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Hi all, I wrote the below post in my blog and was curious about your thoughts. The idea from it actually came from a discussion of FB. Some saying that compassion, and/or "hand holding" is part of EMS, like me, and others saying that it can be, but that it's not necessary to do good medicine. Anyway, the below isn't directly regarding that, but it's what got the ball rolling in my head.. From, www.chasing-my-life.com Let’s talk about the spirit of EMS for a minute… June 4, 2013by Dwayne Let’s talk about wankers first. (wackers, wannabes, Ricky Rescues, whatever). I’ll start. They hurt my heart. Truly. And they also, without knowing it, hurt their own hearts as well. And probably worse, they hurt the spirit of EMS very much. I believe that there is an amazing spirit that lives at the very heart of EMS. If we listen to it, it can make EMS the most amazingly rewarding career that I can imagine. If we don’t, then we can sometimes end up being just another wanker that’s been given a truck with lights and a siren. And I’m not a big fan of the wankers. They just don’t ‘get it.’ We’ve worked hard for the privilege of being “the” person that people call when they are terrified. The person called when they, or someone that they love, are hurt, or ill, or sometimes just mentally or emotionally lost. Yet somehow there seems to be a huge segment of the EMS population that has decided to whine about that. To complain about the fact that they’ve been asked to actually perform in the role that they’ve worked towards and applied for. They’ve decided that to be cool you have to show how detached you are from compassion and simple human decency. Fortunately, I believe that most of us don’t fit into that category. And most that do don’t want to, they are just not strong enough yet to go against their buddies that choose to act cool instead of being competent. Let me lay out a few guidelines regarding our EMS spirit, yours and mine. If you’ve transported an old person and later referred to them as a ‘lizard’ or ‘gomer’, you’re a wanker. If you’ve bragged about how much you love the sound of breaking ribs during CPR, you’re a wanker. If you’ve ever explained to someone how you’d love to give your most recent suicide attempt (real or pretended) better instructions so that they can be successful in the future, you’re a wanker. If you’ve ever chosen to leave a patient’s spirit in worse shape than when you found it, in any way, you’re a wanker. Those gomers and lizards have lived a long time, and have accomplished things that you can’t possibly imagine. They’ve lived through a world war, some of them more than one, and multiple depressions, including the Great One. They’ve watched their friends, brothers, sisters, and too often, their children die. They’ve been humiliated as their driver’s licenses have been taken from them, again as their bladders and bowels began to betray them, and in many, many cases they were forcefully removed from their homes and placed in terrible institutions against their will, by the children that they raised. They now live in a world that many of them don’t understand, are afraid, feel unwell, and are powerless. They deserve, and have unquestionably earned more than our county gives them, but at the very least they deserve our respect and very best care. Those breaking ribs belong to a human being that is almost certainly in the last seconds of their life. Trillions and trillions of memories, loves, tears, laughter, all ending at that moment. The cracking sound that you’re so proud of will be heard, very often, by their families and loved ones. It’s that sound that they will involuntarily associate with the last memory of their mom, dad, or child, for the rest of their lives. Sometimes these worn, tired, amazing people need help. They need a hero. So they call for an ambulance. If you’re a wanker, unfortunately they sometimes get you instead. You laugh about the smell of their rooms, make jokes about their diapers, the way they talk, the way they chew, draw pictures of their sagging breasts. You drop them off at the hospital and then go to the bar later, strutting, wearing your EMS or firefighter t-shirt, accepting accolades for all of the amazingly heroic things that you did with your day, though no heroic things were done. Accept free drinks for being willing to put your life on the line during every shift!! Wanker bullshit at it’s finest. If you’re a wanker, you have the opportunity on these calls to be a hero. But as there were no burning buildings, or bullets to dodge, no cameras around to put your face in the paper, you couldn’t be bothered. You had the ability to ‘see’ this tired old person. To get them to tell you their stories, and truly listen to them. To get them an extra blanket even if they didn’t need one, simply to show them that they were still important. More important, you had the opportunity to stand up for them after the call. To choose to promote their dignity instead of joining your buddies in crowing about their uselessness. During each call we have a chance to make a difference in someone’s spirit, and therefore their life. After each call we have a chance to make a difference in EMS. And please, if you’re a wanker, spare me the argument of, “I may say those things after a call, but that doesn’t effect my patient care!” Bullshit again. In fact, if I even have to explain this to you then you’ve likely deluded yourself so completely that I’m not sure that you’re reachable at this point. Do our attempts to make a difference always work? No, almost never. Do they sometimes create drastic change? Yes. Do they ALWAYS make some positive difference in our patient, and just as important, in us? Yes, they do. Every, single, time. Is there ever a good reason NOT to try? One. If you’ve got a dozen plates spinning, trying to save a life, then perhaps you don’t have time for this type of compassion. But as soon as one of those plates is taken down? You’re out of excuses again. Besides, despite what you allow your family and girlfriend/boyfriend to believe, those are what? 1/10 of 1% of your calls? Maybe your attempt at some positive thing does something, or maybe it doesn’t, or maybe it does but you won’t be there to see it at some later date. Any way you slice it, succeed or fail, making the attempt is just simply good medicine. Language is powerful. Each time we use, or hear such terms as those above it should make us feel a bit ill. You know that feeling. When you’ve discovered that you pushed the wrong drug, or the wrong dose? Or delivered a medication before finding that you forgot to consider interactions with the other drugs they’re already taking? That ill feeling that you get when you know that you’ve done bad. That you were called to help, but hurt instead. Wanker or not, I’m confident that you know what I mean. I certainly know that feeling well. I know that you went into this wanting to be a champion for those that can’t champion for themselves. I know, I truly believe, that you went into this to make a difference. I know that at the end of the day that you want to lay your head down knowing that someone’s life is better because you were a part of it when they were in trouble. Please. Listen to your EMS spirit. Take a minute on every call and actually see your patients beyond their pathologies. Treat their bodies, but heal their minds and spirits. If you’re not doing so then you’re missing a vital part of the medical arts. It costs nothing but an additional bit of your focus. It takes no additional time. But the rewards are monumental. Leave the wankers to do what wankers will do. But today, choose not to participate. Will the world change because you’ve made a different decision? Yes, for this one person, their families, and friends, the world will be different. It should feel like a privilege to hold such power as to be able to be part of a stranger's memories for the rest of their lives. Those memories will be good or bad, either way those that carry them will be changed. To the professionals in EMS that get the reason, and the need for such posts…I salute you. Thank you for watching out for my family and myself. For bringing the best of EMS to every home, and to every patient. I promise to continue to do, every day, the best I can to be considered your peer and to live up to your example. To those of you that think that this is just a bunch of feel good rah, rah, bullshit. I thank you to, for the work that you do, though I’ll likely never consider you a professional. My wish for you is that you to take a minute to think, and go back to the days when you could be proud of the job that you do every day. When you do? Man, nothing would make me happier than to welcome you to the ranks of the brotherhood of professional EMS providers and scratch another name off of the wanker list. To those of you that really don’t know what the hell this is all about? That’s ok… You will. And as you move forward maybe this will give you a bit of a compass to help guide your way. I hope so. I’ll keep an eye out for you down the road… Have a great day all…

i worked for a non union shop that paid 39K and another non-union shop that paid 52K a year. that was a very livable wage. it can be done. The problem I see with the IAFF when they do the collective bargaining is that they bargain against the citizens of the city or county who have no say in what they pay you. you are effectively holding a city hostage when you threaten to walk out when your current contract ends. that puts the city in a terrible position to be in. in my opinion, a union has NO business being in the public sector, especially in the public safety sector because you effectively hold many of the cards. You don't get what you want then you can say "we'll go on strike and you will have no EMS or fire coverage" and the citizens call their city councilmembers and say "pay them what they are asking because we cannot be without fire coverage or EMS coverage" thus you get what you want. You effectively hold me hostage to your demands and I'm not able to do a damn thing about it because your union really does hold all the cards. sure it's a great thing for you because you get great pay, great benefits and you can lord over the heads of those non-union saps who make piddly and say "lookie here what we get and what you don't" but I really do not get a say in the matter of how much you get paid because your union negotiates your pay with the city council and the perceived threats of strikes and slowdowns and decreases in services of such a vital service almost ALWAYS ends up with the union getting what it wants. And to me that is what is WRONG with unions,.

This was a great post. Thanks for sharing. It definetely makes me reflect on my own actions, which I need to do every now and then. Last night I had a patient with chest pain, turned out to be a M.I. The best thing about the call was that while my partner went to get the stretcher closer the patient was scared and she hugged me. REALLY hugged me. After that I could see that she felt better. That hug that I felt awkward about in the moment did more for her, in my opinion, than any Nitro, ASA, or Morphine possibly could. It allowed her to relax and be comfortable with me. Too often I find myself treating the signs and symtpoms and forget there is a patient under there.

Wow, nicely done. I knew there was a reason I like you so much. Just to show that I "get it" I'll share my EMS week Facebook post on here since some of our brothers and sisters don't use the Crackbook. And at the end of EMS week:

I don't mean to bust anyone's balls here, but if you're not 100% committed to studying to pass the NREMT (I passed NREMT-I first time), then it really sends up flags as to what kind of provider you're going to eventually become. This field is oversaturated wtih mediocre providers, followed up by those that do just enough to get by and get themselves in over their heads (seen it too many times to be told differently). EMS as a whole needs to stop catering to the 'lowest common denominator' and really become more selective about who it lets into the classroom....