# What drives you?



## NomadicMedic (May 20, 2020)

I had a long conversation yesterday with an EMT that works for my service. He’s a really good guy. Mature, with a lot of life experience. He’s been dissatisfied with the job for the past month or so, and has been pretty vocal about the fact that he wants to quit or move on.

We sat down yesterday and started to hash it out. I asked him to think about what made him happy. What was the real reason that he did what he did. He immediately answered, “the money“.

After we talked for a while, he realized that it wasn’t the money. It turns out that he’s a high touch kind of guy. Needs appreciation and reassurance. He needs to know that what he is doing is valid and important. He also needs to feel as though he is contributing. Wants to be involved in projects.

The biggest issue was, he didn’t know how to explain any of that. All he had was an overall feeling of disenchantment. He knew that what he was doing wasn’t making him happy and he didn’t know how to fix it. He focused on the money, because that seemed to be the easiest thing to change. We talked about what would happen if he went to work for another service. Yes, he might make a little bit more money, but at the end of the day, when the new car smell wore off… He would still be disenfranchised with the overall business of the business.

He asked me what it was that motivated me. And I answered without hesitation. The real motivation for me is to see new employees and students performing at an exceptional level. When I see people that I trained working as EMTs, it makes my whole experience worthwhile. My second driving force is systems. I’m an organized, operational minded guy. I like specific framework-based operational systems. And that’s something that I am lucky that I can contribute to my current place of employment. Helping to develop standard policies procedures and guidelines is something that I’m interested in, and when it makes work safer or faster, I feel validated.

After that conversation, which ended really well, I thought about it a lot.

I thought about ways to find opportunity for the people on my team to feel valued, worthwhile, and appreciated. I’m planning to work on that moving forward. it’s not an overnight fix, but it’s certainly something worthwhile and needs to be at the top of my priority list. As my role in the organization changes, I believe it’ll be one of the largest items of focus as a pertains to retention. 

And now I’m curious. What drives you? Think deeper than the stock answer, “to help people”. The real reason is usually much deeper than that. If you just wanted to help people, you could be a dog walker, deliver meals on wheels, or be a patient care Tech in a nursing home. There’s a lot more to the reason why we do this job. And I would really like to know your reasons.

This may help me to find new ways to engage and retain our strong workers who deserve to feel validated and appreciated at the end of the day.


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## mgr22 (May 20, 2020)

This is kind of an offshoot of helping people, but I want to feel whatever I'm doing is contributing something to someone besides the stockholders or the boss. EMS usually scratches that itch for me. Also, I enjoy the challenge of assessing ambiguous presentations. I'd take a medical case over trauma any day. And I want to be tested with as much responsibility as I can handle. Finally, I like seeing how science works in the real world.


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## CCCSD (May 20, 2020)

Looking cool wearing shades on calls with my stethoscope around my neck, unzipped boots and untucked shirt,  wearing tactical pants, with at least three TQs on my belt.  That’s what drives me.


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## CANMAN (May 20, 2020)

NomadicMedic said:


> I had a long conversation yesterday with an EMT that works for my service. He’s a really good guy. Mature, with a lot of life experience. He’s been dissatisfied with the job for the past month or so, and has been pretty vocal about the fact that he wants to quit or move on.
> 
> We sat down yesterday and started to hash it out. I asked him to think about what made him happy. What was the real reason that he did what he did. He immediately answered, “the money“.
> 
> ...



The fact you even spent time with him and had this level of a talk most likely meant alot to him. You sound like a great supervisor. Kudos.


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## DrParasite (May 20, 2020)

What motivates me to come into work every day?  money.  if you take that away, my desire to come into work evaporates.

Now, I enjoy my job.  I appreciate my supervisors and my management.  but if they stopped paying me, would I keep doing it?  no.  if they cut my salary, would I look for a new job?  yes.  if they gave me more money, would I be happier?  yes.  But that doesn't mean the solution to an unhappy person is to simply throw more money at them.

now, if you want to talk about intrinsic and extrinsic motivational factors, we can do that too.  Would I be happier at my job if there were changes?  if I could do more?  if there was less red tape, less old school thinking, and more clearly defined processes?  if there was more chances for promotion, and an end to the good ol' boy promotion system, where people who are there longest get promoted, regardless of if they are able to do the job?   absolutely.  

But at the end of the day, what causes me to keep showing up to work every day?  having that direct deposit making it to my bank account every 2 weeks.  Take that away, and all the other things are irrelevant.


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## NomadicMedic (May 20, 2020)

DrParasite said:


> What motivates me to come into work every day?  money.  if you take that away, my desire to come into work evaporates.
> 
> Now, I enjoy my job.  I appreciate my supervisors and my management.  but if they stopped paying me, would I keep doing it?  no.  if they cut my salary, would I look for a new job?  yes.  if they gave me more money, would I be happier?  yes.  But that doesn't mean the solution to an unhappy person is to simply throw more money at them.
> 
> ...



Money is always the superficial answer. I know your background, and I know you’re probably well compensated for what you do. But for an EMT, who’s making crummy money, and could make more working at the supermarket deli, there’s usually more to it. For most people, there’s a motivator that goes beyond money and keeps them coming back. And I’m not talking about the what if’s. We all wish for less red tape and favoritism and all the rest of the unpleasantness... I’m talking about being honest, doing a little soul searching, and discovering what element of what you do is the one that provides satisfaction?

For some, it’s the technical skills. For others, it’s the connection with patients. For others its seeing a project completed and functioning. Everyone has a reason for doing, and if you practice a little self awareness, you might be surprised when you discover your elemental driver.


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## NomadicMedic (May 20, 2020)

CANMAN said:


> The fact you even spent time with him and had this level of a talk most likely meant alot to him. You sound like a great supervisor. Kudos.



I honestly don’t want to lose this guy. He’s a staff motivator and a natural leader. People gravitate to him, and what he says carries influence. People like that are important to help shape culture, if they stay engaged. If you lose these folks, or they become disengaged, it can change the texture of the operation.


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## NomadicMedic (May 20, 2020)

CCCSD said:


> Looking cool wearing shades on calls with my stethoscope around my neck, unzipped boots and untucked shirt,  wearing tactical pants, with at least three TQs on my belt.  That’s what drives me.



fashionista. Got it.
savage. 
classy, bougie, ratchet.


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## DrParasite (May 21, 2020)

NomadicMedic said:


> I know your background, and I know you’re probably well compensated for what you do. But for an EMT, who’s making crummy money, and could make more working at the supermarket deli, there’s usually more to it.


cool, so you know that before I got this job, I spent 10 years working full time in EMS right?  I was on a truck, answering 911 calls, doing the occasional IFT, and spending time in the comm center.   I've done the 60 hr weeks, tons of OT, working at multiple jobs, going from one 12 hour shift to the next 12-hour shift at my other job.  It gets old, which is why many of our best and brightest move on to bigger and better positions in public safety, or healthcare, or change careers.  and I will also say I enjoyed not having a boss who micromanaged me, being able to sit in a truck in a park on a gorgeous day and not be bothered, and having the ability to say that I had a positive impact on the lives of some of my patients.  Please don't think that because I did decide to get out of EMS as my full time profession, that I have forgotten what it's like to run 911 calls in the projects, get paid poorly for little recognition, and had to work in ****ty conditions for piss poor management.


NomadicMedic said:


> For most people, there’s a motivator that goes beyond money and keeps them coming back. And I’m not talking about the what if’s. We all wish for less red tape and favoritism and all the rest of the unpleasantness... I’m talking about being honest, doing a little soul searching, and discovering what element of what you do is the one that provides satisfaction?
> 
> For some, it’s the technical skills. For others, it’s the connection with patients. For others its seeing a project completed and functioning. Everyone has a reason for doing, and if you practice a little self awareness, you might be surprised when you discover your elemental driver.


Ahh, so you are talking about the motivators.  A better question might be "what keeps you in EMS?" or "what is preventing you from quitting this job tomorrow going to work for another EMS agency?

As for me, I'm very self-aware.  What keeps me at my job is money.  this financial incentive allows me to pursue my other passions, keep a roof over my head, and feed my family.  Do I love the independence, the ability to have an impact on the entire organization, and the fact that the CEO knows both my name and my son's name, in a company of 6000 people?   absolutely.  But EMS, historically, has allowed managers (or the bean counters that allocate funds to EMS agencies) to make excuses as to why they can't pay people more, and, unfortunately, they use those other motivating factors as justification why they don't or shouldn't need to raise salaries.  


NomadicMedic said:


> After we talked for a while, he realized that it wasn’t the money. It turns out that he’s a high touch kind of guy. Needs appreciation and reassurance. He needs to know that what he is doing is valid and important. He also needs to feel as though he is contributing. Wants to be involved in projects.


Who wants to work for an EMS agency that doesn't appreciate them, forces them to do tasks that are not important (busy work), not permit them to contribute to the organization as a whole, and be solely relegated to the ambulance, where that's all they will ever get to do?

What you describe is employee retention 101.  Treat people appropriately.  let them contribute to the organization, and do stuff besides be on the ambulance.  Most top talent want this; and by top talent, I mean those employees who could apply to 5 of your competitors tomorrow, and get better offers.  Give them a reason to stay with your agency.  Those examples you gave are a start.  If more EMS agencies did that, our turnover problems would be much lower.

but we also need to pay people a living wage, so they don't have to leave to make more money at the supermarket deli because they want to get married and start a family, and the hours and salary at the deli are more conducive to family life than 60 hour weeks on the ambulance.


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## Aprz (May 21, 2020)

Some good points on pay.

I will say there are a couple of motivators for me.

I used to work with my best friend. You would've never guessed that our relationship would go downhill. When I felt like she stopped talking to me at work, we got into more fights, I stopped enjoying my job for awhile even though I was paid a lot for a paramedic. She left my unit which helped and I also frequently worked on a quick response vehicle by myself that I love to work on. A lot of people don't like to work by themselves, but I love it.

I feel like my co-worker treat me like I'm a good paramedic. In one of my favorite TV shows, a criminal said they did something because they were good at it. For a California paramedic, I feel like I am pretty good.

I do want more out of this job. Being a California paramedic, I pretty much can only assess, IV, and maybe intubate if you are unconscious/dead enough. I've only paced/cardioverted a handful of times. Other than Morphine and Ondansetron, I don't give most meds. Part of why I am looking at flight, a major paycut for me (nearly 50%) is not just working on a helicopter or plane, but because I want to do more for my patients. It is the same reason why I upgraded from EMT to paramedic; I was tired of just being a driver on an ALS unit. EMT and paramedic pay difference wasn't a lot when I became a paramedic. The paycut is huge for me and I am afraid of leaving my stable job, good seniority, something I know I can do for a job that I am afraid I might not like or be good at. What if my co-workers are mean to me. I cannot stand working with mean people. What if I am a terrible flight medic? What if I am just giving people rides on a helicopter without doing much medicine? Then I will have left my great paying job for essentially nothing or worse.


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## mgr22 (May 21, 2020)

Aprz, I think the most significant statement you made is that you love to work by yourself. Why swap that for something else?

I spent most of my adult life searching for things I loved doing. When I found them, I stayed with them. That made me happy. As long as I could pay the bills, the money was secondary. There was no amount that made me love jobs I didn't.


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## NomadicMedic (May 21, 2020)

One of my absolute favorite things is working as a solo medic on a fly car. It’s mentally stimulating, can be a challenge... always a good day for me.


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## mgr22 (May 21, 2020)

NomadicMedic said:


> One of my absolute favorite things is working as a solo medic on a fly car. It’s mentally stimulating, can be a challenge... always a good day for me.



Same here. I miss it terribly.


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## Aprz (May 21, 2020)

mgr22 said:


> Aprz, I think the most significant statement you made is that you love to work by yourself. Why swap that for something else?
> 
> I spent most of my adult life searching for things I loved doing. When I found them, I stayed with them. That made me happy. As long as I could pay the bills, the money was secondary. There was no amount that made me love jobs I didn't.


The quick response vehicle shift I work is only an overtime/part time shift. It's not something we can bid onto to work full time. It's a newer thing out here and only a few of us are allowed to work it. I work it on top of my normal ambulance shift. I hope they make it a full time shift we can bid on, but I don't know if my seniority will be enough since there are only one of those shifts right now (only 4 people would be able to bid, night or day, front or back half).

I really enjoy working shifts with people I really like. There are a couple of people that I'll always pickup shifts with when their shifts are open. My old EMT partner used to be like that, but now I've lost that feeling with her. I'm afraid to work with her again. Like I am not afraid that we will do something wrong for a patient in the middle of the shift, but I feel like it'll hurt our friendship more. We used to be really tight and not so much anymore. I was afraid that we wouldn't recover our friendship last bid. I don't think our friendship will ever be the same.


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## VentMonkey (May 21, 2020)

NomadicMedic said:


> I honestly don’t want to lose this guy. He’s a staff motivator and a natural leader. People gravitate to him, and what he says carries influence.


Without coming across as arrogant, I’d like to say, I feel, I possess these qualities.

Having been up, down, and all around about every paramedic position that this company offers, I’d say my service has given back to me what I’ve put forth in self-motivation.

Some days it sucked (sometimes it still does, but eh, I’m a firm believer in “if it didn’t suck occasionally, it’s not a job”; not a big “unicorn” guy), but it’s indirectly paid off.

I think I have found out my drive is certainly more clinically-based. I figured out quickly that I had no desire to ever be a manager at any level after having been a frontline supe for a bit more than half of a decade.

I’ve learned that I can only train so much before I’m at my wits end with the out of ratio interns who want to actually learn vs. those that talk more than they’ll ever walk it.

I’ve learned that, superficial or not, money certainly is form some motivation.

I like not having to break my back doing OT on an ambulance unless I want to, and still being able to afford a comfortable living.

In summary, my drive has always been inherent. I went through several phases of my paramedic career before I saw it come to fruition. Now? I mostly sit back and reap the rewards. 

I’m satisfied with work, that’s about all I can ask for. Nothing will ever drive me more than the desire to keep my family happy. That took me a bit to figure out. Work will always be a secondary driving factor for me.


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## mgr22 (May 21, 2020)

Aprz said:


> The quick response vehicle shift I work is only an overtime/part time shift. It's not something we can bid onto to work full time. It's a newer thing out here and only a few of us are allowed to work it. I work it on top of my normal ambulance shift. I hope they make it a full time shift we can bid on, but I don't know if my seniority will be enough since there are only one of those shifts right now (only 4 people would be able to bid, night or day, front or back half).



Perhaps you can find similar work somewhere else.


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## RocketMedic (May 23, 2020)

Money and teaching people how to do things the right way, safely, the first time. Really don’t like supervision as much as I thought I would, and the more time I spend in EMS, the less I want to play the games required to be a manager in most contexts.
As for the original poster’s comments- welcome to HR 101. People like to be appreciated and to matter.


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## NomadicMedic (May 23, 2020)

RenegadeRiker said:


> Money and teaching people how to do things the right way, safely, the first time. Really don’t like supervision as much as I thought I would, and the more time I spend in EMS, the less I want to play the games required to be a manager in most contexts.
> As for the original poster’s comments- welcome to HR 101. People like to be appreciated and to matter.



Interestingly enough, I shared some of the comments with the rest of the supes and they said, in short, "that's BS, we appreciate then all". 

We've got to send these people to some leadership training.


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## RocketMedic (May 23, 2020)

NomadicMedic said:


> Interestingly enough, I shared some of the comments with the rest of the supes and they said, in short, "that's BS, we appreciate then all".
> 
> We've got to send these people to some leadership training.



Sounds like you’ve got some pretty mediocre supes.


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## NomadicMedic (May 23, 2020)

RenegadeRiker said:


> Sounds like you’ve got some pretty mediocre supes.



That's an understatement


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## ffemt8978 (May 23, 2020)

RenegadeRiker said:


> Sounds like you’ve got some pretty mediocre supes.


Let's not forget most people are promoted to the level of their incompetence after which they stop getting promoted.


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## DesertMedic66 (May 24, 2020)

What drives me? Typically an EMT or a pilot /s

For teaching I love seeing a students face when they finally grasp and understand a topic that they were struggling with. 

For EMS as a whole I enjoy they challenge and the puzzle that patients are. I do enjoy helping people but I would be lying if I said that was my main motivator. I think that is what drew me to the critical care/flight side of the house. I will gladly take a complex medical patient over a trauma patient any day of the week. Sure the skills I can do for a trauma patient are cool but not extraordinary complex.


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## E tank (May 24, 2020)

What drives me is validation, in the context of whatever role I happen to be in. I wear a lot of hats and I'm no different than the CNA in a SNF or the BC with the big city FD. The trick is to not let the validation become a "religion" of sorts. To keep it in perspective, like an employment benefit like vision and dental...once validation becomes the prime motivation, I've gone down a path of no return....the prime motivation has to be conscientious attention to detail and work ethic...the validation has to be a function of those things and can't be considered a guarantee because validation comes from other people that are...seeking validation...


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## CCCSD (May 24, 2020)

I always get a valet to park my rig, so can be validated.


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## E tank (May 24, 2020)

CCCSD said:


> I always get a valet to park my rig, so can be validated.


Ha!...keep talkin' dude...you know I'm right....


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## DrParasite (May 24, 2020)

NomadicMedic said:


> We've got to send these people to some leadership training.


Don't forget to send senior managers to the same training, and hold the supervisors accountable when they don't act in a way that their leadership training told then was how good leaders act.


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## Tigger (May 25, 2020)

I keep circling back to this thread, this is not as easy an answer as I thought.

I really enjoy taking the total jumble that is most every call when you walk through the door and making some order out of it. I take the most pride in being exceptionally efficient and making sure that by the time we get to the hospital that the patient is really set for whatever the next step is. If the hospital is not the right choice, I perversely enjoy the challenge of helping the patient navigate the healthcare system and find the care right for them. 

I don't have a sciences background, in fact I think that's one of the weaker points of my academic career. I have a political science degree and enjoyed studying government systems, as in how and why services are provided the way they are. I think I enjoy taking that angle out to the truck and thinking about why we do things the way we do. If we do things in a slow, convoluted, or unsafe way, I want to come up something better. This is occasionally seen as neurotic by some of the more tenured folks but fortunately it's usually just me as the paramedic at my station and my crew is generally on the same page with finding the best way that _we_ can do things. 

I really believe in "looking good" when you're out doing this job. If you have time to make everything look good while engaging with your patient, to me that means you have thought deeply about the care you provide and are totally dialed in. No time or motion is wasted. To me there is no bigger compliment after a challenging call when someone is like "where's the mess?" If you've been introspective about what you will use in your care, you won't make a mess. I am far from perfect when it comes to all of this, but it drives me to be better. I think I've hit a bit of a clinical ceiling working the suburbs with pretty good but not expansive protocols, so this along with constantly fine tuning my assessment skills are what drive me to be better. I'm not doing hot-poop critical care work, most of what I do is run elderly sick patients, falls, and TAs on the interstate.

On a bigger level, I think EMS suffers from having a lot of people who are satisfied with "good enough." I think I have the unique ability to be pretty good in the back of the ambulance but also see the bigger pictures in EMS. I support evidence based guidelines and work to be involved in that. But I don't get mad when things "get taken away" so long as there is some data to support it. I see problems at a system and not individual level and believe in promoting just and safe cultures. I am a younger person which limits my credibility towards admin staff at times but helps in that many of our fledgling paramedics and EMTs look at me as their mentor as I can be relatable to them unlike the 20+ year folks, who of course have tons to offer as well. I take this "responsibility" and have worked hard to become a decent educator through the community college system and one of the hospitals. 

I love being a paramedic very much. I am fortunately not as addicted to it as I was when I first got the gold patch and let it overcome my life, but I'd be lying if I said it wasn't a true passion.


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## DragonClaw (May 26, 2020)

Still under the umbrella of helping people, but deeper than that. I want to be involved in something that could determine how someone fares later in life. Not that I'm looking for a power trip, but I want to do something that matters, especially if you can see the result of your hard work. 

I haven't had the opportunity to work many codes or call a stroke alert or anything, but I know there's a big good feeling when you hear back about a pt and they're doing great. And you were a part of that. It's a gift you were able to give.

I want to answer the call, especially as many don't. Just call me and I'll be there. 

I want to have a good camaraderie with like minded folks. People you entrust your life to. Even if it's not anything high stakes, but even driving around town or on a LD.

I do want something more than a desk job.

I want to be dependable, knowledgeable, teachable and a teacher on an every day basis. I don't have a lot of experience, but I share what I know.  I want to be first pick on the team, someone you want in your corner when things get bad.  Someone you know will keep the course and a cool head if things get bad.

The other day, our truck's electricity went out. No brakes (not sure why), no power steering. I was able to clear my lanes as I got over into a parking lot with little inerta to spare . As a reaction I hit the primaries and siren (at this point I didn't know what was going on. It made a sad woop woop and died). I shifted to park and waited a bit.

It was on a city street, parter was riding shotgun, so no pt.

I was concerned as things started to unfold that we had vehicle issues and then realized we had basically no power, but didn't freak out. Without power steering I really had to work the wheel but it was manageable.

Even small "emergencies" are things to learn from.

If we'd been going faster in heavy traffic it would have been worse.

I also love medicine. It's fascinating. 

Point is. I just want something that fulfills me.  The element of importance in what I do, urgency, medical and I'll admit, the possible danger is...

I don't know how to describe it.  As I'm very cautious and analytical (leg incident was an outlier), but it draws me. The same way a police or military career would.  Not that I'm looking for trouble, but it's like.... having the chance to be able to do this, to carry the risk, is an.. honor? Not everyone wants any sort of responsibility over anyone else and not that I'm having to have a God complex. I don't know how to describe it.  I'm just glad to be able to offer myself in the place of everyone who says "I just don't know how I could do that job", "I can't deal with what you do", or "I could never..." so they don't ever think they have to. 

I don't know how to explain what I'm trying to say really.

For those who know, I guess you know. And for those who don't, no amount of explanation will suffice.

Edit. 

I know everything isn't an emergency and it's sometimes hard for me to explain everything I think, feel or know.  And then there's all the things I don't.  

On things where it's life threatening (most things for me at this point.  A vast majority), its all the little things. 

A patient thanks us for the nice smooth ride.  Because last time they went by ambulance it was super bumpy and high speed, white knuckle terrifying. 

It's the nice conversations you can have and learn about a patient. 

It's the patient who was in the hospital for 9 months SP MVC finally going to a rehab. 

For hospice pts its trying to make them comfortable.  If family is there, letting them know they're going to get great care from compassionate providers. 

When you are able to talk to a nurse or someone else and learn something.  Maybe it's about wounds or their protocols, medical or hospital terminology etc.

My patients are mostly low acuity, but I'm grateful for this job as it's been a stepping stone I'm going to use to the fullest. How to talk to patients and family, work with others in a team environment, lifting and body mechanics, driving larger vehicles, building rapport with hospital staff, doctors, nurses, FFs, other EMS services. 

I want to be the best provider, partner, employee, friend, I can.

I don't settle for being less than I can be.  That's one thing that bothers me about others in life.  They let that flame of passion dwindle or die out. They'll get the job done, sure.  But they're not going to go the extra mile.  They won't be happy in anything.  Everything is an inconvenience.  

It's kinda sad to see the burnout. Most of these people used to be incredibly motivated. They used to care.

I know I'm smart enough to do more and I feel it's my duty to help others.  So if I don't it's kind of... rude? A waste? 

Aside from my upset and edgy posts, I've been given a lot  In life. I've been lucky even with everything that's gone on.  Crappy parenting made me never want to be like that.  It made me want to do things right the first time.  Bad times show you and others what you're made of.  

I just have a lot to give now and in the future.  
A lot of times I just want that chance to do that.


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## akflightmedic (May 26, 2020)

Excellence. Pride. Validation. Money.

I strive for excellence. Do not confuse this with perfection, as that does not exist. However, excellence in all that I do is attainable. My excellence may be subpar to someone else's, but if it truly is my excellence at that time, in that moment, then I have done it. When I learn later that it was not actually my best excellence, due to lack of knowledge, training, or experience, then I improve myself in order to improve my excellence.

The above requires some humility, integrity, and desire for positive change without a negative undertone. Performing at my best, so that others may learn from it definitely drives me. Not only in a patient care setting, but business and darn near everything else in my life.

Pride. I have to take pride in what I do, I have to know why I do it and how I do it and then take pride in execution of that. I do take pride in a routine granny call and being able to make her smile. I would be a fool to admit there is not also a sense of ego doused in there...such as in my stubborn head I say, I am gonna get this grumpy looking, grumpy acting old person to smile...or I will say something similar about a critical patient or a difficult extraction. No matter the case, I take pride in challenging myself from something quite simple and mundane to something overwhelming and seemingly impossible. I take pride in those things and the satisfaction is usually in my head only.

Validation. I want to know I am doing something beneficial. I want to know it is meaningful, to others, not just myself. I want to leave a mark on people, places and things in a good way. Again, there is that underlying need for serving the ego, but its true. I have always had the desire to help and do good things while others appreciate and benefit from my hard work and efforts. This particular part of the drive has also burned me many times over, especially in recent years, however I do not stop seeking it and I do not stop allowing it to drive me.

Money. Despite all my feel good liberal tendencies, I do value myself more and more these days. Money drives me in the sense it allows me to do things I want to do, not things I need to do. At the peak of my prior company, I had millions of dollars. Having that cash allowed me to go work "undercover" if you will at some very low paying jobs simply because I wanted to do it, to have the experience. I definitely answered the question of what I would do if money was not a concern. I did not stop working that's for sure. LOL. Then a couple lawsuits and a very protracted, nasty divorce, my "endless" well started to dry up, so I sold the company and extracted myself. Because of the pride in my work and my people, I suffered tremendously emotionally and physically. Because of my seeking validation, I was burned at the stake mercilessly by others who had less and had their own intrinsic driving factors (two in particular were driven purely by cash).

Despite what transpired, I return to the original list above and acknowledge they are my driving factors. Because of those driving factors, I returned to school and completed my R.N. I have started a new company. I have returned to both the streets and the facility, basically have started over from the bottom and am again rising up, due to those driving factors. I have my lessons learned and will apply them (Excellence). I am happy with my resolve (Pride). People know what I did in the past and they already know I will do it again (Validation).

Great topic, took a while for me to reply because I wanted some time to give it serious thought and not be some off the cuff cheesy remark. I try to personally reflect and speak with honesty and transparently without sounding like a douche.


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## johnrsemt (May 27, 2020)

NomadicMedic:  I wish even 1/4 of supervisors and managers had your attitude about things.  Turnover wouldn't be as high as it is in EMS.  If people were treated better people wouldn't always be looking for something better.

Keep up the good work


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## FlorianFred (Sep 19, 2020)

I feel funny answering this, I am but a lowly MFR as a Volunteer Firefighter.   I generally tell people that quote from a Charles Bukowski book, "I don't hate people, I just feel better when they aren't around".  I'm 55 years old, I've made a very nice living as a programmer, a data scientist (building mathematical models that predict human behavior), a management consultant, and the head of a small but reasonably successful marketing firm.  Then I moved away from the big city and the east coast to a small rural area of the south.  My wife grew up here, but I don't know anyone, and I figured I'd volunteer for the fire department to try and "plug in" to the local community. 

I tend to gravitate to things that people don't like or want to do.  If it's competitive, then I'm out....but I'm happy to take out the trash or do whatever needs to get done.  Now fighting fires is exciting, but it's competitive.  A call goes out for a structure fire, and we can get well over a dozen volunteers to go screaming to the scene, wherein they'll throw on an SCBA, grab a halligan and/or potentially fight each other to be lead on the hose.  But a medical call goes out for a 90 year old woman who has fallen, or 70 year old guy with chest pains, or a 30 year old contemplating suicide, and in some of our districts, we can't get a single person to go.  They'll say the Ambulance service will get it, but we have two ambulances for 450 square miles of county, and most of the time a VF could get there first.  So I started gravitating to the medical side.  I found an Assistant Chief who truly epitomizes compassion for the community he serves, and I've begun following him around and learning how to be a decent MFR.  He got me into the EMR/MFR training, and then has made sure he or one of his lieutenants went with me on several calls.  And it's truly weird, but I like doing this....I mean I REALLY like doing this.  I've been kneeling in vomit, bitten by a PT's dog, yelled at by several patients, and almost always ignored by the EMTs and Paramedics on the ambulance service; but after every single call, I feel good....I feel satisfied.   I honestly don't know why.  I spent nearly my entire working life trying to figure out how to make someone (as well as myself) more money, and I while I've loved the money, the prestige, the office, the lifestyle....I have never felt as "satisfied" with my contribution in this world as I do when I'm helping someone.   They are scared, they are in pain, they need help....if I can remove some fear, alleviate some pain, just help even a little, well that's worth doing.

I envy those of you who feel that way about your work....I spent 35 years doing and getting a lot of things, but I never found that reward in any of my jobs.


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## luke_31 (Sep 21, 2020)

FlorianFred said:


> I feel funny answering this, I am but a lowly MFR as a Volunteer Firefighter.   I generally tell people that quote from a Charles Bukowski book, "I don't hate people, I just feel better when they aren't around".  I'm 55 years old, I've made a very nice living as a programmer, a data scientist (building mathematical models that predict human behavior), a management consultant, and the head of a small but reasonably successful marketing firm.  Then I moved away from the big city and the east coast to a small rural area of the south.  My wife grew up here, but I don't know anyone, and I figured I'd volunteer for the fire department to try and "plug in" to the local community.
> 
> I tend to gravitate to things that people don't like or want to do.  If it's competitive, then I'm out....but I'm happy to take out the trash or do whatever needs to get done.  Now fighting fires is exciting, but it's competitive.  A call goes out for a structure fire, and we can get well over a dozen volunteers to go screaming to the scene, wherein they'll throw on an SCBA, grab a halligan and/or potentially fight each other to be lead on the hose.  But a medical call goes out for a 90 year old woman who has fallen, or 70 year old guy with chest pains, or a 30 year old contemplating suicide, and in some of our districts, we can't get a single person to go.  They'll say the Ambulance service will get it, but we have two ambulances for 450 square miles of county, and most of the time a VF could get there first.  So I started gravitating to the medical side.  I found an Assistant Chief who truly epitomizes compassion for the community he serves, and I've begun following him around and learning how to be a decent MFR.  He got me into the EMR/MFR training, and then has made sure he or one of his lieutenants went with me on several calls.  And it's truly weird, but I like doing this....I mean I REALLY like doing this.  I've been kneeling in vomit, bitten by a PT's dog, yelled at by several patients, and almost always ignored by the EMTs and Paramedics on the ambulance service; but after every single call, I feel good....I feel satisfied.   I honestly don't know why.  I spent nearly my entire working life trying to figure out how to make someone (as well as myself) more money, and I while I've loved the money, the prestige, the office, the lifestyle....I have never felt as "satisfied" with my contribution in this world as I do when I'm helping someone.   They are scared, they are in pain, they need help....if I can remove some fear, alleviate some pain, just help even a little, well that's worth doing.
> 
> I envy those of you who feel that way about your work....I spent 35 years doing and getting a lot of things, but I never found that reward in any of my jobs.


Sounds like you found out that you genuinely enjoy helping others in need. It can be very rewarding to be able to provide help or comfort when someone has reached the end of their ability to handle the situation.


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## Jambow (Sep 21, 2020)

one agency that i worked for adopted the FISH philosophy
a simple thank you form management went a long way with a few employees
they also handed out small fish that you could wear on your uniform
I enjoy the autonomy that we have to work on out own, I have worked in hospitals and in other allied health roles
nothin is close to what we can do in an Ambulance
another thing is the co-workers, most that have left or retired. End up missing the comradery that comes along with working with other (normally) like minded folks.
What helped me (long ago) was accepting the fact that we are not usually EMERGENCY SERVICES
I accepted that we are there for help for who ever calls for it
I will echo an earlier post...I also got into the education aspect. Teaching con-ed and eventually full classes


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## DrParasite (Sep 22, 2020)

FlorianFred said:


> I feel funny answering this, I am but a lowly MFR as a Volunteer Firefighter.   I generally tell people that quote from a Charles Bukowski book, "I don't hate people, I just feel better when they aren't around".  I'm 55 years old, I've made a very nice living as a programmer, a data scientist (building mathematical models that predict human behavior), a management consultant, and the head of a small but reasonably successful marketing firm.  Then I moved away from the big city and the east coast to a small rural area of the south.  My wife grew up here, but I don't know anyone, and I figured I'd volunteer for the fire department to try and "plug in" to the local community.


All these things tell me a few things about you: you're ridiculously smart (I wouldn't even know where to start to understand mathematical models to predict human behavior), you're educated (I'm guessing masters level?), and do the job because you enjoy it.  While you claim to be "a lowly MFR as a Volunteer Firefighter" I think your attitude shows that you want to be there.  If I was you, I would look at taking an EMT class, so you understand why you do a lot of stuff as an MFR (I'm an advocate of raising standards for volunteers, because it allows you to assess and treat the patient better).


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## AHenriques (Sep 22, 2020)

NomadicMedic said:


> I had a long conversation yesterday with an EMT that works for my service. He’s a really good guy. Mature, with a lot of life experience. He’s been dissatisfied with the job for the past month or so, and has been pretty vocal about the fact that he wants to quit or move on.
> 
> We sat down yesterday and started to hash it out. I asked him to think about what made him happy. What was the real reason that he did what he did. He immediately answered, “the money“.
> 
> ...


So, im not technically an EMT but im the equivalent of a firefghter EMT in Portugal and i can answer your question no doubt! The thrill, the rush, and the comradery. I dont do it mainly to help others, thats a consequence... I do it beacause i love to do it! The trauma, the mess, that heart condition that keeps you on your toes all the way... yeah

I do it because i like it, and i would not trade it for anything!


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## StCEMT (Sep 23, 2020)

Like most, it isn't just one thing for me. I enjoy the challenge and variety. I enjoy the challenge that comes with the environments, unsuspected findings, etc in patient care. Assessing, treating, packing and extricating a multi system trauma with a 20ft fall straight down using a FD ladder truck from the side of an abandoned building at midnight on 4/20 just simply makes for an interesting night. Its not unheard of for us to have GSW's occur in our immediate area. Not fun initially, but its an interesting dynamic. Sometimes I get to do things to help people. I've gotten good neuro outcomes on arrests before. I just found out I helped an addict get into rehab. Sometimes I can help people's pain with various injuries. I take pride in trying to do quality work for people, because I truly believe what we do matters. I also get a good deal of autonomy. I'm not a fan of constantly having someone to answer to. Yea, I have rules to play by, but I get to make a plan with my partner to best take care of our patient.

Thats what keeps me in EMS. That isn't what keeps me at my employer. It isnt a secret I have no love for my employer. But I stay because I dont want to be a fire fighter (almost all work here is fire based), it would be a pay cut to leave for many places, and it is the best place for me to finalize my exit plan. That being said, I dont think the frustration is really worth the money any more and am making attempts to move.

So....I will stay in EMS right now. I really love what we do and try really hard to make a difference on the calls we actually help on that is our bread and butter work. And I enjoy getting to pass on what I have learned to students and new providers. But it isn't worth staying at a place where getting my *** chewed for eating for the first time in 10 hours because we are busy is acceptable. 

After talking to a local PA, he has me interested in working with the Army as a PA. He used to be a medic and then was involved in 68W training in some fashion as a PA. I briefly took education courses in college and almost went that route, so that route has the appeal of greater autonomy as well as getting to directly influence prehospital care on and individual level.


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## FlorianFred (Sep 23, 2020)

DrParasite said:


> All these things tell me a few things about you: you're ridiculously smart (I wouldn't even know where to start to understand mathematical models to predict human behavior), you're educated (I'm guessing masters level?), and do the job because you enjoy it.  While you claim to be "a lowly MFR as a Volunteer Firefighter" I think your attitude shows that you want to be there.  If I was you, I would look at taking an EMT class, so you understand why you do a lot of stuff as an MFR (I'm an advocate of raising standards for volunteers, because it allows you to assess and treat the patient better).


Thank you for your comments, and you are correct, I do have a masters degree (M.S. in Computer Science).  I like your suggestion of taking the EMT class to deepen my knowledge in the emergency medical field.  I'm embarrassed to admit that I sort of dismissed EMT training out of hand because I thought it was really for those who were going into the profession as a paid-professional.  But to your point, no one says you have to go full-bore into it, you could also take the course just to be smarter and better as a volunteer.  Our local university offers an EMT-basic course, as does our local ambulance service, so I'm going to look into those classes.  Thanks again!


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## Emily Starton (Sep 24, 2020)

More power and success to you!


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## DrParasite (Sep 24, 2020)

FlorianFred said:


> I'm embarrassed to admit that I sort of dismissed EMT training out of hand because I thought it was really for those who were going into the profession as a paid-professional.  But to your point, no one says you have to go full-bore into it, you could also take the course just to be smarter and better as a volunteer.


Unfortunately, that type of thinking is all too common among volunteers (including many at my own department).  As well as among career staff who want to be firefighters, but 80% of their calls are EMS related.....

I've been an EMT since I was 17.  Been on the ambulance since I was 16, and the fire engine 6 months before I got on the ambulance.  I've been a paid FF, a volunteer FF, a paid ambulance EMT, and a volunteer ambulance EMT.  As a volunteer, I obtained my EMT within 1 year of being on the ambulance, and firefighter 1 within 4 months of turning 18 (FF2 came two years later, after I graduated college). Even though I haven't been on an ambulance in almost 5 years, I still maintain my EMT certification, still do the required continuing education, and when I go on EMS calls, I am usually the lead provider, because, quite honestly, I'm a better clinician than our full-time career staff who do this day in and day out.  When the person calls 911, they don't know (or really care) if the person that shows up is being paid or not, but they need the best treatment you can provide.

Even though I have a real job now, when I am able to pick up shifts at the station, few people who I treat would be able to identify that I was not a full-time career FF with my department (except for one paramedic who did call me out when I said I was just a volunteer when I first moved down to NC, due to my report to her and my assessment of a potentially sick asthmatic patient).  It didn't happen overnight, but there is nothing saying volunteers can't be as proficient as their career counterparts.

Ok, I'll get off my soapbox now... best of luck in your EMT class.


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