How much change and how quickly

[Just Plain Ruff]

Read a response from Herbie today and I thought, make this a thread.

Herbie in essence said, "new people should have a realistic expectation of how much change and how quickly change will happen when getting into this field"

So I'd like to know this.

When you entered the field of EMS, what did you hope to accomplish and how fast did you hope to accomplish it?

What kinds of changes did you want to see happen and did those changes ever take place?

If they took place, were you a part of them or did you just go with them?

My main thought line is this, should we be preparing the new medics and emt's on how to be a change agent or just to learn the job and do the job?

Many places I've worked have said they welcome change but when a good idea or a new thing came around that would change the game at the service, the delays and fence sitting lasted so long that interest was lost.

Do we set expectations low on changing things or keep saying that "anything can be changed"?

Thoughts

[uglyEMT]

Good thread Ruff! I was thinking the same thing after reading Herbie's post.

I am currently in a position to shed a little ligth on this topic. My squad is currently facing a "change" right now. The young new EMTs are asking for all the newest stuff they have heard about or read about (equipment to protocols) (this is also a shift inside the State Cert Courses where more is being taught yet service protocols are not up to date) but some of the "old guards" like the status quoe(sp). Being I got certified under the old curriculum (the last class for it) I did not get the opportunity to get all the "new" teachings so I see things from the old gurad's perspective. But I also come here, do many CEU's, and read medical lit to keep up to date and progressive thus seeing the side of the new blood.

I want to see my squad be progressive, have the latest protocols, have the newest tech at their finger tips. But at the same I see where some of our tried and true ways are sometimes the best ways.

What I think we should tell our newest members to this great profession is patients. Learn the ropes, learn the medicine, learn the patients. Then as time goes on and you see an opportunity for a change bring it up, backed by scientific facts and or precidents, and go from there. Don't expect it to happen overnight but if you keep at it it may eventually happen.

I know it has been mentioned here many many times, Wake County, I bet they didn't just start being progressive one day. I bet as the old guards retired and new bloods moved up the food chain things slowly began to change. Once the change happened and gained momentum it was an unstopable force and now boast one of the Countries most progressive services. So hopefully our new EMTs and Medics as they get farther along may help facilitate the changes to make their service progressive. Patients is the key and a virtue.

edit to add responses to the direct questions

When you entered the field of EMS, what did you hope to accomplish and how fast did you hope to accomplish it?

I had no idea what Iwas getting into or wishing to accomplish. I was a wet behind the ears rookie and about the only thing I knew of EMS was the many transports I took in the back of one straped to a board with a funny thing around my neck.

What kinds of changes did you want to see happen and did those changes ever take place? If they took place, were you a part of them or did you just go with them?

I want to see my squad be progressive. I want protocols that are scientific based. I want training to be undertaken to bring inline the veteran members with the newest class coming out and incorporating what they are allowed to do into our SOPs. As far as did these happen, I am working on it. I finally made it to a poistion where I can effect some changes and feel others are behind me so it may just get done. Yes I did just go with them when I first started but now I want to lead the charge.

Edited June 23, 2011 by UGLyEMT

[Dustdevil]

I know it has been mentioned here many many times, Wake County, I bet they didn't just start being progressive one day.

They still haven't. They're just great at talking BS to impress the easily impressed with.

[uglyEMT]

They still haven't. They're just great at talking BS to impress the easily impressed with.

See you learn something everyday. Here I thought they were progressive just from how many times they get mentioned and talked about.

Well time for followed by BOHICA

[DwayneEMTP]

...When you entered the field of EMS, what did you hope to accomplish and how fast did you hope to accomplish it?...

None really. I went to basic after seeing a woman get hit by a cab, discovered the City, decided I wanted to try and be as smart as some of the people I respect here and try my best not to look like a bigger idiot than necessary. I had no political agenda or significant opinions other than wanting to surgically remove the word 'hero' from hosemonkeys.

...What kinds of changes did you want to see happen and did those changes ever take place?

Soon I'd hoped that the AAS for EMS would take hold and I would work with fewer and fewer shitheads as time went on. No, it's not taken place. In fact working in Southern Louisian I was in a remote medic course when they asked if we'd push MS for an apparent MI and I immediately said, "Sure.." and was truly shocked to find that I was the only 'Yank" in the class, as well as the only person to answer to the affirmative. I even had this hot chick sitting next to me (She moved only moments later) say, "Yeah, so I guess if you think that you're Soooooooo smart that you can diagnose an inferior wall MI and not kill your patient with the morphine then you're just some kind of super medic or something!!" To which I replied, "You don't feel comfortable diagnosing an inferior all MI to within a reasonable enough degree of certainty for you to treat your patients? And you do EKGs?"

Not only did the entire Remote Duty Medic Class! claim that they couldn't, but that they wouldn't even consider treating chest pain without first speaking with a doctor. Their local protocols allowed vascular access without medical control consult in major trauma and cardiac arrest only. And not a single person was bothered by that.

The further I go in EMS and the more providers I meet the more it becomes clear to me that American EMS in it's current incarnation is terminally ill...I'm not convinced that it's a pathology that we can reasonably expect to resolve.

...If they took place, were you a part of them or did you just go with them?..

For me, in my experience it's not about helping to move EMS forward, it's about kicking and scratching and clawing....fighting every day with everyone that will listen to try and convince it not to run backwards...it's an exercise it trying to be able to celebrate treading water instead of actually drowning. And I truly have no idea what to do about that until we get Fire to move on to some other hobby.

...My main thought line is this, should we be preparing the new medics and emt's on how to be a change agent or just to learn the job and do the job?...

I don't believe that you can teach them to be proactive for change. Some people are leaders, most are followers and though it would be awesome to try and teach the up and coming the political realities of EMS, it will make little to no difference without a strong leadership. I saw one of my personal heros Jack Welch on an interview show the other day. He's considered by many to be the most successful business manager in American history. He said something to the effect of, "In my time in business I've come to believe that most people, to create positive change, need to start with a backbone and then they need someone to tell them that change is ok." Most of the providers I know, despite all of their bullshit and bluster about type A personalities, are followers.

And there are just not many leaders out there. And the few that rear their ugly heads immediately find that they will run into job scared supervisors that don't want to listen to their shit and will do what they can to keep them contained...thus allowing themselves to maintain the status quo and sleep..like they've always done.

...Many places I've worked have said they welcome change but when a good idea or a new thing came around that would change the game at the service, the delays and fence sitting lasted so long that interest was lost.

As above.

...Do we set expectations low on changing things or keep saying that "anything can be changed"?

I do what was done for me. Dust, ak, Asysin3leads, and others convinced me to get an AAS as opposed to a cert. I think that they did this because it was good for EMS, but more importantly because it was good and healthy for me. And they were so perfectly right. I try and mentor in that same spirit. I'm going to try and change one attitude today, try and help someone make a better decision or be more proud of themselves. Not because I believe that that will save EMS. But because it's good for them, and helping them be better makes me feel good, plus creates a better environment for me to work in, and that in fact makes be better still. And then...like a pie eyed dumbass, I go to sleep and hope that somehow that attitude will spread, and jump up into the arena of being rare...and if we can even get so strong as to have that attitude be rare, as opposed to almost unheard of, then we'll have some folks that won't allow mediocrity as a standard.

Or so I hope...

Dwayne

[fiznat]

The changes that I've seen (and expected) have been more personal changes rather than having to do with the whole system. I've grown quite a bit since I started doing this around 10 years ago, and while I haven't changed my system I can definitely say that I've altered my daily experience within it.

A lot of times people are really negative about the state of EMS, but I've found that for the most part people can neutralize much of the negativity simply by being the best providers they can be. When we are out on calls it is just you and the patient, and the outcome from those encounters has everything to do with our own individual choices. The happiest people I know work hard not to be lazy, to treat every patient with kindness, to learn and follow up, to keep going to school. Our coworkers (both in EMS and in the hospital) notice those things, and it has been through those means that they've altered their personal "EMS realities."

Focus on yourself, not the system. If more people did that I think larger change would follow on it's own.