# What Burns you out at times on EMS?



## Brandon275 (Oct 31, 2012)

We have all been there, burnout syndrome.  Rather it be from working tons of hours and running on sleep, to picking up the same patient over and over again or the low pay we have in EMS.  It could be a combination of them all.  

For me I would have to say it is the relentless b/s calls we get sent on.  For example.  Last night I went to the local shelter for a man with knee pain since june.  He told me that he had a ride arranged to go to the hospital but he said the shelter told him if he went by private vehicle they would not let back in for the night because of liability issues.  So we were called by them to take this man to the hospital for really no reason and right to triage he went all in the name of saving the shelter from liability.  This is a constant type issue in the system I work in.  

The abuse of the ambulance by people that should know better is infuriating to me.  Right now it has been harder to ignore because like most EMS professionals I have been pouring in 70hrs a week.  Anyway, what are some of the things that irk you??  Please share!!


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## NYMedic828 (Oct 31, 2012)

Showing up to work.



Those BS calls are probably the only reason you have a job. If we only responded to legitimate calls we could cut our staffing by 95%. It isn't your system, it's every system. The wealthy rarely call for EMS and they are often less stricken by chronic disease.



The standards of EMS and the incompetency of 90% of the workforce is my major gripe. I would certainly like to be paid more quite honestly we haven't earned it and most don't deserve it. There plenty of people who work just as hard if not harder and don't make as much as our low wages. And our "training" is not an argument especially at the EMT level.


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## RocketMedic (Oct 31, 2012)

Total and complete agreement with NYMedic.


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## the_negro_puppy (Oct 31, 2012)

Drug seekers
Taxi'ing people to hospital


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## Chief Complaint (Oct 31, 2012)

Burns me out?  Nothing.

Annoys me?  4am calls for something non emergent.


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## Tigger (Oct 31, 2012)

Posting. There is only so much time a human being can expect to remain sane cooped up in the same environment day in and day out.


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## VCEMT (Oct 31, 2012)

Working for AMR. In other words, working with burnouts that spread their virus of incompetence and laziness. 

Other than that, nothing. I'll run whatever call I'm dispatched too, it's what I'm paid for. sadly, I have to do it with AMR.


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## RocketMedic (Oct 31, 2012)

VCEMT said:


> Working for AMR. In other words, working with burnouts that spread their virus of incompetence and laziness.
> 
> Other than that, nothing. I'll run whatever call I'm dispatched too, it's what I'm paid for. sadly, I have to do it with AMR.



That's not exactly fair to AMR- it's highly divisional.


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## Joe (Oct 31, 2012)

Tomorrow is my last day with amr. Going to a better kept up first in department where i can actually feel like an emt rather than LaCounty fires taxi service. I have been running an average of 14-17 call in a 24 hr shift for the last year. I have not had one day where i didnt want to go to work. I dont mind the bs, the attitude i get from people (fire and pt). I love talking to people. If i can make them smile amd act like a normal person im happy.


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## DrParasite (Oct 31, 2012)

Tigger said:


> Posting. There is only so much time a human being can expect to remain sane cooped up in the same environment day in and day out.


I have to say, Posting has probably done more to kill EMS camaraderie than almost any other great idea to come out of the minds of management.  that and caused more good employees to leave the agency for non-posting places.



VCEMT said:


> Working for AMR. In other words, working with burnouts that spread their virus of incompetence and laziness.


it's not just AMR, it's many places.  poor attitudes, laziness, and tolerance for incompetence all spread like a cancer, and unless management or the senior personnel stop it early on, it can destroy a once good organization from within. 





VCEMT said:


> Other than that, nothing. I'll run whatever call I'm dispatched too, it's what I'm paid for. sadly, I have to do it with AMR.


I'm the same way, with one caveat; as long as I get my bagel sandwich in the morning, 20 minutes to both get or eat my lunch sometime before 2pm, and an end time sometime within an hour of my scheduled end time (unless I have class right after work, or have early relief coming in), you can run me all day (and give me the occasional little EMT's room break when I need it).  don't give me BS admin jobs to do (pick up chairs, food for a meeting that I can't attend or eat, drop off backboards, etc, and btw if you get a call while you are doing that, go on the call), just let me do my job and "save lives."

Oh, and I don't like drunk calls.  if you are drunk and you call an ambulance, don't expect compassion.  You did it to yourself, and get absolutely no sympathy from me.  but I will still do my job and take you to the hospital, just not with a smile on your face.


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## Shishkabob (Oct 31, 2012)

I can promise you that if even 30% of our calls were legit useage of EMS (not even life/death, just legit) moral would be much higher.  Infact, if I have one legit call a day, I'm content.



As far as "those BS calls keep you in work", if Medicare/Medicaid/insurance companies actually did as they should, and EMS crews didn't use the magic words, there wouldn't be reimbursement for those calls and there'd be a bigger push for community paramedicine.  A good portion of BS users we never get reimbursed for anyhow.


Like DrP stated... give us some time to eat lunch / relax for a short period during the day, and get me off at or darn near my scheduled time, and I'm happy.  



I've been at my current agency for a bit over a year now and still enjoy it, even though there are a good bit more BS calls.  This is my third agency, so I KNOW what it can be like.


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## 46Young (Oct 31, 2012)

I used to work an all-night schedule and liked it, but now that I have ten years ion the job, I strongly dislike getting woken up after 2200 hrs unless it's a true emergency. I work a fair amount of OT, I work a second job, and I would prefer that I not be useless at home the next day because I was up most of the night. 

That crap ruins your health. If it weren't for CrossFit and Paleo, my physical health would be on the road to ruin by now. 

Had I remained in the NYC 911 system, the top gripe would be having to sit on street corners every day waiting for calls. Having a station with beds, a kitchen, day room, showers, and a gym is much better.

Had I remained with Charleston County EMS, my main gripe would be having to be available as soon as we showed arriving at the hospital. Really, we would have a call on our screen before we could turn the bus off, let alone even wheel the pt into the ED. At times it would take me until after midnight just to catch up on all the unfinished reports, and then we would get called to post on some street corner for an hour and a half at 0-dark-30. Then get held for another 12 or 24 hours (24/48 schedule). 

Try working a 24/48 that has busy nights, with frequent forced OT, and no Kelly days. See how long it is before you crack. I was lucky and got a better job offer four months in, just before I was going to call my old employer to maybe get re-hired.


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## Brandon275 (Nov 1, 2012)

Linuss has a great point.  The b/s calls we go on are now not being covered by medicare/medicaid.  The knee pain since june at the shelter I had the other night is going to be on the hook for the bill despite having medicaid and he will not pay it of course so now my company is out that money.  So in reality it keeps us on the truck but it drains our company financially.  Its a lose lose.


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## Veneficus (Nov 1, 2012)

Linuss said:


> As far as "those BS calls keep you in work", if Medicare/Medicaid/insurance companies actually did as they should, and EMS crews didn't use the magic words, there wouldn't be reimbursement for those calls and there'd be a bigger push for community paramedicine.  A good portion of BS users we never get reimbursed for anyhow.



I think there is a lot of truth to this and I mostly agree.

However, nobody is going to pay for community paramedicine until providers can actually do it. That is going to mean an increase in education. (not to be confused with a mandatory degree)

As it currently stands, the EMT-B and Paramedic curriculum is simply not geared towards treat and release or alternative destinations.

It is my opinion that an actual degree on the part of EMS providers with push that agenda faster. However, the degree program also has to be set up for it. I suggested simply copy and paste an existing one from another country.

Then, following the well worn path of other providers, EMS can demonstrate knowledge and value to not only medicare, but the community, and insurance companies.

The sad fact is US EMS is not paid for medical care, it is paid to drive people to the hospital.


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## Handsome Robb (Nov 1, 2012)

Chief Complaint said:


> Burns me out?  Nothing.
> 
> Annoys me?  4am calls for something non emergent.



What he said.

If ya'll hate your job so much why are you still working in EMS? I hope people with some of the attitudes in this thread never run on any of my family members or friends. 

Bums using us as a taxi around the city makes me mad but whatever. I had an urban outdoorsman tell me he was cold and wanted to go sit in the waiting room because they have heat the other day, that was a hoot.

If I had to pick one call that "burns me out" it's patients with a documented seizure disorder who are noncompliant with medications and their friends call when they seize. Or even better, when they are compliant with their medications and they seize but their family still calls and greets us with "their doctor told us not to call unless it lasted for longer than x amount of minutes but s/he was having a seizure!"


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## JDub (Nov 1, 2012)

Tigger said:


> Posting. There is only so much time a human being can expect to remain sane cooped up in the same environment day in and day out.



This. I work 12 hour shifts and all we do is post all day. I am not super tall (around 6 foot) but I have no room inside the trucks at all. Then we have trucks like the one I was in yesterday that did not have a working A/C so me and my partner spent all day sweating in the truck. That is why as soon as I get out of paramedic school I am moving somewhere with 24 hour station based shifts.

Otherwise nothing else really burns me out yet.


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## Handsome Robb (Nov 1, 2012)

JDub said:


> This. I work 12 hour shifts and all we do is post all day. I am not super tall (around 6 foot) but I have no room inside the trucks at all. Then we have trucks like the one I was in yesterday that did not have a working A/C so me and my partner spent all day sweating in the truck. That is why as soon as I get out of paramedic school I am moving somewhere with 24 hour station based shifts.
> 
> Otherwise nothing else really burns me out yet.



It still shocks me how shiesty some of these companies are. I work for a private company contracted under a Public Utility Model and if we have an issue with a rig like no A/C or heat we get pulled in and they put us in a different one that isn't having issues, albeit we have a decent stable of units to draw from.


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## ExpatMedic0 (Nov 1, 2012)

agreed. Also there appears to be some terrible areas and agency's to work as a Paramedic in the states. Nothing wrong with moving for better pay and working conditions.




Chief Complaint said:


> Burns me out?  Nothing.
> 
> Annoys me?  4am calls for something non emergent.


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## mycrofft (Nov 1, 2012)

What used to make me go ballistic (and not in the good sense) was the ablity and propensity for management to calmly announce a new policy which make patient care lessen and ignored the laws of physics, time and space as well as legal and professional ethics then reply to all queries "We are sure you will be able to rise to this professional challenge". Like they used psychological Botox.^_^

If you're going to sell me down the river, at least twirl your moustache or look the least bit uncomfortable. Using a supreme poker face tells me the following:
1. You don't give a damn about patients or your "subordinates".
2. *AND/OR* you are supremely ignorant but are convinced listening to the peons who actually do the work just encourages them to expect to give input when the job needs fixing.
3. You are on meds or fooled the tox screen when they hired you....which since it was a "buddy" thing, wasn't hard.

They all eventually quit, were forced to resign, or were turned out by grand juries, I retired....I won.


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## Tigger (Nov 1, 2012)

NVRob said:


> It still shocks me how shiesty some of these companies are. I work for a private company contracted under a Public Utility Model and if we have an issue with a rig like no A/C or heat we get pulled in and they put us in a different one that isn't having issues, albeit we have a decent stable of units to draw from.



We have an excellent fleet but that still doesn't make posting my favorite thing. A brand new ambulance is still far inferior to a station.


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## VFlutter (Nov 1, 2012)

The "What happens on the truck stays on the truck" mentality


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## Joe (Nov 1, 2012)

Take your anti what happens on the truck and shove it. Partners who are sell outs can find a different place to work. If you cant trust your partner then who can you trust? Andthing short of death amd extreme destruction should be handled in the truck.


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## VFlutter (Nov 1, 2012)

Joe said:


> Take your anti what happens on the truck and shove it. Partners who are sell outs can find a different place to work. If you cant trust your partner then who can you trust? Andthing short of death amd extreme destruction should be handled in the truck.



Yet another reason why EMS will never become a profession or taken seriously in the medical community. Do you see this in any other profession? What happens when a nurse makes a mistake, do they keep quite and cover it up? No, they report the issues and create an incident report. This is not to get people in trouble it is just the responsible thing to do and allows for the analysis of events. Incident reports are the reason many drug companies change labels or hospitals improve policy. 

Posts like this make me wonder why I even bother


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## ExpatMedic0 (Nov 1, 2012)

Joe said:


> Take your anti what happens on the truck and shove it. Partners who are sell outs can find a different place to work. If you cant trust your partner then who can you trust? Andthing short of death amd extreme destruction should be handled in the truck.



Well Joe I am just curious where your going with this? Say you catch your partner who is an I or P keeping the left over narcs instead of "wasting them" or what if they push the wrong medication and kill a patient? You going to cover there rear?  What if they assault a patient, or steal something, Where do you draw the line?


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## STXmedic (Nov 1, 2012)

Joe said:


> Take your anti what happens on the truck and shove it. Partners who are sell outs can find a different place to work. If you cant trust your partner then who can you trust? Andthing short of death amd extreme destruction should be handled in the truck.



You need to find a new profession. Something that doesn't involve responsibility and people's well-being. Mature a little and join us in the grown-up world. If you make a mistake, own up to it. If you're partner makes a mistake, tough :censored::censored::censored::censored:. He needs to own up to it on his own. I'm not saying go look for any little mistake and immediately go crying to your supervisor. But your attitude is incredibly immature and potentially harmful.


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## Tigger (Nov 1, 2012)

Joe said:


> Take your anti what happens on the truck and shove it. Partners who are sell outs can find a different place to work. If you cant trust your partner then who can you trust? Andthing short of death amd extreme destruction should be handled in the truck.



Death or extreme destruction. No mention of deficient patient care. Guess that's not important in EMS after all.


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## RocketMedic (Nov 1, 2012)

Tigger said:


> Death or extreme destruction. No mention of deficient patient care. Guess that's not important in EMS after all.




Of course not. It's per protocol.


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## JDub (Nov 1, 2012)

ChaseZ33 said:


> Yet another reason why EMS will never become a profession or taken seriously in the medical community. Do you see this in any other profession? What happens when a nurse makes a mistake, do they keep quite and cover it up? No, they report the issues and create an incident report. This is not to get people in trouble it is just the responsible thing to do and allows for the analysis of events. Incident reports are the reason many drug companies change labels or hospitals improve policy.
> 
> Posts like this make me wonder why I even bother



I agree with your point.

With that said though, I feel nursing isn't a great example. I worked in a hospital and this was an issue there also. The only difference is that it was completely based on cliques there. If a nurse made a mistake, all the people she was friends with would cover it up. If someone that didn't like her found out then it was reported and it just caused a while mess.


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## Tigger (Nov 1, 2012)

JDub said:


> I agree with your point.
> 
> With that said though, I feel nursing isn't a great example. I worked in a hospital and this was an issue there also. The only difference is that it was completely based on cliques there. If a nurse made a mistake, all the people she was friends with would cover it up. If someone that didn't like her found out then it was reported and it just caused a while mess.



I think that the culture of EMS probably accounts for why there are more "cover ups" (screw up, get fired not re-educated) than other areas of healthcare. That said I have no doubt that it happens more than infrequently in other areas of healthcare too. 

It would be a bit oblivious to say that nurses never cover stuff up, they just generate incident reports.


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## bill williams (Nov 1, 2012)

Taking the same patient every other day to dialysis as soon as we walk in the door at 6am. It wouldnt be so bad, except she is over 300lbs and we have to carry her down 20 steps in a stair chair that was made in the 1930's. 

Getting chewed out by the boss because the nurse didnt fill out the transport paper correctly. 

Getting out an hour late everyday, only to see everyone else waiting around to clock out. 

Explaining to dispatch that we do not have enough supplies to run another call, this is followed by "cant you run one more call?, its BLS"

Seeing all the fat unhealthy people that I work with complaining about bariatric patients, when they themselves are larger than the patient.

Co-workers that respond lights and sirens to pick up a patient going back to a nursing home. WE ARE NOT A 911 PROVIDER!!!!!!!!!!! SO TAKE THOSE IV's OUT OF YOUR POCKETS, AND THE TRAUMA SHEARS, AND ALL THE OTHER POINTLESS CRAP YOU CARRY IN YOUR POCKETS THAT SERVE NO PUROPSE WHATSOEVER.

Partners who call med control on every single call, discharges, to taking someone to a dr's appt.

Working 20 hours of OT, and not even clearing 1,000 dollars on my paycheck.

Being yelled at by dispatch because our paraplegic patient cannot sit in a wheelchair for their Dr. Appt. So now we have to wait until the appointment is finished. Instead of clearing to run more discharges.

I need a beer or 10.


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## STXmedic (Nov 1, 2012)

bill williams said:


> I need a beer or 10.



Sounds like it......


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## DrParasite (Nov 1, 2012)

ChaseZ33 said:


> Yet another reason why EMS will never become a profession or taken seriously in the medical community. Do you see this in any other profession? What happens when a nurse makes a mistake, do they keep quite and cover it up? No, they report the issues and create an incident report. This is not to get people in trouble it is just the responsible thing to do and allows for the analysis of events. Incident reports are the reason many drug companies change labels or hospitals improve policy.


that's the difference.  if a nurse screws up, she gets reeducated, often on the clock, and an analysis is done to see if the person did indeed screw up, or if the system helped cause the screw up.  

If the same mistake happens in EMS, you can expect suspension, termination, or a formal reprimand which can end your career.

notice how different jobs treat mistakes?  think maybe that can be a contributing factor to burnout?


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## Shishkabob (Nov 1, 2012)

Tigger said:


> We have an excellent fleet but that still doesn't make posting my favorite thing. A brand new ambulance is still far inferior to a station.



To be honest, stations are over-rated in many urban systems.  Let's get serious here, if you're anywhere near busy on a regular basis, you'll hardly make it back to the station (especially a far off one) let alone spend much time there.


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## DrParasite (Nov 1, 2012)

Linuss said:


> To be honest, stations are over-rated in many urban systems.  Let's get serious here, if you're anywhere near busy on a regular basis, you'll hardly make it back to the station (especially a far off one) let alone spend much time there.


Throwing the BS flag here.  why do you think urban firehouses exist?

Yes you will be busy, but more often than not, you will get some downtime.  even if it's just a safe place to rest your eyes, eat a meal, use the bathroom, catch up on charts, etc.  Maybe you get time between 2am and 6am.... maybe it's between 7am and 10am.  

Having a station that you never see is much better than being stuck in an ambulance for 12 hours when you don't have one.  busy or not, I still like the ability to sit down on a couch, even if its just for 5 minutes to relax.

 and if you are running for 12 hours straight, maybe your agency needs more ambulances to cover the volume?


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## 11569150 (Nov 2, 2012)

Joe said:


> Take your anti what happens on the truck and shove it. Partners who are sell outs can find a different place to work. If you cant trust your partner then who can you trust? Andthing short of death amd extreme destruction should be handled in the truck.



Alright Joe I think I see what you are trying to say.  I see this not so much as a play on the "lets cover everything up" mentality like a lot of people have been ranting about but more along the lines of the "loyalty" and "lets use the chain of command and handle things at the lowest level possible." Please correct me if I'm wrong, but I'm seeing a great deal of fire house mentality coming from this statement.  I work both a fire job and an ambulance job and my fire job is much more regimented as I work with a crew of 4 for a 72/96.  I have a strong bond with my crew members and we handle a lot of business "in house" that never reaches the Chief's or even at times the captain's ears.  That kind of loyalty is often missed in ambulance work as we usually don't work with the same partners and there are only two people working together at a time.  That loyalty and chain of command still exists but there's often a grey area when there isn't that second or third co worker constantly there to witness/discuss possible concerning scenarios.  An ambulance worker must indeed have loyalty towards his/her co worker but must also know when to discuss things with supervisors as they may sometimes be your only other direct line of contact.  This type of loyalty is unique for the medical field as you often don't find nurses or doctors who have worked fire or similar close knit professions and been part of this lifestyle so they don't have that constant feeling of trying to be true to your family.  They handle their problems the way they've been trained and we handle ours the way we were trained. Both are sometimes similar and often they are very different.  

As far as that remark someone made about EMS never being considered a profession or taken seriously, I find that very insulting.  This has been my dream profession since I was a small child and I take much pride in what I do regardless of what the "medical community" thinks about EMS. For the record: our local hospital works very close with our ambulance and we assist them quite a bit in the ER.  The doctors and nurses trust our opinions and will often ask the medics their thoughts on the appropriate action for treatments, transfers, etc. based on what they saw in the field.  I don't know what everyone's experiences are, but around here there is much love and respect in all fields of medicine.  Stepping down off my soap box I will finish with this to remain in step with the thread topic: what burns me out the most with this profession is how quick people are to draw away from the pride and respect that it really has.  We have been entrusted to care for people in their time of need and we again and again enter people's homes and other private places to bring them to a safe place for what ever help they might need; b/s or not.  We are in the business of helping others which has a certain nobility to it.  Let's try not to lose track of that.  Everyone can be just as professional whether you're a doctor, nurse, super medic, EMT, volunteer firefighter, whatever.  Were all on the same team.  Lets act like it.


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## mycrofft (Nov 2, 2012)

DrParasite said:


> that's the difference.  if a nurse screws up, she gets reeducated, often on the clock, and an analysis is done to see if the person did indeed screw up, or if the system helped cause the screw up.
> 
> If the same mistake happens in EMS, you can expect suspension, termination, or a formal reprimand which can end your career.
> 
> notice how different jobs treat mistakes?  think maybe that can be a contributing factor to burnout?



That's how nurses with a union get treated. Without one, or say working convalescent, you can be gone so fast.


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## mycrofft (Nov 2, 2012)

Joe, expand on "trust". It's driving the thread bonkers.


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## Joe (Nov 2, 2012)

11569150 said:


> Alright Joe I think I see what you are trying to say.  I see this not so much as a play on the "lets cover everything up" mentality like a lot of people have been ranting about but more along the lines of the "loyalty" and "lets use the chain of command and handle things at the lowest level possible." Please correct me if I'm wrong, but I'm seeing a great deal of fire house mentality coming from this statement.  I work both a fire job and an ambulance job and my fire job is much more regimented as I work with a crew of 4 for a 72/96.  I have a strong bond with my crew members and we handle a lot of business "in house" that never reaches the Chief's or even at times the captain's ears.  That kind of loyalty is often missed in ambulance work as we usually don't work with the same partners and there are only two people working together at a time.  That loyalty and chain of command still exists but there's often a grey area when there isn't that second or third co worker constantly there to witness/discuss possible concerning scenarios.  An ambulance worker must indeed have loyalty towards his/her co worker but must also know when to discuss things with supervisors as they may sometimes be your only other direct line of contact.  This type of loyalty is unique for the medical field as you often don't find nurses or doctors who have worked fire or similar close knit professions and been part of this lifestyle so they don't have that constant feeling of trying to be true to your family.  They handle their problems the way they've been trained and we handle ours the way we were trained. Both are sometimes similar and often they are very different.
> 
> As far as that remark someone made about EMS never being considered a profession or taken seriously, I find that very insulting.  This has been my dream profession since I was a small child and I take much pride in what I do regardless of what the "medical community" thinks about EMS. For the record: our local hospital works very close with our ambulance and we assist them quite a bit in the ER.  The doctors and nurses trust our opinions and will often ask the medics their thoughts on the appropriate action for treatments, transfers, etc. based on what they saw in the field.  I don't know what everyone's experiences are, but around here there is much love and respect in all fields of medicine.  Stepping down off my soap box I will finish with this to remain in step with the thread topic: what burns me out the most with this profession is how quick people are to draw away from the pride and respect that it really has.  We have been entrusted to care for people in their time of need and we again and again enter people's homes and other private places to bring them to a safe place for what ever help they might need; b/s or not.  We are in the business of helping others which has a certain nobility to it.  Let's try not to lose track of that.  Everyone can be just as professional whether you're a doctor, nurse, super medic, EMT, volunteer firefighter, whatever.  Were all on the same team.  Lets act like it.



I guess i got worked up with all the crap this forum has had lately. You however hit the nail with a better hammer then i did.  I hold my partner to an extreme degree of professional demeanour. We polish boots every morning and try our best to not let anything get to us. If he messes up and its not a life threatening mistake i let him know that it doesnt fly. He does the same for me. We have never had a complaint from rn or pts.i attribute that to our ability to not be a little peach and cry to supe at every turn. 

Do not ever think i would cover up anything illegal your dumb. Were professionals. We have fun because without it i will turn into another burnout that frequents the forum to stand on my soap box.

Trust is huge with us. I always know my partner has my back. If one of us is in trouble we both own up. Were a team. Like the quote says some things never reach brass desk and frankly thats how it should be.


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## 11569150 (Nov 2, 2012)

Joe said:


> I guess i got worked up with all the crap this forum has had lately. You however hit the nail with a better hammer then i did.  I hold my partner to an extreme degree of professional demeanour. We polish boots every morning and try our best to not let anything get to us. If he messes up and its not a life threatening mistake i let him know that it doesnt fly. He does the same for me. We have never had a complaint from rn or pts.i attribute that to our ability to not be a little peach and cry to supe at every turn.
> 
> Do not ever think i would cover up anything illegal your dumb. Were professionals. We have fun because without it i will turn into another burnout that frequents the forum to stand on my soap box.
> 
> Trust is huge with us. I always know my partner has my back. If one of us is in trouble we both own up. Were a team. Like the quote says some things never reach brass desk and frankly thats how it should be.



Well said.  I figured you didn't mean for that first comment to be taken quite so literally as others took it.


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## Tigger (Nov 2, 2012)

DrParasite said:


> Throwing the BS flag here.  why do you think urban firehouses exist?
> 
> Yes you will be busy, but more often than not, you will get some downtime.  even if it's just a safe place to rest your eyes, eat a meal, use the bathroom, catch up on charts, etc.  Maybe you get time between 2am and 6am.... maybe it's between 7am and 10am.
> 
> ...



That's my thought, if you're so busy to never see your station, then more ambulances are in order. Yes we are paid to run calls, but to expect excellent patient care while running crews into the ground is simply not realistic. 

Even if you run a lot at night, I still want a locked door to sleep behind to keep eager urban outdoorsmen from sneaking up on me.


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## VFlutter (Nov 2, 2012)

11569150 said:


> As far as that remark someone made about EMS never being considered a profession or taken seriously, I find that very insulting.  This has been my dream profession since I was a small child and I take much pride in what I do regardless of what the "medical community" thinks about EMS.



I am sorry you find that insulting but that is the truth, and sometime the truth hurts. I do not want to debate this again like I have numerous times before but I suggest you look up Flexner's criteria of a profession and get a solid understanding of the difference between a job and a profession. It sounds like you are new to EMS by your post but I honestly hope that  you keep that attitude as you continue to work but unfortunately many do not.


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## 11569150 (Nov 2, 2012)

I have 6 years in the field so yes fairly new.  I was not debating your "dictionary" definition of the field.  Semantics.  I was pointing out that people do take EMS workers seriously and EMS workers certainly act just as professional as anyone in a "true profession" if not more so (at least in my area) since most, like myself, also have a fire background.  Our hospital based ambulance provides an excellent career for the EMTs and paramedics with more than comfortable pay with a union, retirement, and insurance benefits to boot.  The salary from the EMT position alone has allowed me to purchase my first home for my family and I and I still have three pay step increases not to mention the four step increases for paramedics.  It's one of the best careers to have in town and that's good enough for me to call a profession.  My mistake I guess, I was arguing the "professionalism" of the field not whether or not it is technically a profession.


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## epipusher (Nov 4, 2012)

The one major thing that has always bugged me and still does: late runs. Only because I know what is waiting for me at home. I love bs runs, easy and less likely to die and little to no clean up. I love frequent fliers, again, easy and job security. I love the trauma runs and the serious medical runs, they keep you on your toes.


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## 46Young (Nov 5, 2012)

11569150 said:


> As far as that remark someone made about EMS never being considered a profession or taken seriously, I find that very insulting.  This has been my dream profession since I was a small child and I take much pride in what I do regardless of what the "medical community" thinks about EMS.



Most of us started out with the intention of EMS being our lifelong profession, our "calling" if you will. I remember that when I started in EMS, working per diem at a private IFT company, all that I wanted was to do NYC 911 EMS. Nothing else mattered. After a while, I wanted to be a 911 medic. Then, benefits and retirement became more important, and through research of numerous systems throughout the country, I've found that retirement in single role EMS is not that great. 

Meanwhile, the frivolous calls, the late jobs, the nights and weekends, no meal breaks, realizing that I was one pt care error from losing my job no matter how sterling my record, sitting on a street corner in an ambulance, seeing that there are practically no promotional opportunities, this all started to wear on me, just like it does for many other EMS professionals. Some stay for the long term, many do not. Many gradually marginalize the profession as just a transitional job and look for something better.

Again, early in my career, just being a NYC 911 EMT or medic would have made me plenty happy. But then the realities of the job wear you down over time. It's a gradual process, but many of us end up with the attitude that EMS (in the USA) is just a job, and not a profession per se. I've found this to be true enough of the time in the different systems I've worked in several states, that I feel this is true most everywhere. This forum only confirms that.

Look back on this thread in 5-7 years and see if you still feel the same. 75% chance you will not. If you do, then enjoy a happy career in EMS (seriously, no sarcasm). I know of a few people here or there who still love EMS after 25-30 years in, but they are the exception rather than the rule.


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## 46Young (Nov 5, 2012)

Tigger said:


> That's my thought, if you're so busy to never see your station, then more ambulances are in order. Yes we are paid to run calls, but to expect excellent patient care while running crews into the ground is simply not realistic.
> 
> Even if you run a lot at night, I still want a locked door to sleep behind to keep eager urban outdoorsmen from sneaking up on me.



I agree. Also, where we used to sit in Queens NY, National/Roosevelt Ave, we would often get drunks banging on our door for a ride to the hospital at 0300 give or take, and on four seperate occasions I've found a drunk sleeping on our back bumper up against the back door. After the first one rolled off into the street as we began to respond, it was routine to do a lap around the bus before going enroute.

The time the junkie starting beating on our bus with a plastic sword was quite funny as well.....


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## 46Young (Nov 5, 2012)

11569150 said:


> I have 6 years in the field so yes fairly new.  I was not debating your "dictionary" definition of the field.  Semantics.  I was pointing out that people do take EMS workers seriously and EMS workers certainly act just as professional as anyone in a "true profession" if not more so (at least in my area) since most, like myself, also have a fire background.  Our hospital based ambulance provides an excellent career for the EMTs and paramedics with more than comfortable pay with a union, retirement, and insurance benefits to boot.  The salary from the EMT position alone has allowed me to purchase my first home for my family and I and I still have three pay step increases not to mention the four step increases for paramedics.  It's one of the best careers to have in town and that's good enough for me to call a profession.  My mistake I guess, I was arguing the "professionalism" of the field not whether or not it is technically a profession.



I guess I've been lucky in that I've never worked in a service where we (EMT's and medics) were marginalized and regarded with disdain by medical staff or the public for the most part. The systems were hospital based in NYC, s third service in SC, and FD based in VA. The employers were all regarded highly for the most part, so I'm sure that helped. No inter-departmental animosity to deal with, so I'm sure that helped.


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## TransportJockey (Nov 5, 2012)

46Young said:


> I guess I've been lucky in that I've never worked in a service where we (EMT's and medics) were marginalized and regarded with disdain by medical staff or the public for the most part. The systems were hospital based in NYC, s third service in SC, and FD based in VA. The employers were all regarded highly for the most part, so I'm sure that helped. No inter-departmental animosity to deal with, so I'm sure that helped.



We are lucky like that here in the ABQ metro. My 911 service is looked down on for management issues by the hospitals, ad equipment shortages at times, but the crews are looked at as very competent clinicians for the most part who can work wonders with what we have 
But I am getting burnt out too with the massive call volumes and no down time. And low pay with private services. The thoughts of places like Deleware, or Wake County, or TX, or Denver is keeping me going to get my FP-C, and build my medic experience.


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## NYMedic828 (Nov 5, 2012)

> I have 6 years in the field so yes fairly new.


By EMS standards, thats fairly senior.



> I was not debating your "dictionary" definition of the field.  Semantics.  I was pointing out that people do take EMS workers seriously and EMS workers certainly act just as professional as anyone in a "true profession" if not more so (at least in my area) since most, like myself, also have a fire background.


Must be nice.



> Our hospital based ambulance provides an excellent career for the EMTs and paramedics with more than comfortable pay with a union, retirement, and insurance benefits to boot.


Depends on the region you reside in and what you consider to be "comfortable" pay.


> The salary from the EMT position alone has allowed me to purchase my first home for my family and I and I still have three pay step increases not to mention the four step increases for paramedics.


Would probably not even get you half a home in Long Island. Minimum here for a tiny house is $400,000 usually assuming it isn't a run down house. Aside from car insurance being $2,000 a year per vehicle.




> It's one of the best careers to have in town and that's good enough for me to call a profession.


I find it hard to believe that EMS provider is one of the best positions in the town unless you live out in the sticks and everyone else is a farmer.



Sorry but I think you are a bit in denial and stuck in your own delusion of what you want EMS to be, as many are. At some point 95% of people eventually realize we are an overpriced taxi service. If you can still be comfortable and happy in that regards, more power to you.


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## 46Young (Nov 5, 2012)

NYMedic828 said:


> By EMS standards, thats fairly senior.
> 
> 
> Must be nice.
> ...



I wasn't going to point all of that stuff out, but +1 on the above.


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## 46Young (Nov 5, 2012)

TransportJockey said:


> We are lucky like that here in the ABQ metro. My 911 service is looked down on for management issues by the hospitals, ad equipment shortages at times, but the crews are looked at as very competent clinicians for the most part who can work wonders with what we have
> But I am getting burnt out too with the massive call volumes and no down time. And low pay with private services. The thoughts of places like Deleware, or Wake County, or TX, or Denver is keeping me going to get my FP-C, and build my medic experience.



If you want to leave, then do it now, before these municipal employers change their retirerment systems to hybrid DC/DB, or otherwise reduce benefits. Regardless, go to where you really want to live for the next 25 years, and get the retirement clock started. Moving from state to state for a better EMS career is a time honored tradition with us. I've worked in three states myself.


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## TransportJockey (Nov 5, 2012)

46Young said:


> If you want to leave, then do it now, before these municipal employers change their retirerment systems to hybrid DC/DB, or otherwise reduce benefits. Regardless, go to where you really want to live for the next 25 years, and get the retirement clock started. Moving from state to state for a better EMS career is a time honored tradition with us. I've worked in three states myself.



I've worked in three as well. Just needing to wait for the semester to be over. I've already started to apply places. Any other third services you'd recommend?


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## ExpatMedic0 (Nov 5, 2012)

11569150 said:


> I have 6 years in the field so yes fairly new.



haha oh you pour soul, you walked right into there trap. Many of these guys I am sure are good fellows, have "put there time in" so to speak.... but as you can see a lot are "burned out" for a variety of reasons. Some are also in the process of switching into other careers.

It is what you make out of it. If you want a vocational certificate to haul people up and down stairs for peanuts and be treated/paid like dirt, yes that is an easy option. An option the majority will probably take in the U.S. right now regrettably 
If you want to further your education, be a professional, take some initiative and do something you enjoy, then do it. Relocate, get a degree, work for a better agency, go into supervisor, education, research, flight, management, government agency, international contractor, remote medical, the list can go on and on. There can be light at the end of the tunnel  I have been in it for about 10 years and I am not going anywhere ;-) At the same time things need to change and I can understand others frustrations.


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## 46Young (Nov 5, 2012)

TransportJockey said:


> I've worked in three as well. Just needing to wait for the semester to be over. I've already started to apply places. Any other third services you'd recommend?



Perhaps Lee County EMS in Fl. 

King Co. WA Medic One seems like a long shot, although if I wanted to commit to single role EMS for life, that would be the place I'd want to work.

When I worked for Charleston County EMs in SC, the pay wasn't too bad, although from what I've read their retirement is still 28 years, and they're apparently getting rid of the TERI, which is where you retire but still work, and get your retirement checks in deferred comp. We call it the "DROP" up here. The working conditions weren't desireable for me, but it may be acceptable for you, and things may have changed for the better in the 4+ years since I've left there. Some forum posters have more up-to-date knowledge, and I remember seeing a Charleston thread here not too long ago. I'd like to retire in Charleston some day - it's really nice down there.

Otherwise, I feel that the Carolinas and the surrounding states pay very pootly for EMS. $30k-$35k starting for a medic on a 56 hour/week schedule is typical. That's like $11/hr! Sure, the cost of living may be low, but it's still $11/hr, and your retirement will be based on your top pay, which may be as low as $50k or $60k. I don't know about you, but 50% of $60,000 isn't much to retire on al all :angry:

Texas might be your best bet. Several forum members work there, and they all seem pretty positive about where they work, so ask around.

Another option might be Alexandria (VA) Fire and EMS  - single role medic. They pay decent, fire treats them very well, and their schedule is 24/48/24/96, so you can live far away and still work there. They have people driving up from as far as VB and NC. You could work PT for Sussex Co. DE if they hire PT as well, and be quite well off financially.


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## TransportJockey (Nov 5, 2012)

46Young said:


> Perhaps Lee County EMS in Fl.
> 
> King Co. WA Medic One seems like a long shot, although if I wanted to commit to single role EMS for life, that would be the place I'd want to work.
> 
> ...



Thanks man. My parents are actually from the Alexandria area and they love it there. I was looking at Sussex too. I'll look into Alexandria now. How is va reciprocity? And you said single role, but do you go through the academy too and get mandated to get fire training too?


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## 46Young (Nov 5, 2012)

TransportJockey said:


> Thanks man. My parents are actually from the Alexandria area and they love it there. I was looking at Sussex too. I'll look into Alexandria now. How is va reciprocity? And you said single role, but do you go through the academy too and get mandated to get fire training too?



Reciprocity is a piece-of-cake as long as you have NR-P. Just some PPW and you're all set.

IIRC, Alex requires the CPAT, and they have a year to require you to cross-train, then you'll be left alone, but that hasn't happened, and likely will not. Either visit a fire station (they're busy, so maybe no luck), or just hang out near the Alex. Hosp. ED and you'll run into one of their units fairly quickly. I'll try to find out more if I do some OT out that way.


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## TransportJockey (Nov 5, 2012)

46Young said:


> Reciprocity is a piece-of-cake as long as you have NR-P. Just some PPW and you're all set.
> 
> IIRC, Alex requires the CPAT, and they have a year to require you to cross-train, then you'll be left alone, but that hasn't happened, and likely will not. Either visit a fire station (they're busy, so maybe no luck), or just hang out near the Alex. Hosp. ED and you'll run into one of their units fairly quickly. I'll try to find out more if I do some OT out that way.



Thanks man. I'll look up more when I finally get done running calls today. Sounds like a pretty chill place and I might go visit there and see


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## 46Young (Nov 5, 2012)

TransportJockey said:


> Thanks man. I'll look up more when I finally get done running calls today. Sounds like a pretty chill place and I might go visit there and see



Cool.

Alex City and Arlington can be expensive, so I would look farther out to live if you get a job offer.

http://alexandriava.gov/fire/info/default.aspx?id=62512

Get in the process right now, just in case, as their process closes on Nov 30th.


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## Milla3P (Nov 5, 2012)

There's only one thing that burns me out. Pedi Fatalities. I want to go home. I want to drink. I want to put on a suit and tie and pretend I never saw anything.


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## Handsome Robb (Nov 6, 2012)

Milla3P said:


> There's only one thing that burns me out. Pedi Fatalities. I want to go home. I want to drink. I want to put on a suit and tie and pretend I never saw anything.



Agreed. I had two pediatric fatalities within a couple of weeks of each other and it almost made me quit my job and drop out of medic school.


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## the_negro_puppy (Nov 6, 2012)

in 3 years i've never had a Pedi arrest or fatality.

I will be happy if I can go my whole career without


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## NYMedic828 (Nov 6, 2012)

the_negro_puppy said:


> in 3 years i've never had a Pedi arrest or fatality.
> 
> I will be happy if I can go my whole career without



Same here. 6 years.


Had a 9 year old stabbed multiple times by her mother. (deep wounds) That was my worst peds job but it didn't bother me. Nothing really phases me...yet...


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## lightsandsirens5 (Nov 6, 2012)

the_negro_puppy said:


> in 3 years i've never had a Pedi arrest or fatality.
> 
> I will be happy if I can go my whole career without



Not so lucky here. But then again I've been at this for almost 6 years. 

I'll be happy if I never get another one, but honestly, the ones I have been on never really bugged me at all past the end of shift.


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## mycrofft (Nov 6, 2012)

46Young said:


> Most of us started out with the intention of EMS being our lifelong profession, our "calling" if you will. I remember that when I started in EMS, working per diem at a private IFT company, all that I wanted was to do NYC 911 EMS. Nothing else mattered. After a while, I wanted to be a 911 medic. Then, benefits and retirement became more important, and through research of numerous systems throughout the country, I've found that retirement in single role EMS is not that great.
> 
> Meanwhile, the frivolous calls, the late jobs, the nights and weekends, no meal breaks, realizing that I was one pt care error from losing my job no matter how sterling my record, sitting on a street corner in an ambulance, seeing that there are practically no promotional opportunities, this all started to wear on me, just like it does for many other EMS professionals. Some stay for the long term, many do not. Many gradually marginalize the profession as just a transitional job and look for something better.
> 
> ...



I posted a comment to the effect of most of your points above in 2009, and was met with resounding cries denying it. Now, not so much.:mellow:


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## 46Young (Nov 6, 2012)

mycrofft said:


> I posted a comment to the effect of most of your points above in 2009, and was met with resounding cries denying it. Now, not so much.:mellow:



Funny how time and perspective changes things.


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## ExpatMedic0 (Nov 6, 2012)

One year I found a baby in trash can. Luckily the baby was fine, just had to cut the cord from the placenta and APGAR that bad boy ect.ect. 

That same year I had several pedi arrests, but most where DOA from trauma. I surely do not enjoy them but they do not effect me anymore than adult emotionally. Maybe it will change one day if I have kids. 

However, on the way to the call I can feel my heart beating faster than normal, thinking about pediatric doses for medications and how to deal with bystanders/parents.


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## SDog (Nov 8, 2012)

Veneficus said:


> I think there is a lot of truth to this and I mostly agree.
> 
> However, nobody is going to pay for community paramedicine until providers can actually do it. That is going to mean an increase in education. (not to be confused with a mandatory degree)
> 
> ...



Forgive me cause I haven't read all post. But I agree with you. Give it 5 to 7 years and its gonna be basic paramedic advanced paramedic community paramedic  and they all will be degrees. This certificate stuff will be gone and ems is gonna become a "profession". Question is community paramedic even accredited yet? I know people right now getting there masters but it is to my understanding that they don't know when or if it will be accredited.


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## ExpatMedic0 (Nov 8, 2012)

just FYI:
http://www.jems.com/article/administration-and-leadership/collaboration-will-be-key-community-para

http://www.emsworld.com/article/10318789/minnesota-gets-its-community-paramedics

http://communityparamedic.org/Home.aspx


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## Handsome Robb (Nov 8, 2012)

Getting pulled out of the garage 1 minute before your shift ends when all your stuff is checked back in including narcotics. That one grinds my gears.


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## ExpatMedic0 (Nov 8, 2012)

NVRob said:


> Getting pulled out of the garage 1 minute before your shift ends when all your stuff is checked back in including narcotics. That one grinds my gears.



+1  :excl::excl::excl::excl:


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