Defragmenting EMS

[Dustdevil]

Interesting article from an esteemed colleague. Although I think the article bites off more than it can chew in such a short column, I do think she raises an interesting question/point. I am equally interested in what others here think about it.

http://www.ems1.com/ems-advocacy/articles/807569-Defragmenting-EMS

Defragmenting EMS

A voice that creates a roar that cannot be ignored

By Jules Scadden

"We all share the wound of fragmentation. And we can all share in the cure of unification." Gabrielle Roth

There is one glaring fact in EMS — we are fragmented. While we actually agree on almost everything that is wrong with EMS, addressing how to fix those challenges and who should lead that charge is where dissention occurs. There is disagreement on who or what organization should be the leader or "voice" for EMS.

When we don't like what one organization or group thinks, we just develop another in the belief it can fix what others have not. The results over the years are numerous "fragments" of a profession seen by others as "EMS doesn't know who they are."

A recent article by an esteemed colleague asked "Where is our Martin Luther King?" Perhaps more pertinent questions are:

→ Who are all the fragments of EMS and how do we bring them together?

→ Why are the organizations, their partners and "grassroots efforts" that claim to represent EMS not coming together in a common mission with a strong united voice for EMS?

A voice that creates a roar that cannot be ignored. In May and June this year, two important events by EMS practitioners will provide opportunities to present a united front and voice a common mission to our legislators and the public as a whole.

Next month's first Annual EMS on the Hill Day — on May 3-4 — is an opportunity to bring the voices of EMS to Congress. Discussions on the various EMS list serves, online social networks and magazines often highlight the need for EMS to be recognized as an essential profession. EMS on the Hill Day is an opportunity to get the attention of our congressional leaders. The event is for everyone; groups and individuals, street practitioners, EMS leaders and allied healthcare partners from every state and organization.

While NAEMT is sponsoring the event, you do not have to belong to them to participate. This initiative is an opportunity to use our voices, as a united constituency, to bring the concerns and challenges EMS faces every day to the attention of legislators who can make a difference. Remember, they work for us! EMS on the Hill Day is an opportunity to demonstrate the power to effect change when many voices unite under a single vision and work toward common goals for the betterment of EMS practitioners and EMS services as a whole.

Later that month, The National EMS Memorial Bike Ride's annual event will take place during EMS Week May 15-21. The mission of the "Muddy Angels" is to "honor EMS personnel by organizing and implementing long distance cycling events that memorialize and celebrate the lives of those who serve every day, those who have become sick or injured while performing their duties, and those who have died in the line of duty.” The NEMSMBR brings together EMS practitioners from all over the country and abroad, their families and supporters to:

→ Remember EMS workers who have died in the line of duty

→ Raise public awareness about line of duty deaths and disabilities in the EMS profession

→ Honor EMS workers who continue to work despite dangerous safety conditions

→ Advocate for a national tracking of injuries, near misses and a line of duty deaths in EMS

→ Provide a safe, friendly and supportive environment for registered participants to bicycle

→ Promote healthy lifestyles for EMS providers through physical activity and nutrition

The ride in May will have three starting points. The northern route will begin in Bennington, Vt., and South Portland, Maine, on May 15, meeting in Nashua, N.H., that evening. Both starting locations experienced a LODD this past year and opening ceremonies will take place at each point to remember and honor those individuals. The southern route will begin in Paintsville, Ky., and on May 21, both routes will meet at a designated spot in Maryland to ride into Washington DC together.

On May 22, there will be a brief Ceremonial Service honoring the Muddy Angels (all participants, sponsors, supporters, and coordinators), EMS services and personnel — especially those along our routes, EMS and public safety officials, special invited guests, and other important individuals with a dinner and dance following the ceremony to mark the end of this year's EMS Week ride.

The Board of Directors of the National EMS Memorial Bike Ride fully supports the National EMS Memorial Service "in its tireless effort to recognize the losses of our peers and the phenomenal support it gives to the families of our lost brethren."

The Muddy Angels, in support of the National EMS Memorial Service, will additionally hold a special one-day event on June 25 in Colorado. The ride, starting in Denver and ending in Colorado Springs, supports the National EMS Memorial Service and the families of the honorees. EMS must not be fragmented in honoring and remembering the individuals and their families who have given the ultimate sacrifice in the line of duty.

These events represent the opportunity to unite EMS, set aside personal agendas and bring the fragments together. It is not a single person or "Martin Luther King" or one organization that will "fix" EMS. Just as defragmenting a computer's hard drive improves function, bringing the fragments of EMS together can only improve and enhance the EMS profession.

"We may have all come on different ships, but we're in the same boat now."

Martin Luther King Jr.

Edited April 16, 2010 by Dustdevil

[Chief1C]

I think that A.J. Heightman guy would be a good voice to represent all of EMS. I like his articles.

[Kiwiology]

Get Rob to do it, give him a few copies of JEMS to sign and wow, Larry Flint is back baby!

[Dustdevil]

It is extremely rare that A.J. Heightman ever says anything about EMS that I agree with. I think he's just too concerned about being politically correct and making all parties "feel good" about their participation in EMS to actually say anything profound. For EMS to progress, it's going to take leadership that isn't afraid to ruffle feathers and challenge the status quo.

As much as I love Jules, I'm not really on-board with what she seems to be getting at in this article. She is absolutely correct about the benefits of being united. However, as we have often discussed here, it simply cannot and will not ever happen in EMS. EMS is fragmented for a reason. It is fragmented because not everyone is here for the same purpose. The fire service, the privates, the vollies, the first responders, and all other stakeholders have independent agendas that rarely have anything to do with quality patient care. You cannot unite these factions. Any effort to do so is a pointless exercise in futility, and only delays the inevitable.

What is the inevitable? The inevitable is one of two things: Either EMS will progress as a medical profession, and push the selfish special interests aside to do so, or else it will eventually become just a side-job for the firemen nationwide. I honestly see no other potential outcome. That means that someone is going to have to step aside and let progress happen. Attempting to assimilate those people into the cause is counterproductive.

[Chief1C]

Don't know then.. I had to stop sharing JEMS articles with the local students. I got harped on for sharing Bledsoe's article on the Myth of Oxygen. Their instructors are sorely out of date. I like outspoken opinions that make people think.

EMS can't be healthy, or safe. It's just not possible. You cannot avoid the stress, if you aren't phased by it at all, then you've got something going on "up stairs". Hide the guns. No ambulance is safe to work in, as long as we have the option to transport two victims. They need to be built like a tank, with a padded, rolling, interior. Probably the best thing they could do for health, is put a gate at the entrance to fast food places, with a height restriction, so the ambulance won't fit.

We need a bigger EMS Memorial than the firemen have.. Maybe with bronze busts of the people there and we need a Museum too. There's a couple fire museums in every state. There's only been one set in stone place to honor the founding of EMS, and it closed. Cops prolly have museums. Hell.. The funeral profession, has museums.

Need a blanket article, for all Newspapers. Never seen anything, about EMS Week.. "EMS Prevention" aka CVA, Heart Disease, Diabetes, etc. prevention programs, etc.. Fire Prevention week is like a goddamn holiday.

See.. Now I'm stressed out. Sarcasm.

[Richard B the EMT]

@4c6:

NYPD does have a museum. I visited it back in 1970, when doing research for a "term paper" connected with my getting my drivers' license.

FDNY EMS has a really small museum, in a tiny room at the EMS Academy, started before the merger. I could probably put the entire contents of this museum into my minivan, as it is mostly pictures.

It has some additions from a year ago: Items recovered from the World Trade Center, including the Ambulance Equipment Checklist from the vehicle Carlos Lillo was on. He was one of the 2 Paramedics in the FDNY killed that day, and are included in the 343. He was also a classmate of mine in the EMS Academy preceding the current building.

[Kiwiology]

I got harped on for sharing Bledsoe's article on the Myth of Oxygen. Their instructors are sorely out of date. I like outspoken opinions that make people think.

I love that article .... there is nothing magic about slapping everybody on fifteen bloody litres by nonrebreather!

[armymedic571]

It is extremely rare that A.J. Heightman ever says anything about EMS that I agree with. I think he's just too concerned about being politically correct and making all parties "feel good" about their participation in EMS to actually say anything profound. For EMS to progress, it's going to take leadership that isn't afraid to ruffle feathers and challenge the status quo.

As much as I love Jules, I'm not really on-board with what she seems to be getting at in this article. She is absolutely correct about the benefits of being united. However, as we have often discussed here, it simply cannot and will not ever happen in EMS. EMS is fragmented for a reason. It is fragmented because not everyone is here for the same purpose. The fire service, the privates, the vollies, the first responders, and all other stakeholders have independent agendas that rarely have anything to do with quality patient care. You cannot unite these factions. Any effort to do so is a pointless exercise in futility, and only delays the inevitable.

What is the inevitable? The inevitable is one of two things: Either EMS will progress as a medical profession, and push the selfish special interests aside to do so, or else it will eventually become just a side-job for the firemen nationwide. I honestly see no other potential outcome. That means that someone is going to have to step aside and let progress happen. Attempting to assimilate those people into the cause is counterproductive.

Dust,

At first I was going to disagree with you. However, the more I think about it the more I realize that you are right. My discontentment is in the fact that the realization of that fact SUCKS.

It just goes to show that just because you do not like the message, does not make it wrong.

Good thread.

[UMSTUDENT]

I think that EMS should have long ago been defined as a health care profession. Dust is right. True unification is impossible. There is a small contingent of our profession who adamantly opposes any other direction for the profession, and they're right. Those who agree with this vision need to step up to the plate.

I feel that it is really going to take two things to make true progress:

A) An organization that is well organized by smart, charismatic leaders who can clearly articulate the points we all know to be true. This organization may need to be borderline militant, choosing to directly obstruct and oppose those organizations (IAFF, etc) that choose to keep our profession behind. The central tenant of this organization's advocacy should be around increased education standards.

B ) A true leader. I've always seen this person as a prominent, well educated physician/academic who is willing to politic a bit. We have our share of advocates, but no one who has really been willing to challenge the status quo about the future of the profession. We're seeing more and more studies that seem to be diverging on two separate paths: 1) EMS personnel are inherently incapable of doing anything resembling complex medical procedures (intubation, refusing of care) vs. 2) These studies are flawed and performed on biased cohorts (municipal fire systems, rural Pennsylvania-Wang). EMS has really made great strides and could probably play a more prominent healthcare role if providers were properly educated and utilized.

Someone needs to step up and push us into higher education and more prominent roles in preventive health and primary, community care. Even still there is professional disagreement among people on the "enlightened" side.

I compare myself to Dust, whom despite agreeing with me on virtually every argument regarding higher education, has seemingly always disagreed with my vision of eventual advanced practice. Dust brings up important questions about being good at what we already do, before biting off more challenging endeavors. I argue that higher education will only be mandated once the market, in this case healthcare, sees a reason for anything short of certificate trained, paramedic mill firefighters. Its a good argument to have and I have always appreciated the opportunity to forge my opinions on this essential question.

Regardless, someone needs to first step-up to the plate and vehemently disagree with organizations that continue to push us towards the predominantly public safety realm and not healthcare.

Edited April 18, 2010 by UMSTUDENT

[Chief1C]

On a side note, the National EMS Museum has done a superb job, updating their website.

http://www.emsmuseum.org/