Our OP exemplifies the root problem of most everything that has been discussed re: EMS in crisis. It is, but not in the way he thinks. It is in crisis because HE is in crisis.
There had never been the continuity of employed crusaders in the profession to effect change for one reason; the turnover rate is sky high due to burnout. Burnout is sky-high due to the fact that NO ONE FACES IT.
Burnout is the poop in the living room that everyone is in denial about.
If there's a chance, as I see it, for EMS to grow as a profession the very first thing that must be put in place is something that allows active medics to MOVE THROUGH the emotional, psychological, moralistic, spiritual and psychic traumas they experience in their work. The people to set that up are medics themselves. Everyone else who's tried to do it has failed because they are not living within those conflicts themselves.
Nursing and other medical professionals have been able to organize because turnover doesn't begin to really accelerate until burnout takes hold, usually after ten or more years in the field; and then, because exposure is doled out in increments, it takes another five or so years before the individuals pull the plug on their careers. And yet, because there is a solid profession there they can actually extend the suffering somewhat comfortably for years more because they're paid well to do it. This is not a good thing for anyone, especially the patient, but Hey! It pays the bills!
With medics, the burnout period is massively accelerated, largely because of the steady exposure to intense and unrelenting trauma. I'm not talking about gory crashes or children dying in your arms, I'm talking de-sensitizing yourself to the human condition by "having" to transport human shells back and forth to the Nursing Home being the essence of the work along with dealing with human beings who now have degenerated into "abusers".
Most medics hit one or more of these walls and in the absence of an outlet to process, come to terms with and then move on WHOOSH!! they're gone. I don't know what the stats are for average burn out today, but if you look at them one level deeper you'll see that the first three years have the biggest proportion of turnover.
The "culture" of the medic is still in an infantile Macho stage. I'll betcha a buck most of the medics on this site showing no pity to the OP will be gone within 3 years themselves!
Those who last much longer are essentially gluttons for punishment (and damn good medics) and too drained to have the energy to organize; especially since the biggest proportion of the people who they have to organize are not ready to dedicate themselves to the field by doing such things as getting educated. This "wait and see" attitude limits growth.
It's a numbers game and we ain't got the numbers to effect change. We don't have a profession because FNG's come in, get burned out fast and there is always the need to have warm bodies in the ambulance. It's relatively easy to get new blood because there are so many wanna be FNG's who are hooked on the "idea" of Johnny and Roy and about the third time the reality really slaps them in the face; Bye Bye!
The systems depend on this turnover to be cost-effective. They're not employing professionals, they're filtering through wanna-bes, the smallest majority of whom stick to it, really become medics and then, they'd just as soon that THEY leave because, well they gotta give them a raise every year!
It's quite the vicious circle, isn't it?
