Attitude.

[NomadicMedic]

I just saw a crew from another ambulance service at the gas station, stopping to grab a soda. I was coming out with a cup of coffee and said, “hey how’s it going!“ They both looked at me and kind of sneered and said, “just living the dream.“ One guy said, “I can’t wait till the shift is over“

Why is it that everyone who works in EMS loves this negativity? They love to appear beaten down and exhausted beyond belief. I’ve been listening to the radio, I know that crew hadn’t gone out on anything other than a BLS sick person all day. This pervasive attitude of negativity is a huge turn off to new people and experienced folks as well. There are days when I’ve had enough, but I still smile and say hi to everybody.

You don’t have to be sunshine and rainbows every day, but at least try to be cheerful. I don’t understand this whole attitude and it makes me wonder where it came from and what we can do to fix it.

 

[EpiEMS]

One guy said, “I can’t wait till the shift is over“

Before somebody tries to blame this on compensation, that is only part of the picture. This is a major industry-wide cultural problem that can't be patched over by just increasing pay (hedonic treadmill sets in quite quickly & so does entitlement to a new wage level. We even see this in volunteer agencies (being burned out is "cool").

Narrowly speaking, with respect to EMS, I think there is a lot to be said for improving working conditions (no street posting), reducing shift length, and increasing education. An interesting dissertation that provides some discussion is here for reference: https://etd.ohiolink.edu/apexprod/r...ession=osu1531751856368551&disposition=inline
I'll have to look through the literature for more correlates of burnout. Either way, professionalizing management of EMS agencies is a start.

(All that being said, this issue is not just an EMS one, but a broader economic & cultural one beyond my scope, so I encourage us to stick to EMS where we can. )

 

[Tigger]

I left my last job in part because this attitude is so pervasive. But I could never figure it’s source, just that management often stoked it for whatever reason. A lot of the “senior” employees were just unpleasant to be around and wore their salt like some kind of honor belt. I guess new people see them as role models and the cycle perpetuates.

People can rag on fire all they want, but that negativity seems to exist in far less of a capacity. We have our own issues but I would say for the most part our people are happy to be here.

 

[EpiEMS]

I left my last job in part because this attitude is so pervasive. But I could never figure it’s source, just that management often stoked it for whatever reason. A lot of the “senior” employees were just unpleasant to be around and wore their salt like some kind of honor belt. I guess new people see them as role models and the cycle perpetuates.

People can rag on fire all they want, but that negativity seems to exist in far less of a capacity. We have our own issues but I would say for the most part our people are happy to be here.

I’ve always wanted to do a study of management in EMS and correlates of performance/outcomes. I have a prior coming into this that management coming up from the ranks without any formal management education is a correlate of suboptimal performance.

Speaking of fire, why do you think that is? Is it the public image and positive feedback? Compensation/lifestyle? Something else?

 

[E tank]

Unrealistic expectations. Sometimes delusional expectations.

Being happy in a job to a great extent is being aware of what there is that you can maximally benefit from and acknowledge that you're there more or less voluntarily. This takes some measure of humility and a lot of maturity.

If enough immature egomaniacs make up your staff, these problems will be chronic.

 

[DrParasite]

A lot of the “senior” employees were just unpleasant to be around and wore their salt like some kind of honor belt. I guess new people see them as role models and the cycle perpetuates.

EXACTLY!!!!! New guys see the senior guys acting like this, and they want to be in the cool club, so they act like that... Those that don't act that way get shunned out of the cool club.

Truth be told, I was never miserable on the truck, but I did have bad days, where if someone asked how my day was doing, I would respond "I can't wait for this shift to be over." But I refused to buy into the culture of suck, where the job sucked, so we should just complain about everything. This made me unpopular with certain people, because I did my job, and went home at the end of the shift. I also felt if you are that miserable, and that awesome, you should have no problem finding a better job where you weren't miserable.

I made a point to be happy, and avoid the culture of suck. on a nice spring day, we would go to the park, shut the truck off, and enjoy the weather. My partner and I would also get a bagel first thing in the morning because, without food, I was def cranky and miserable to be around. When we went for food, I would always ask if our dispatchers wanted anything, and on night shifts, I would make a Dunkin run for a certain long-legged blonde who worked in the ER.

Did we have bad days? sure. Did I have wet dog smell from getting caught in a downpour once or twice? yep. And do I think things could, and should, have been better, if only we had better equipment, more staffing, or better pay? absolutely. But I knew I couldn't control those things, so I did what I could to make the best of the situation, and always showed my employer and my career in the best possible light. And I also know that as bad as my employer was, it could always be worse.

 

[Carlos Danger]

Here's one recipe for creating employees with bad attitudes:

1. Start with mostly young, immature people who have little life or work experience and seem to have an ever increasing sense of entitlement
2. Attract them to a profession with implications of excitement and glamor, when it is actually anything but
3. Give them plenty of training on exciting technical skills that they will rarely if ever use, but very little training on the mundane skills that they'll need every day
4. Immerse them in a culture that idolizes the crusty, burnt-out old operator who just DGAF
5. Provide poor to mediocre compensation and invest little or nothing in their educational or professional development
6. Continue to wonder why these employees tend not to display great attitudes and stellar customer service

 

[VentMonkey]

Here's one recipe for creating employees with bad attitudes:

1. Start with mostly young, immature people who have little life or work experience and seem to have an ever increasing sense of entitlement
2. Attract them to a profession with implications of excitement and glamor, when it is actually anything but
3. Give them plenty of training on exciting technical skills that they will rarely if ever use, but very little training on the mundane skills that they'll need every day
4. Immerse them in a culture that idolizes the crusty, burnt-out old operator who just DGAF
5. Provide poor to mediocre compensation and invest little or nothing in their educational or professional development
6. Continue to wonder why these employees tend not to display great attitudes and stellar customer service

Should be sticky-note posted on every EMS manager’s office door. #EndThread

 

[johnrsemt]

I have never had that attitude; I have had bad days, bad shifts, but always tried to be happy and upbeat.
Never been grouchy or down around others like that.

 

[Fezman92]

I’ve managed to change 2 of my 3 shifts because my partner is so tired/angry/salty. He doesn’t show it around patients obviously but working with him isn’t as fun as working with my other coworkers.

 

[NomadicMedic]

I’ve managed to change 2 of my 3 shifts because my partner is so tired/angry/salty. He doesn’t show it around patients obviously but working with him isn’t as fun as working with my other coworkers.

I told my boss at my part time job that I could quit, or he needed to assign the salty arse that was on that shift somewhere else, because I found the atmosphere so toxic I didn’t want to even be in the station when he was there.

My weekend shifts are now drama free. Things don’t change unless you speak up

 

[mgr22]

I told my boss at my part time job that I could quit, or he needed to assign the salty arse that was on that shift somewhere else, because I found the atmosphere so toxic I didn’t want to even be in the station when he was there.

My weekend shifts are now drama free. Things don’t change unless you speak up

Is this the norm now? If I'd tried to tell any of my bosses how to staff shifts, I'm pretty sure I would have been invited to not show up for any of them.

 

[NomadicMedic]

Is this the norm now? If I'd tried to tell any of my bosses how to staff shifts, I'm pretty sure I would have been invited to not show up for any of them.

That was an option. I actually offered to resign, as I just work a couple of weekend shifts per month. I told my supervisor that the agency wasn't a place I enjoyed working due to the other guy on that shift, but I'd understand if it was easier to lose a part-time Paramedic over a full-time AEMT. He told me "there have been dozens of complaints about him, and I wasn't alone." Of course, because it's EMS and nobody in "leadership" has any real idea of how to manage problem employees, we just move them. He now works a late-night shift and my weekends are quiet.

But if my boss told me "too bad," I would have been more than happy to hand him my keys. Life is too short to deal with a part-time job that stresses you out. Also, paramedics are in high demand here. I could walk out and have 4 other PT gigs lined up as quickly as I could make phone calls. I only work at that agency because it's very flexible with shifts, less than 10 minutes from home, and I work as a single medic on a squad most of the time. I don't really need the beer money or the headache that comes from toxic coworkers.

 

[IsraelEMS]

Somedays its the bad calls, the CPR in PPE, the trauma that you go to too late, suicide, the domestic abuse, etc. I had a shift a couple weeks ago that was 10 hours straight of depressing calls. It ended with a guy who beat and choked his wife so bad that she almost died. While she was conscious she refused to press charges because they were foreign workers and he would lose his visa and be deported. The cops ended up arresting him anyways because he probably would finish the job if he had the chance.

But some days its just the lack of a good call that can do it. We never have days without calls like you described but I have had days with all covid or transfers or silly issues. Sometimes just feeling like you are not helping anyone can be depressing.

There is not so much cultural negativity in the EMS here but we do have burn out and people do sometimes become jaded. I wish there was a way to help people hold on to those fantastic moments that are too rare. The old lady who feels better just because you are holding her hand, the successful pediatric resuscitation, the births, the moment when we were in the trauma room and the doctor told our pregnant MVC victim that her twins were ok. When people feel like they are making a difference its hard to be so negative.

 

[mgr22]

Somedays its the bad calls, the CPR in PPE, the trauma that you go to too late, suicide, the domestic abuse, etc. I had a shift a couple weeks ago that was 10 hours straight of depressing calls. It ended with a guy who beat and choked his wife so bad that she almost died. While she was conscious she refused to press charges because they were foreign workers and he would lose his visa and be deported. The cops ended up arresting him anyways because he probably would finish the job if he had the chance.

But some days its just the lack of a good call that can do it. We never have days without calls like you described but I have had days with all covid or transfers or silly issues. Sometimes just feeling like you are not helping anyone can be depressing.

There is not so much cultural negativity in the EMS here but we do have burn out and people do sometimes become jaded. I wish there was a way to help people hold on to those fantastic moments that are too rare. The old lady who feels better just because you are holding her hand, the successful pediatric resuscitation, the births, the moment when we were in the trauma room and the doctor told our pregnant MVC victim that her twins were ok. When people feel like they are making a difference its hard to be so negative.

It takes patience and practice to achieve the kind of balance you're striving for. I think the process starts with realistic expectations -- e.g., most calls aren't exciting, many shifts aren't enjoyable, some patients can't be helped in the time you have with them. You can still make a difference by accepting those constraints and working around them.

 

[IsraelEMS]

Mgr22, I agree 100%. Too many people come in thinking either that its all lights and sirens, blood and gore or that they will save the world every day. Neither is realistic. When you learn to take the little moments as wins, it helps a lot. I guess I wish that there was a way to hand people the maturity and clarity to see that. It would make working with some people so much easier and more enjoyable.

 

[akflightmedic]

While I agree we cannot hand them the maturity and clarity, there is a way for US, the experienced, to assist the new gen EMS.

We need to become instructors. And we need to teach EMS in a positive light. Sure, guts and glory stories occur occasionally, however there should be so much more truth in representation to the student body. When the entire course focuses on nothing but trauma or severe illness, it lacks attention to basic human care, kindness, and a realistic presentation of what it is going to be like when they hit the streets.

This is also due in part to how compact the courses typically are, and of course none of what I mentioned will ever be on a test...not from the State or NR anyways. They will be tested on it every single day they work going forward, so just knowing that means we should at least be teaching it, right?

When instructors or preceptors continuously down talk the actual reality, they are in a sense influencing or creating a jaded student. Another reason why I dislike how some instructors are just cleared with no real education, or even a single class on adult learners. The entire system could use a nice overhaul, until that occurs, there are many little things we all can be doing to create microinfluences.