Professionalism and the lack thereof.

[paramedicmike]

I've thought a lot about how I want to present this. I'm kind of in a tough spot given my status as a grad student in this particular clinical setting. However, what took place today by EMS providers in the area where I'm doing this particular rotation made me so angry I couldn't see straight.

The information I think I can share at this point is pretty generic and will be addressed anonymously to those in question. We can all learn from this experience, though.

From a professionalism standpoint, appearance is hugely important. Scruff on your face may be fine if you're a Hollywood actor or a model for GQ or something. If you haven't shaved in a few days and look like you haven't bathed in a couple days it doesn't instill a lot of confidence. Even less so when your white uniform shirt is dirty and sloppily tucked (difficult to understand as it was still morning... not like you've been out running calls all night) over your belly that hangs to your knees. Reeking of cigarette smoke compounds all this.

Couple this with one of your partners (and really, do you need 6 people to show up for a call that can be adequately managed by 2?) who tried to deny the access of a patient family member by raising your voice to a trauma surgeon by announcing "911 is for emergencies! How would you feel if we waited for the family only to have this patient have a head bleed? You'd feel pretty stupid now, wouldn't you?" First of all, the family member was not going to delay you. Second of all, raising your voice is by itself unprofessional. Thirdly, you have no ground to stand on as you didn't listen to the report from another physician present and you didn't even bother to assess the patient! Not even for lung sounds on an intubated patient! And you have the gall to raise your voice to two physicians and question/lecture them?

Whiskey? Tango? Foxtrot?

I have never been so embarrassed to be associated with EMS and other paramedics as I have been today. I have never been so disgusted and disheartened at the blatant demonstration of ignorance, incompetence and unprofessionalism as I was after witnessing events from today. I have never been so angry in a professional arena as I was today being forced to watch you make fools of yourself and give this industry and profession a black eye.

So, way to go Kent County EMS. All the progress that some of us have fought for in tireless efforts to improve EMS was tossed out the window by the inability of you guys to demonstrate even the most basic of courtesies to other health care providers, patients and their family members.

This isn't rocket surgery (my Dust-ism for the day). This is basic stuff. Every single one of you should be fired for how you handled yourself. AND you should be compelled to write letters of apology to all of the people your ignorance affected. You have disgraced yourselves, paramedics nationwide, and EMS as a whole.

edit: corrected a few, minor grammatical issues. No content changes made.

Edited October 7, 2011 by paramedicmike

[Asysin2leads]

I've thought a lot about how I want to present this. I'm kind of in a tough spot given my status as a grad student in this particular clinical setting. However, what took place today by EMS providers in the area where I'm doing this particular rotation made me so angry I couldn't see straight.

The information I think I can share at this point is pretty generic and will be addressed anonymously to those in question. We can all learn from this experience, though.

From a professionalism standpoint, appearance is hugely important. Scruff on your face may be fine if you're a Hollywood actor or a model for GQ or something. If you haven't shaved in a few days and look like you haven't bathed in a couple days it doesn't instill a lot of confidence. Even less so when your white uniform shirt is dirty and sloppily tucked (difficult to understand as it was still morning... not like you've been out running calls all night) over your belly that hangs to your knees. Reeking of cigarette smoke compounds all this.

Couple this with one of your partners (and really, do you need 6 people to show up for a call that can be adequately managed by 2?) who tried to deny the access of a patient family member by raising your voice to a trauma surgeon by announcing "911 is for emergencies! How would you feel if we waited for the family only to have this patient have a head bleed? You'd feel pretty stupid now, wouldn't you?" First of all, the family member was not going to delay you. Second of all, raising your voice is by itself unprofessional. Thirdly, you have no ground to stand on as you didn't listen to the report from another physician present and you didn't even bother to assess the patient! Not even for lung sounds on an intubated patient! And you have the gall to raise your voice to two physicians and question/lecture them?

Whiskey? Tango? Foxtrot?

I have never been so embarrassed to be associated with EMS and other paramedics as I have been today. I have never been so disgusted and disheartened at the blatant demonstration of ignorance, incompetence and unprofessionalism as I was after witnessing events from today. I have never been so angry in a professional arena as I was today being forced to watch you make fools of yourself and give this industry and profession a black eye.

So, way to go Kent County EMS. All the progress that some of us have fought for in tireless efforts to improve EMS was tossed out the window by the inability of you guys to demonstrate even the most basic of courtesies to other health care providers, patients and their family members.

This isn't rocket surgery (my Dust-ism for the day). This is basic stuff. Every single one of you should be fired for how you handled yourself. AND you should be compelled to write letters of apology to all of the people your ignorance affected. You have disgraced yourselves, paramedics nationwide, and EMS as a whole.

edit: corrected a few, minor grammatical issues. No content changes made.

Mike, I feel for you. Unfortunately, of police, fire and EMS, EMS is currently the least disciplined and least professional. I don't say that as a criticism but more of a problem to be worked on. In my years of EMS, I too have been shocked at the level of unprofessionalism I have encountered. Now, I'm not saying my uniforms were always pressed, but really I never encountered the concept of showing up to work without being showered and having clean clothes until I worked in EMS. I don't know how people's parents raised them or what exactly goes on in people's minds, but I have come to the conclusion that an unprofessional employee in any profession is not so much an indictment of someone's character as it is an indication of serious flaws in management. Supervisors are paid for a reason, to supervise. Unfortunately, I have found the prevailing trend in EMS is to kick responsibility of an unprofessional employee back down onto their partner. Supervisors will go out of their way to make it seem like their behavior is somehow your responsibility, and by approaching them you are somehow at fault for not being able to rectify the situation. That is complete garbage. It is not the responsibility of field employee to make sure people's teeth are brushed or they aren't acting like a yutz. That is a supervisor's duty. An employee who acts in such a manner indicates an overall lack of supervision and accountability at all levels, and it has the makings of a toxic system. I feel very sorry for your plight.

[island emt]

Mike: I can understand the frustration with dealing with these type of providers.

Some folks can be just punched in on the clock & look that way. I worked with a few pigs over the years and have even turned the garden hose on one that really really needed a bath. BO that brought tears to my eyes. Of course he went whining to the boss! Boss said it was about time somebody cleaned him up. :=

The fact that a mere PAramedic had the audacity to raise his/her voice and question the attending's in the hospital says a lot about their system and how well they are respected.

Our mission is to be a leader in meeting the present and future health care needs of the citizens and visitors in out community through a network of high quality advanced life support services, education and prevention programs which share common goals and values.

Service: We are committed to help the sick and injured by providing superior service to our patients and our community with skill, concern and compassion.

Quality: Because our patients are our primary concern, we will strive to achieve excellence in everything we do.

People: The men and women who are our paramedics, and those associated volunteers, physicians, nurses and students are the source of our strength. They will create our success and determine our reputation. We will treat all of them with respect, dignity and courtesy. We will endeavor to create an environment in which all of us can work and learn together.

Stewardship: Fulfilling our mission requires that we use our resources wisely and with accountability to our publics.

Integrity: We will be honest and fair in our relationships with those who are associated with us, and other health care workers as well.

Edited October 7, 2011 by island emt

[DFIB]

In my area EMS is really new. The oldest EMT has been out of school 3 years, no EMT-I's or EMT- P's. There are some guys that aren't that good. There are others that arent that well kept but my crew has always been able to distinguish ourselves as professionals. I know and see some of tha Drs on a social level and they undoubtedly ask me when we will be working and appreciate the care we put into our patients and jobs.

Dealing with sloppy, unprofessional, yahoos is embarrasing and dishartening. It makes me try harder, I try to think of myself as an agent for higher standards, Whether we notice it or not, other professionals notice.

[ORmedic65]

I can only somewhat relate to what you saw Mike, as I haven't been in the field that long. However, I must say that acts such as these disgust me; these are the people that our patients and other healthcare providers remember when they think about EMS, they don't remember the ones who took the time to take care of their appearance, or who were courteous and polite, no, they remember the filthy, cocky, poor excuse for a "paramedic". I just don't understand how someone can come into work and somehow believe that it's alright to be unkempt and rude, if you're not going to even make an effort to take care of yourself, how can your patient trust that you are going to take care of them?

[AZCEP]

I feel for you Mike. I really do. Unfortunately this is not unique to EMS, or medicine in general. Everyone wants to be viewed as the most important, credibility be damned.

One question: were these knuckleheads students in your facility, or providers passing through the dept.? Students can typically be sent on their merry way, as I'm sure you would have.

[Kaisu]

A lot of the problems with lack of professionalism, I believe, stem from the root of this profession as an offshoot of paramilitary public safety as opposed to medicine. Gungho git 'er done attitudes are fine and good when axing structures and/or tearing apart cars; not so appropriate for medicine. The same old lack of formal education, easy entry into the field and poor wages and shitty hours discourage the professional minded and medically driven from either entering or staying in the field. It makes me crazy.

I have noted that one individual can make a big difference in the culture of a place. Lead by example. Express dismay in a non-confrontational manner at anything you see in the field that reeks of whacker. A dedicated professional, especially as the leader of your crew, can make your crew, then your shift, then the entire organization better. Believe it or not, most management wants the same thing. Those that don't really have no leg to stand on in this day and age.

[paramedicmike]

I feel for you Mike. I really do. Unfortunately this is not unique to EMS, or medicine in general. Everyone wants to be viewed as the most important, credibility be damned.

Welcome back. Good to see you around again. Hope all is well with you.

I think your insight on this is quite astute. This isn't a problem limited to EMS providers. In this particular case, however, the EMS providers in question were the only ones responsible for the actions outlined. This was completely unprovoked.

One question: were these knuckleheads students in your facility, or providers passing through the dept.? Students can typically be sent on their merry way, as I'm sure you would have.

They were not students in the facility. They were on duty providers passing through the department on a call.

[Kiwiology]

Dude that makes my eyes bleed just reading it

Professionalisim is the demonstration of adherence to specific standards and the upkeep or bettering of them in the interest of the advancement of whatever specific body of expertise, knowledge and competency the particular role in question involves.

For example; well groomed, clean uniforms, appropriate interpersonal interaction (conduct)/communication skills and the use of knowledge and skill for the purpose of achieving role-orentaited goals.

Now that might make me sound like some sort of academic wanker but in the situation you describe it's quite true. If you roll up with a weeks worth of stubble and shirt hanging out it shows you don't really care about your presentation or the negative connotation its going to have to those around you, by loudly yelling at the family and the doctor about this bloke having a head bleed it really shows a lack of knowledge, a lack of appreciation for the system in which you work and that you have a really bad attitude.

I'd love to say our Ambulance Officers are better, and by-and-large they probably are, but I bet some out there are not much different.

[AZCEP]

The slovenly appearing individual will remain until standards are raised to the point they are no longer able to get by within the system. Pulling them aside will only create the impression you are trying to stroke your own ego to them.

I will suggest that there are doctors/lawyers/politicians that suffer from the same lack of demonstrating the level of maturity we would like them to. Maybe writing a note to the offending department's duty supervisor would be of some use, if only for the short-term.