter in law says that if it comes
down to Trump vs Hillary, she’ll stay home. Which is okay, because
that’s in effect a vote for Trump. She is pretty conservative. No
college, but she’s a sharp young women.
Mrs. EMS Artifact didn’t like Cruz, but likes Trump. If anything, she is far more
conservative than people think I am. She can’t stand Hillary or Bernie, especially Hillary.
My friend Peg, a former Canadian and former left leaning Democrat, hates
Obama, Hillary, and Bernie. She likes Trump, but not Cruz.
Women not liking Cruz seems to be a trend, at least in my not very scientific polling.
I have several friends who are life long Republicans who like Trump.
They’re tired of the GOP establishment bending over for the Democrats.
They want conservative fiscal policies, don’t care about social issues either way, do care about immigration.
I could go on and on in this vein, but I think the point is clear.
ME: In all fairness, Trump is remarkably naive on foreign and defense affairs.
His comments about making NATO, South Korea, and Japan pay for more of
their defense are short-sighted and, if enacted, could well lead to the USA
losing leverage there and those nations asserting a more independent
foreign policy that might not align with US interests.  As for his domestic
policies, he makes vague promises that make for great soundbites.  For
those that mock and dismiss him, I’ll note that Obama got elected on vague
promises of “hope and change.” That worked for enough voters.  It might
just well for Trump.
TOTWTYTR: I don’t know if Trump is a conservative or not. I think he’s more of a
populist than anything else. If he wins, I hop he’ll make good choices
for his cabinet, national security adviser, head of the CIA, etc… The
big question with Trump is federal judges, especially SCOTUS.
This is my biggest question mark about Trump. What will he do if he wins? Will he govern from the center,
the right, or the left? Or a mix?
Of course he won’t be the first candidate that was elected with the electorate not knowing where he
stands on some crucial issues.
Of course, I could be wrong about that. He might pick judges that are more liberal than would Hillary.
I doubt it, though.
Obama has proposed that our allies pick up more
of the funding for NATO and their own defense. Which is one reason we
don’t have nearly as many allies as we did a few years ago.
Japan has increased defense spending, as have other of our allies. They have
zero faith in Obama fulfilling any of the US obligations to defend them if it
comes to that. T: aiwan and South Korea share that, as do allied countries in Europe.
Our so called allies in the Middle East are also very concerned about this election.
I’m not suggesting that we pay for all of our allies defense forces, but there is value
in having a strong military of our own. Helping other nations is part of that, but they are going
to have to increase their commitment to defending themselves. Especially Europe, which I expect
is once again going to be defending the gates of Vienna from the Islamic hoards. Or maybe London,
Paris and Berlin.
ME: Both parties are to blame for the Trump phenomenon. The Republicans talk a tough game,
especially on immigration, and routinely fail to deliver — primarily because many of
their large business supporters depend on immigration. All the Republicans have delivered
during the Obama administration, with congressional majorities for six of eight years, are
press releases, showboating, grandstanding, and pandering to a small fringe of evangelical
voters who wouldn’t vote for the Democrats anyway. The Democrats have delivered more government
entitlements, more wealth transfer, a near Communist fascination with class envy, and a naked,
brazen attempt to appeal to every identity group out there.
TOTWTYTR: Trump is expressing the disgust of people in both parties with the
status quo. You’ll notice that no one has asked Obama to go out and
campaign with or for them. For good reason, President Jug Ears is not
particularly popular.
ME: The media?  Well, they have some fault too. They bemoan the lack of
substance in politics, yet they engage in “gotcha” journalism designed to
dig up past mistakes and foibles, thus eliminating anyone except those
bland candidates who, since fifth grade, have strove to avoid anything
controversial or embarrassing.  They’ve turned politics into a horserace
and a reality show.  In fact, “Who Wants To Be President” might well turn
out a better candidate than the primary process has this year.
The media is in the bag for the Democrats. Very few people in the media
identify as Republicans and even a casual perusal of the news will show
that the main stream media does all it can to cover for Obama and
Hillary. I expect that the attacks on Trump in the MSM will intensify
now that he’s the presumptive nominee.
The modern left and the modern right are both incredibly out of touch with
most Americans.  Both parties engage in “crony capitalism” where free
enterprise is a myth.  Rather, big business plays both parties for
subsidies.  The Republicans fund “economic development” and grant subsidies
to corporate agriculture.  Meanwhile the Democrats will fund “green energy”
and want to address economic justice by giving money to people with bad
credit and build nice things in areas where people are rioting.
So, when modern liberalism helps us “feel the Bern” in our “safe spaces”
and modern conservatism is worried about the bathroom at Target, yet fails
to seriously address terrorism or an economy that works for what the modern
left and the Wall Street crowd calls “flyover country,” we can look in the
mirror and realize that the sad state of American politics and the American
media have given us Donald Trump.  We’ve ended up with a self-funded
billionaire who, by his sheer wealth, is perceived to not have to pander to
any donors and says the first thing on his mind.  America, meet your
reality show presidential candidate.
TOTWTYTR: Thus, we have the rise of a neo populist candidate that has been remarkably non specific
about what he actually plans to do to “Make America Great Again”.
Obama gave rise to Trump’s model of campaigning. He too ran as a neo populist who was remarkably
non specific about what he would actually do. We’ve had eight years of fundamental transformation and
it appears that much of the voting public is tired of that.
I’m not sure if the public knows that they want in the next President, but they have made it very clear what they
DON’T want.

https://theambulancechaser.com/2016/05/489/

Filed Under: Politics

What Might Be Wrong With EMS and EMS Education

Posted on May 4, 2016 Written by

Earlier this week, I was speaking with someone in the EMS regulatory world and they mentioned having to possibly roll out a class on a new infectious disease concern.  I began to wonder if part of the problem is that many EMS providers are technicians who are taught to “fix” a patient’s “condition.” Every so often, the latest buzz hits EMS and we all roll out something “new” to address this.

Some years, the EMS flavor du jour is anaphylaxis.  Some years, it’s been cardiac arrest.  Some years, it’s been acute coronary syndrome.  Yet other years, stroke becomes a focus. Currently, we seem to be torn between sepsis and emerging tropical infectious diseases (Ebola and now Zika).  All of these are important topics and something that any EMS provider should be capable of at least beginning to address. Meanwhile, we have all of the various factions advocating that EMS will get the respect it deserves if we go into “community paramedicine,” “tactical medicine,” or “critical care paramedicine.”  Then factor in the various advocates pushing differing models of EMS, whether private, third-service, or fire-based.

Yet, what everyone is overlooking is simple. We’re teaching EMS providers the recipes for cooking, but not how to actually cook.  Every one of these new ideas that rolls out fails to address the simple fact that EMS providers aren’t taught the fundamentals of medicine.   Teach anatomy, physiology, pathophysiology, pharmacology, assessment, and skills appropriate to the provider level.  If you taught the core fundamentals of medicine rather than flowcharts and protocols, you’d have an educated provider who, at any level, is capable of adapting and providing clinically appropriate to almost any patient.

If you teach a chef, you teach them their way around the kitchen.  If you train a cook, you teach them how to make things from the recipe.  In EMS, we’re turning out short order cooks who need a new recipe anytime the clinical tastes change as opposed to professional chefs who know how to make a recipe of their own and can vary that recipe for their patient/customer. And until we fix that, all of the latest card courses and “urgent” continuing education modules to address the latest problem won’t fix the real problem with EMS.

 

Filed Under: EMS, EMS 2.0, EMS Education

You Get What You Pay For

Posted on April 29, 2016 Written by

In Texas, we have a strong tradition of limited government.  In particular, we limit the role of county government.  In most counties, county government provides law enforcement, jails, courts, and roads.  Because of the limits placed on county government by the Texas Constitution as well as the limited source of funds available to county government (primarily property tax revenues), the majority of county governments in Texas do not directly provide fire or EMS services.  In response to the need to fund fire and EMS services for smaller communities and/or unincorporated areas of the county, the Texas Legislature authorizes the creation of Emergency Services Districts (ESDs).   ESDs have the authority to levy a property tax to provide fire and/or EMS protection within their boundaries. That tax is up to ten cents per one hundred dollars of property value.

North Hays County ESD #1 is the Emergency Services District that serves Dripping Springs and much of the rest of northwestern Hays County.  They currently tax their property at a rate of 2.52 cents per one hundred dollars of property value.  They are holding an election on May 7 to raise the tax rate to a maximum of seven cents per hundred dollars of property value to continue funding EMS in their district.  Currently, San Marcos/Hays County EMS is their contracted EMS provider and, like many EMS systems, faces increasing call volume as well as increasing costs of providing EMS in the district.  (Disclosure: I formerly worked as a part-time medic for San Marcos/Hays County EMS. I have also responded with San Marcos/Hays County EMS on mutual aid with another EMS service in the area.)

Enter the local state representative in the area — a man named Jason Isaac. Mr. Isaac has come out publicly against the tax increase and is pandering to a reactionary anti-tax element of a conservative electorate.  Heck, I’m pretty conservative.  Those that know me have described me as a fiscal conservative, socially libertarian, and a neo-conservative hawk on foreign policy.  I’m no Bernie Sanders here.

If Mr. Isaac is truly concerned about the actions of the ESD, he would know that the Texas Department of Agriculture has information about the formation and operation of ESDs.  But it’s easier to put out posts on social media addressing an issue where the accountability lies with local government.  I thought that Texas conservatives favored local control and local solutions for local problems?

But there are some very legitimate roles for government to play, particularly local government. One expectation that all of us have, save for a few anarchists, is for our 911 calls to be answered and for help to come.  Better yet, we expect competent providers to deliver compassionate and clinically appropriate emergency medical care.  San Marcos/Hays County EMS has delivered that care to Hays County for years, including the residents of North Hays County ESD #1.  I’m standing for quality EMS, not sound-bites designed to appeal to fears about property taxes.

Filed Under: EMS, EMS Politics, Politics

If We Can’t Take Care Of Our Own

Posted on April 26, 2016 Written by

So, yesterday I blogged about the tragedy with the Fairfax County firefighter/paramedic who killed herself.  The suicide is believed to have been connected to multiple workplace climate issues, including bullying.

I shared the blog yesterday on several EMS Facebook pages and several medics commented about similar experiences at their employer.  One especially poignant comment was, “I always thought it was just me…”

Here’s the thing.  When you have multiple people who don’t know each other, all from different fire and EMS organizations, all saying the same thing — it is cultural.   It is pervasive. And it’s got to stop right now.

Humor, even some inappropriate humor, is an excellent form of coping with the stresses associated with service in the fire and EMS world.  But we in the fire and EMS world don’t know how to do humor right. We mock and haze our colleagues.  We mock our patients with sayings like “I’m not an ambulance driver, I’m a NASCAR driver sponsored by Medicare.” We mock education and advancement of the profession by denigrating “book learning” and wearing t-shirts that say, “Would you like to talk to the paramedic in charge or the EMT who knows what’s going on?” And when someone calls the jokesters out, they’re labeled as “butthurt.”  Well, call me butthurt because this has got to stop.

The story about Fairfax County has made the news outside of the fire and EMS world.  It will get into the hands of those with an agenda and the politicians.  If we can’t clean up our own messes, the politicians will. And the solutions proposed by the politicians will be worse than the problem.  If you don’t believe me, I submit Obamacare as an example of a solution from politics.  If you don’t think that those who’d like to privatize fire or EMS services won’t use this as an example of how a private company with a good HR department wouldn’t have let this happen, then you haven’t been paying attention.

A friend of mine said, “If we can’t take care of our own, what makes me the public think we can take care of them?” That nails it right there. We can start taking of our own at our own stations and on our own rigs.  And it starts right here, right now.

Filed Under: EMS

A Next Step in EMS Provider Safety and Health

Posted on April 25, 2016 Written by

Over the last few years, EMS provider safety and health has come to the forefront.  Rightfully so. Whether unreported, under-reported, or just ignored in the past, we’ve recently begun to recognize the threats to EMS professionals of all sorts.  There are several organizations, most notably the Code Green Campaign, who’ve done an excellent job at suicide prevention and mental health awareness in EMS. Other EMS providers have noted the upswing in violence toward EMS responders and have raised awareness and training to address this threat.

However, one of the latest public safety suicides, that of a firefighter/paramedic in northern Virginia, really hit home to me. There are allegations that the medic in question was the victim of workplace bullying and cyber-bullying.

Somewhere, somehow along the way, the public safety world got fed a lie in that hazing and bullying are part of a so-called brotherhood. There’s certainly nothing wrong with some good natured teasing and some ribald jokes (of which I know quite a few).  However, when you’re continually targeting a particular person or group at your workplace, that’s definitely “not cool.”

I’ve been in some organizations, especially when I was younger, where jokes got carried too far.  When I was much younger, I was, for a short time, a midshipman at the U.S. Naval Academy.  I saw hazing.  I experienced hazing.  And all it did, at least in my case, was cause me to reevaluate my decision about a naval career.  There’s no brotherhood in tormenting those beneath you.  And “they did it to us” is no justification for continuing to do the wrong thing.

We’ve got way too many toxic workplaces in public safety.  The behaviors range from bullying to hazing to cliques that control the workplace.  I could spend an entire post on the destructiveness brought on by the cliques of “cool kids” in a workplace that serve to alienate and marginalize everyone else.  When you combine the “cool kid” clique with social media posts where the “cool kids” brag about their weekend exploits and hijinks, particularly with willing and participating members of management, you create a toxic culture where some members of the organization become ostracized.  Whether it’s intentional or just ignorant, it’s the height of hypocrisy to discuss teamwork and have teambuilding exercises when there’s alienation occurring right underneath ones’ eyes.

Between provider suicides, mental health crises, and losing EMS’s best and brightest to other professions, it’s clear that EMS has some issues to resolve.  Resolving those issues is going to require a massive shift in attitude towards how we treat other, towards a real brotherhood (or sisterhood), and making things at the station a hell of a lot less toxic.  It’s time to realize that being a professional is about doing the right thing, not just the fun thing — and it begins with how we treat each other. Let’s have that discussion about how we’re treating each other.  I’m not completely sure we’ll like what we’re hearing.

Filed Under: EMS, EMS 2.0
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