S*** rolls downhill
In the 1960s there was a realization that our healthcare system was broken. You could only get care when you got to the hospital. The days where a physican was part of or entered the community were coming to an end.
The paramedic was born. For no other reaon than to fill the hole that was left.
Shortly after I became an EMT, paramedics were being hired to work in emergency rooms. With the inability to recruit nurses for a variety of reasons, after the nursing lobby displaced ED techs, a hole was created, the paramedic was then asked to plug this hole.
From amuzement parks, to zoos, (A to Z get it?)
whenever a low cost medical provider is needed so desperate is the situation, EMTs of all levels are thrown in to plug the hole. Some specialize in their hole. call it wilderness, industrial, whatever.
With the breakup of the family unit and society in the US, the care of the elderly had been institutionalized. Another hole, somebody had to get these people from point A to B and back. Somebody who was part of the "medical system." EMS providers were again put into a failing situation.
For many years in public safety and medicine we have been witnessing the total collapse of our society. As the number and types of people that need a safety net increased, EMS (mostly in the way of public safety) and by extension the EMT (of all levels) was called upon to help by transporting to the hospital. This stop gap worked for a while, but it was simply the finger in the dyke. The "abuse" many of us witnessed in our EMS career by "patients" was really the manifestation of our failed social and medical systems.
EMS providers are thrown into the impossible situation now. The hole is so big it doesn't matter how many you throw into it, you cannot fill it. You cannot slow the leak. The problems are social and not medical. It is why even after you take the pt to the hospital, you wind up taking the same frequent flyer again and again for the same thing.
The providers get frustrated. They came to help to make a difference. They hoped to make a living at it. EMS providers get "burnt out" or frustrated because whether they realize it or not, deep down somewhere, they know they are just spinning their wheels. The record is broken and there is no satisfaction in it anymore.
I have explained the economics of service professions ad naseum, I'm not doing it again.
In order to "help" people EMS providers need more education. Whether you like it or not, get a pay raise or not, or any other lazy excuse I have heard over the years, it remains. But the education is not all medical in nature. You have to learn what social programs are available, how to get people nvolved in them, what you can do at the social level so that it doesn't become a plea for help by dialing 911. If you want to make a difference, if you want to save lives, do some good, or whatever idea brought you to EMS, you have to perform the task needed, not the task you want to, only on the people you want to or feel are deserving. Instead of jumping in the hole trying to fill it, you need to form a chain around it and stop people from falling in.
Everyday in this world, somebody has a "real" emergency. No matter what is done they may not survive, they will never be the same if they do. They are discharged alive and functional if they make it. They have chronic issues forevermore until the body can't cope. The damage done accelerates the bodies natural breakdown even if it is latent for years. Defiant as you stand before nature, before that which mankind does not understand, you will be overwhelmed. You don't have a chance. Tangible, needed, desired, help is that which precludes crisis. Stopping a minor lac from being infected is where lives are saved. Getting an old person a walker so they don't fall and smash their skull will save more peoples lives than every neurosurgeon, critical care surgeon, and Emergency physician combined.
One of the things I have learned is that we really don't know the names of most heros. They are not the ones on TV or who went above and beyond once to save a life. They go above and beyond everyday. They come early, they stay late, they do the undesirable tasks for years, they give of thier time, their money, and every measure of value you can think. They save more lives and make a bigger difference than we will ever know.
This semester I had the opportunity to meet a physician who specializes in microbiology.(not somethig I want to specialize in) Her team (which spans 4 countries) is working on vaccines for bacterial STDs. During her presentation, she talked of life and death in numbers that look like they came from wall street.
She had pictures of camps in Bangledesh where some of the brightest physicians in the world built toilets without running water and emptied and cleaned them by hand. So little was the money they could not hire nurses. They could not find volunteers. They built them so people could come for treatment during the annual cholera outbreaks after the monsoon season. They estimate they saved more than 100,000 people in a few months. They had vaccinations, some IV fluids for the most desperate cases, the treatment for cholera, and whatever they could find locally on the cheap. They make a difference. Would you like to make a difference like that?
My current and future role is extremely focused. The days of my EMS involvement are less than 1000. I share my insight and experience so that maybe those that are still involved can make the required changes. So you can go home proud that you did make a difference. Save a life. All of those things.
Burnout in EMS isn't required, but if a provider is not satisfied, no amount of money or prestige is going to change that. You are never going to be happy replaying the same broken record day in and day out. You will never be a professional without knowledge.
I was told once: "There are only 2 types of people in the Navy. People whos lives it makes better and people whos lives it makes worse." EMS is the same way. If you came to EMS to help people, start by learning what that means. It is rarely a trip to the hospital.
