Are we (EMS) Lazy, Scared, or Indifferent ?

[Ace844]

"GaMedic, & Everyone,"

Good Morning. You know I have a long response to your post and points here so I will break it up into to parts here is the first. These two posters here and many others have a lot to contribute and have done a lot as far as providing solutions and advocacy in EMS and it’s improvement. Others are “PRPG, DUST, Ditchdoc, WPM, Ruff, scarmedic, paramedicmike, asys, medicccjh, medic001918, richmondmedic, dwayne, and many others who I may not have mentioned, etc..” To not see their contribution here and I am quite sure else where in the professional community which I am at this time unaware of borders on professional heresy. I will try to bring some of their work and statements alive again below for the newer people like you “GA,” who obviously have missed it and thus have been deprived of the presence of greatness. For you to continue to make new threads and suggest that we here aren't doing anything or enough on the various issues you have raised here is well frankly INSULTING!! Insulting to those of my respected, peers, and colleagues here who have endeavored tirelessly both here and in may other facets of their being to improve us as clinicians and the profession, than to have people like you live in continued ignorance and blatantly ignoring the facts to the contrary which so obviously stare you in the face!!! Below and in follow up posts will be my polite attempt to educate you, and make you publicly aware of this fact.

Below are two well stated posts and which make very eloquent points simply:

I too feel it is time we get off our lazy butts... I do believe we have the highest percentage of whiners possible. Let's compare with others...

Fire Departments: Have unionization, benefits, and heck even when they back into the F.D. station house with a patient on-board.. they support each other.

Police/LEO: Want to see some organized guys? This is who we need to follow... yeah, they fight amongst each other, but they know how to combine thoughts, professionalism, and education.... look at their lobbyist and they have yet lost any funding bills.... hmm maybe we should take notes?

Nurses... OMG, talk about a sisterhood... they may fight amongst each other, but YOU better not put one down!... As well, they have increased their level from OJT to Doctoral level. Look at the Surgeon General, he was a former Paramedic, RN and Trauma Surgeon. He still write his title RN, M.D., FACOS.. very proud of his history.

We do not need to re-invent the wheel. Let us take notes of other success and failures, but there is one thing you have to do .. medics have to get off their butts, and take action!. The other agencies DID something other than moan and whine...!

Don't like the pay..the working hours, the patient load, the type of patients, the benefits, the education level?

Truthfully, what have you done personally done to change it?

uh-huh.. Should we be proud of you ?

Actually reading all the posts is quite humorous... the fact is we are missing the whole point. Others are trying to point it out to us, other professions have started and we as usual follow behind......

that is ................

Prevention is the key.

If we were truly professional, educated, and really even caring we would do more on prevention medicine.

We would work closely with MADD, seat belt enforcement, fall prevention and home safety groups. Other professional groups have made that move. Did you report or make notes on how safe or un safe the house was, on your last call? Did you remove that slip rug? Did you contact the social worker to notify that grandma had fallen twice this week and needs rails in her bath tub?... What else could you had done..? Do you feel bad, after the third time you have to respond on someone due to extreme heat, poor living condition, the child that was ejected from not being restrained?

Are we really wrapped up so much into our profession or is it insecure that we actually believe it is someone else's job? By punting it off to someone else ... how professional is this... how lazy would you consider a health care professional to turn an eye to to a hazard? Would you have the same opinion of a firefighter that seen frayed electric cords, later to work a structure fire, caused by that electrical short?

All that was stated in other posts are good points.. but, that is still treating the symptoms not etiology. There will continue to be enough idiots, that consume the wrong food, have a sedentary life style, causes incidences that harm themselves and others.. by performing prevention we will not stop our career or run volume, just enhance it!.

R/r 911

By all means, if we gripe now and then, we didn't mean to offend thou, GAmedic.

Now: I'm not saying that there's nothing out there that EMS wants to change. But try this on for size. Out of any person regularly active on this site, with a few exceptions, we're all in EMS to make changes for the better. We're not here to tell you your ideas are crappy, or awesome. We're not here to be criticized of every shortcoming that EMS may face. We're not here to be complacent. We're not here to bash other people, especially those outside of our 'community'. We're here because we want to. Because, perhaps, many want to improve themselves, and the others wish to help that. We're here because we want to know more. We want to do more. We want to be better. I can only think of a very small number of people who came here to be lazy and complacent. And, usually, they shape up, or ship out. [i really just wanted to use that phrase today...Day's complete.] Like many have stated: "Preaching to the choir". And, just because we don't all jump on your bandwagon, go door to door with AED's, sterilize everything in an ambulance and give activated charcoal to everyone who has ingested anything not certified organic, does not mean you have bad ideas, or mean that the viewers here at The City are bad, either. Regardless of how you decide to call us lazy, scared, or indifferent [Note how "Dedicated, but preoccupied" wasn't a choice in the topic.]

You are a crusader, GA. Go for it. Just remember a few things: Recognize what you can fix. If it ain't broke, don't fix it. Only fix what you can fix. And don't step on the toes of those whose support you'll require to get the rest of those tasks done.

We're not lazy, we're not scared, and we're not indifferent.

Alright, lets get it on!

We've covered the lists of what needs to get done several times while I've been active on these forums [education, lobbying, money, jobs, etc] and haven't seen huge changes yet, although have had good ideas to bring back to my own services.

Now, in an attempt to stop being a cynical bastard - and stop with excuses, lets look at some reasoning:

FD's - Federal level seating. Lobbying. Money. Every community needs one. Looks pretty set to me.

Police: Everyone needs one, educated, responsible, lobbyists and funding.

Nurses: They just make money hand over fist. [Just kidding.] Many years in with doctors, hospitals, and the health field DEPENDS on them. Hands down.

EMS: People state they're 'just as good going in taxi's'. Research shows trauma patients have better survival rates brought in POV. some towns have multiple providers all fishing and scrounging for calls. We're all famailiar with the average pay, benefits, employers, etc. We're dispensible. Many companies go hospital to hospital begging for calls, bearing gifts and presents [mmm...doughnuts..., etc.]

Now, EMS, where do we start? From the bottom up? Educating people of our abilities. Educating ourselves. Take private EMS out of 911? Or from the top down? Throw money at the problem, and it will all fix itself?

As of yet, I've not had the ability to try to help EMS from the top down, but from the bottom, we all have our duties. Honestly, I do not have the answers. I'm not smart enough for that. Have suggestions? I'll follow them. I do not mean to be part of our problem. We're too busy fighting with ourselves

And GA: regarding 12 leads, pulse oxymetry, computers, intubation, medications, and anything else we've gotten in the past 40 years. It took just that. 40 years. EMS has rarely ever gotten anything 'overnight'. In fear of sounding redundant, you may not be the first to think of such great, or not so great, ideas. "Search" works wonders.

Okay, now we're getting places.

Working 2 jobs - not many aren't guilty. Some depend on it, no? It's a tough situation because it hits the employees where the emplyoers don't want to be hit - the wallet. I'm all for it [Hell, I'll stock shelves as a second job for a while], but we need something larger scale. We don't even have a single EMS Union or federal unit yet, as discussed several times before.

EMS is too cut-throat - We needn't be every person for themselves.

If ambulance got more expensive, sure, they'd still get bought...eventually. There are too many excuses out there for companies to blind employees with to keep them from sharing money. Excuses from my current company on why we can't get adequate supplies: We lost a share of a tertiary hospital's discharges, fuel, STATE WORKER'S COMP is too high, they pay too much in benefits, the main station just spent XXX dollars, and there's nothing left. It's all a crock. That's just for what's needed on trucks. [shady, I know.]

EMS Employers [again, not all, but quite a few] know EMT's and Medics are dispensible.

2 - I like the plan, but it's probably not doable in many situations. I'm sure companies would lose track of that sort of thing. I absolutly am thrilled with the idea, however. I think profit sharing is a great idea. Smaller companies who just listen to employees is an even better start.

I mean, how far is too far? Is it considered professional to bring legal action against your employer who may not be paying in accordance with Federal Law? Is that a start?

In what I've seen, it's still too easy to identify one troublemaker and make an example out of them.

We need bigger numbers.

Most of you think I am being a PITA when I continuously suggest a search, and “GAmedic, & others,” The reason I do so is because some of those posts you will find contain some of the most intelligent, insightful statements that I have had the pleasure to read. They contain outstanding proposals and solutions to the problems you are ‘posting’ about.

Also, finding these threads and reading them will give you the opportunity to perhaps be exposed to I have to many people who post here who I have come to respect greatly and see as a greatly underutilized resource among our professional peers. Below are just a few of these..

Advocacy threads:

Increasing Education from a perspective of system management

Formation of a new EMS political action group

How To Lobby Effectively

Detroit Screws Up Again, Kills Another Person

I can do that !. & you thought some of us were crazy !

A Total Restructuring of EMS as a Profession

Letter to Congress in regards to New EMS Adminstration

52 Precepts EMS Students and Providers Should Consider

Medical legal loophole!?!?!?

Personal responsibility:

Whose responsible in your opinion foryour pre-hospital care

Others:

Ruff's list of do not touch topics not to post on EMT CIty

Is EMS definative care?

The final US NationalScope of Practice model/Draft..

EMT (B, I, & P) - Vocation or Profession?

Economic Value of Out-of-Hospital Emergency Care: A Structur

"First Responders" on Ambulances

THE DECLINE OF THE NATIONAL

EMT BASIC Education

getting experience first

[AZCEP]

Good idea city medic -- and i will do you one better --- when you get it completed, share it on this site, so that all of us can use each others. THink how nice it would be if we had 1000 good-canned CEU courses on this site that anyone could use. Even if it doesnt help our companies, which i think it will, maybe we can help that guy in the wilderness who works for a service that doesnt offer any training.

While it is a good idea to put these courses together, an important point is being missed. If the student is blankly reading a presentation, powerpoint or otherwise, will they be able to remember what they read when the time comes?

Most EMS providers are not good at taking a concept off a page and applying it. The majority are combination learners, hear-see-do types. When we eliminate one of these modes, it becomes much more difficult for them.

There are already dozens of "canned" courses out there. The benefit lies in the instructor's ability to relate the information. Knowing there is nothing worse than watching a presentation being read word-for-word from the slides, how can you possibly condone this type of CEU program?

I would also direct you to the Training files. Many good presentations there to build from. The work has already been done, it would be ridiculous to duplicate efforts when you don't have to.

[GAmedic1506]

To Ace and Azep --- Do not poo-poo Tech's idea of improving his service. It is apparant that both of you work at the perfect EMS System where there is no room for improvement, or questioning of the status-quo. As far as the benefit of canned training, I agree that classroom instruction by a qualified instructor with some hands-on practicals is superior, but many of us do not work for the perfect EMS Service that you do. Many systems do not have a paid instructor, or a budget that allows people to attend training classes. Some medics actually struggle to meet National Registry Recert Hours. Some medics have to travel over 100 miles just to find a PHTLS/BTLS course. Then there are medics who arent happy with the status quo and have attended all of the standard classes, and may just want to read something new.

Ace, I am sorry that i pissed in your cherios, it is obvious that my posts are generating more commentary than yours, and that has upset you (although your ego will not allow you to admit that). My intention was not to unseat you from whatever throne you sat on prior to my arrival, I just wanted to discuss EMS issues. I am sorry that I have upset your world so. As far as you being INSULTED, I have not accused any member of this forum, or the forum itself of being lazy. I asked the question "Are WE (EMS) (not emtcity, ruff, ace,or anyone else) lazy, scared, or indifferent ?" That thing at the end of the sentence is called a question mark, which means the statement is a question. Also, please note that I used the word "WE", not "you", which implies that I include myself in the problem. But there is a simple solution to the problem, when you see anything posted by me, just ignore it and go to a different thread. My thoughts, threads, and posts will live or die based on whether or not people enjoy the content. If people find my posts to be boring or stupid they will stop reading and responding. But my guess is that people want to discuss all EMS issues, even the ones that make them a little uncomfortable.

[Ace844]

"GAMedic,"

First of all I didn't belittle 'techmedic's' post or idea, I highlighted and quoted it as a positive one...WORK ON YOUR READING COMPREHENSION!! Also, RE-READ my posts!

As for the rest I will withhold comment for a short time as it will be less than PC or +until then here's your:

My reply will be forthcoming...

ACE

[GAmedic1506]

Thank you ace. I do not want us to get another post locked down, as that benefits no one. Lets just agree to disagree. I respect you because you like the facts and you are not afraid to challenge people. Your not one of those who just say anything to get attention. I think this site will benefit from our disagreements, if we can keep it civil.

[AZCEP]

To Ace and Azep --- Do not poo-poo Tech's idea of improving his service. It is apparant that both of you work at the perfect EMS System where there is no room for improvement, or questioning of the status-quo. As far as the benefit of canned training, I agree that classroom instruction by a qualified instructor with some hands-on practicals is superior, but many of us do not work for the perfect EMS Service that you do. Many systems do not have a paid instructor, or a budget that allows people to attend training classes. Some medics actually struggle to meet National Registry Recert Hours. Some medics have to travel over 100 miles just to find a PHTLS/BTLS course. Then there are medics who arent happy with the status quo and have attended all of the standard classes, and may just want to read something new.

Where exactly did you see that I was "poo-pooing" the idea? It is great that the idea was presented. I was merely giving a warning in the execution of it. To clarify my position, there are dozens of available programs that have free CE programs already available online. Medscape and Cyberrounds are two that jump to mind. These are designed for those that want to learn something new, that is not integrated into the standard alphabet soup classes. They are significantly more difficult than most EMS specific offerings, because of a lack of an instructor to ask questions of, and they are designed for doctors and nurses.

GA, you may be reading a bit much into what is being posted. I am speaking from experience when I suggest having the instructor available to the students. I have built CE programs that failed miserably, due to lack of instructor interactions. If you want to discuss it further, I would be glad to help you build your own. This forum is probably not the best place to pound out the details, but I'm willing to try.

[GAmedic1506]

Thank you azep, I do apologize, as I had misread your comment. And thank you for sharing those two sites, as I had not heard of either one. I will check them out.

[Ace844]

"GAMedic,"

I never said you insulted me, this is what was said:

For you to continue to make new threads and suggest that we here aren't doing anything or enough on the various issues you have raised here is well frankly INSULTING!! Insulting to those of my respected, peers, and colleagues here who have endeavored tirelessly both here and in may other facets of their being to improve us as clinicians and the profession, than to have people like you live in continued ignorance and blatantly ignoring the facts to the contrary which so obviously stare you in the face!!!

It would be wise of you to visit the links and read the material there.

ACE

[GAmedic1506]

Ace, please go back to page 3 and read my last comment. I love you no matter what, and look forward to more civil, yet spirited debates in the future.

[Just Plain Ruff]

Just so we can remember what started all this I put out the original post in quotes and in red so we can remember::

"I started a thread a few weeks back that asked what have you improved at your EMS Agency ? The results were miserable, hardly anyone could cite a single improvement. Atleast the Fire Departments can point to improved building code, reduced fire-deaths, and the overall reduction in actual fires. What can we point to:

* Are cardiac arrest survival rates improving ? Seattle showed us the way to do it years ago, how many other agencies

have stepped up to the plate ?

* RSI is available in only a handful of communities

* The ability to do lab work in an ambulance is now available through ISTAT, but only a handful of providers use it.

* Have we impacted trauma deaths, which was our original mission -- probably, but hard to prove it is our

accomplishment versus the surgeons.

* There are many EMS services that do not have computer-based reporting, even though computers are cheaper than

many of the other pieces of equipment we buy (stretchers, monitors, stair-chair)

When the rookies ask what our generation did for EMS, what will you say ?"

Actually, the results were not miserable. unfortunately if you really go back and look and review who consistently posts here, there are only like about 12-15 consistent everyday posters here. With the amount of views your controversial topics have gotten over the last couple of weeks it would seem that this number should be significantly higher but in my business we follow the 80/20 rule, 20 percent of the people do 80 percent of the work.

I have yet to see on any of your posts what you have done to make EMS a better place and If I did indeed miss your contributions then please enlighten me now.

Unfortunately here, I have seen you come in and post some pretty controversial topics and as Ace said, it seems that you are preaching to us about being complacent or not doing enough to get things done.

Let me tell you a thing or two about what I have learned in my 15 years of working in EMS and now with my 5 years of working in ER consulting and seeing 40 different ER's in 12 different states. The current crop of people in EMS and also in ER nursing etc, are overworked, underpaid and underappreciated. They(me included) rarely have enough free time to spend researching things and trying to make things better. We have obligations such as WORK, Family and raising kids. I work 12 hour days consulting and on the weekends those are precious times that I do not work nor do I do research to make the EMS world and the consulting world a better place.

My making the EMS And consulting world a better place focuses on two things and two things only - 1: taking care of patients 2: Making the client I work for have a cleaner, faster, better, quicker, more productive ER so they can go back to number 1 above: Taking care of patietns because I can make a educated guess that this is what everyone on this forum is here for, to make the lives of our patients better.

I'll concentrate on my job duties and let the people who don't have the obligations that I have and that many others here on this site have make the EMS world better. Sure I have a lot of ideas to make things better but they have all been addressed, it's not my fault if they haven't been implemented in my area or your area yet.

I think that the majority of this group understands and appreciates your idealism and enthusiasm yet a lot of what you have posted here in all your threads have come off as "insulting" and "preaching". I admire you trying to make a difference but to challenge us in a post to say what we have done and then come back a couple days later and say the response was "Miserable" that sounds insulting.

I don't want you to stop posting these types of discussions because it makes us all step back and think but please decrease your tone in how you post them. They have all come off as "preaching"