EMS Professionals?

[medicman14]

I'm brand new to this forum and thank you for creating a place for us EMS'rs to share.

I would like to broach a subject that is discussed in many EMS stations across our great country. The typical open ended question is: “When will we be considered professionals?" The common interpretation is that physicians, nurses, firefighters, police officers, stock brokers, accountants, etc. are professionals and we are "something else."

Please allow me to answer this question; you may take my answer any way you wish.

There is no great soul, up on high, which declares one occupation professional or otherwise. The marker, the identifying characteristic, of a professional is -- now here is the shocker -- US!

How do we "appear" to our public?
How do we approach our patients?
How do we behave when being watched?
How do we market our profession?

These are questions for us, as a profession, to ponder.
There appear to be many new members of our EMS family here, reading these messages. It is incumbent upon all of us, regardless of our personal identity, to profess our professional identity to the best possible measure.

I welcome any and all comments to this message. This is only the beginning of our great trek forward…
:usa:

 

[Flight-LP]

I'm brand new to this forum and thank you for creating a place for us EMS'rs to share.

I would like to broach a subject that is discussed in many EMS stations across our great country. The typical open ended question is: “When will we be considered professionals?" The common interpretation is that physicians, nurses, firefighters, police officers, stock brokers, accountants, etc. are professionals and we are "something else."

Please allow me to answer this question; you may take my answer any way you wish.

There is no great soul, up on high, which declares one occupation professional or otherwise. The marker, the identifying characteristic, of a professional is -- now here is the shocker -- US!

How do we "appear" to our public?
How do we approach our patients?
How do we behave when being watched?
How do we market our profession?

These are questions for us, as a profession, to ponder.
There appear to be many new members of our EMS family here, reading these messages. It is incumbent upon all of us, regardless of our personal identity, to profess our professional identity to the best possible measure.

I welcome any and all comments to this message. This is only the beginning of our great trek forward…
:usa:

Well spoken my friend!

I see two aspects that hinder us. First, I'd remove Firefighters from your list as here locally, not all of them are viewed as professional. Some are just viewed as volunteer, which is the premise of my first hinderance. We have too many people which devalue themselves and offer their services for free. It is a two fold issue. 1) A true professional can place a cost on his service. Look at your afformentioned list. Other than the FF's, do any of the others offer their services for free? Nope. 2) We have too many volunteers who do this for "fun". Its a hobby for them. They get to run with cool lights and get to be in the newspapers and on TV. they can brag to their friends, etc. It is not important enough to them to engage this industry full time. They offer so many excuses, I don't have time, I can't make enough money, blah blah, etc. etc. You want professionalism, then the weekend warrior hobbyists have to go!

Second reason is one that continues to boggle me day in and day out. We in EMS do some really stupid s*@%. If we aren't getting arrested because we didn't pull over for the cop because we were on our way to a call in our POV, then we are driving ambulances drunk, molesting patients, giving alcohol to 11 year olds, or are out playing search and rescue when we aren't trained nor equipped and getting ourselves killed. These examples speak for themselves.

So how do we solve it? There are many hypothesis'. Education, consistant certification levels with defined scopes (i.e. no you cannot intubate as a basic despite your ignorance and belief you should), increasing age requirements by getting rids of kids on ambulances. all could be valid in my mind. But until everyone is in with their all and not just for fun and we stop being STUPID, not much will change.

Taxes, death, and stupidity - The 3 absolutes in this world!

Thoughts?? Opinions?? Great topic!!!!

 

[certguy]

You know , I've volunteered for one thing or another most of my life , military , EMS , SAR , fire , Red Cross , CERT , and soon to be Medical Reserve Corps . YOU DON'T NEED TO DRAW A PAYCHECK TO BE PROFESSIONAL . We're all out there to help and if you look , there's a lot more public to protect than crews to do it , especially in a disaster setting . This country was founded on volunteerism , and in many ares that don't have the budget , they still depend on it . It really burns my backside to see the " pro's " looking down thier noses at those who also fill the need . We're all family here , time to act like it . Your " pro " ranks often start out as vollies . I did , and continued to volunteer in FD while I was in EMS as a pro . GROW UP !!!

 

[medicman14]

Thank you both for replying so quickly!

First, I am proud to be a Paramedic. Many have said: you now are a college graduate, in grad school, when will you give up the medic thing? My response: You will pry my Paramedic certification from my cold dead fingers. I worked harder for my Paramedic education, an AS in EMS, than my bachelor’s degree in business. Nothing I have done, even grad school at a very respected state university, comes close to the sacrifices I made for my Paramedic.

Secondly, I do not equate professional with "remunerated” aka paid. Anyone who walks into grandma's house at 2am is representing our profession. One of the most impressionable messages that I received at the National Fire Academy's Advanced Leadership Issues in EMS course, a course I highly recommend for anyone taking this seriously, was anyone calling 911 is looking for "hep" (that would be the southern version of help, yes I'm from the south). They do not care about the color of your truck, they do not care about the color of your uniform, they do not care about the size of your paycheck. They simply want "hep." I have to credit my very influential NFA ALIEMS instructors Don Lundy and Don Lee for that very profound point.

Third, Regardless of whether you show up on scene in a truck, engine, box, bus, or an ambulance on skids -- you are representing our -- my -- profession. I expect only the best and will settle for nothing less, nor should the patient.

Fourth, I am privileged to have spent my paid EMS career in the great State of Florida. My wife and I have managed a family, including three outstanding children (most of the time anyway) on a Paramedic's salary. I am proud of my career and have a tremendous respect for those who are willing to do it voluntarily. My only demand, yes it is a demand and not a request, that you do it well. You, yes each of you, are representing all of us. I frankly don't care what your paycheck is, you are marketing our profession.

Last, there are bad apples in every bunch. We, all of us, are responsible for our image. Let's make it better. Our profession is quite young, let's make it count. As I recently told a group in Florida, we are preparing EMS for our successors, do it well or go home.

Be safe, go home, and have a Scotch on me.

 

[Ridryder911]

I respect your opinion but totally disagree with you on many accounts.

Actually there is a "quote" definition of professional as being ..."one that cannot exceed or advance further upon their degree, profession"..i.e. that being similar to engineer, physician, attorney.. etc. So yes, in the real world when you are describing in academia, professional standards, even taxes we are not considered a professional, rather a trade or vocation skilled worker.

Some colleges will not even honor this job as a profession due to the nonprofessional entry requirements, the performance attributions, and ratings of that it is more a skill than academic and thus is even labeled "blue collar" in many areas.

Yes, one can act or be professional in their demeanor and have obtained the required or even above knowledge for this so called profession. Thus being a professional within this profession.

I agree with you; what ever agency you represent does represent this profession, and thus the reason EMS should be health care and not a secondary outlet.

I have seen patients that do become irritated when an engine, squad, battalion chief, and then EMS arrives all for one EMS call. So yes, many people do care what they arrive in. Again, not always the best allotted resources. Nothing more than attempting to justify positions and the need of keeping positions. Like in any other profession and business if the need and productivity is not there, then changes should occur within the infrastructure, not just to attempt to broaden job descriptions to keep jobs.

I agree volunteerism is great; but also is one of the most harmful attributes in EMS. Many of the communities could and can afford twenty-four hour paid ALS coverage, but do not because of the of volunteer mind set. The old analogy of "why buy the cow; when the milk is free" comes in mind. Again, if one was to investigate many volunteer services is based upon tradition, not the need of having to rely upon volunteers. As well, if these so called big hearts really cared for their community and citizens, why do we not see them volunteering to be a dog catcher or be a jailer, work on city sewer lines or work on committees for professional EMS in their community? Again, remove the stigma of "hero" and lights and sirens and see what the percentage would be. Yes there will always be a need of volunteers in remote and scarce populated areas and I honor those that provide care and makes sacrifices, but that is a totally different situation.

Their lobby and organizations are the number one antagonist of promoting increasing educational standards and regulations that would ensure a qualified scope and safe care. This has been proven over and over again, with any national curriculum changes and any promotion of standardized educational requirements increasing and when a mention of a minimal scope of practice is introduced.

Yes, I too have managed to feed my family based upon EMS. Unfortunately, EMS does have a dead end career state, and one usually has to have multiple jobs or leave and enter another career to be able to perform those basic essential functions of feeding and providing for a family. Again, most of the reason for such was because of the points I addressed. There is a reason a large percentage of EMS personnel work multiple jobs, and as well many are still considered being paid at "poverty level". I agree, we must change our perception. This should be done in multiple ways from increasing education requirements, to decreasing the fragmentation of services that use EMS as a justification of existence, and by promoting EMS as an individual profession.
Then the public will understand the need and justify the benefits of having EMS and the associated benefits it should have.

R/r 911

 

[medicman14]

A very articulate response RidRyder911. Your comments represent the very purpose and intent of my original posting. It is essential that we grasp exactly where we are today in order to plan for tomorrow.
Everyone please feel free to chime in.

 

[Anomalous]

The opposite of volunteer is conscript.
The opposite of professional is amateur.

Our sons friends at Fort Campbell, KY (101st Air Assault), who are all volunteers, would probably object to being called amateur soldiers because they volunteered.:usa:

 

[JPINFV]

You, sir, have just commited the crime of using the following logical fallicies:

1. Use of a red herring (when, exactly, did the military become important in this discussion?).

2. An appeal to emotion (Regardless of how it makes people feel, the truth is the truth).


How do you plead?

 

[Ridryder911]

The opposite of volunteer is conscript.
The opposite of professional is amateur.

Our sons friends at Fort Campbell, KY (101st Air Assault), who are all volunteers, would probably object to being called amateur soldiers because they volunteered.:usa:

I would not say they are volunteers. They chose that profession and all that is associated within it. It is called volunteerism mainly because it is associated with the government, and if it was associated with a private sector it would be called mercenary. Yes, they were not drafted but chose or volunteered to enter the military as an employment to become a professional soldier. I also would not call them volunteers or amateurs, because since they do receive pay and benefits (albeit it lousy), there are those that can make careers and definitely have educational levels for a speciality profession within itself.

Just because someone signed on for military does make them a volunteer in comparison to the general definition that is commonly used.

R/r 911

 

[certguy]

ems pros

Well said Anomolous ,
Point of order ; Volunteers kicked butt over the most powerful army in the world at the time to grant this country our freedom . Another point ; How many of you who say vollies have no place in EMS have ever worked a large disaster ? When the big one happens , there's not enough of you to go around and who's working alongside you ? Vollies . I'd say there's probably a lot like me who can't or choose not to work the field work the field professionally anymore but have a pro background . This is a valuable resource especially when you're stretched thin . You should be helping them improve , not putting them down . Vollies are in it not for glory , or a fun hobby , but to help thier community . In forums on this site and others , I've read threads from pros that would drive by accident victims off duty rather than help because they're not on the clock or scared silly of getting sued . I believe EMS is a calling , not just a job . Not everybody can or should do it , but if you do , it should mean more than a paycheck and looking down on others . It's a life of service to your community . Times must've really changed because some of these threads really make me shake my head .

 

[medicman14]

CertGuy Reply

It's a life of service to your community . Times must've really changed because some of these threads really make me shake my head .

The first sentence in the quote from your reply is particularly poignant. The second is simply silly.
The purpose of this thread is to provide a paradigm broadening experience to those who cannot see past their zone. Our profession, our community is much larger that any one of us; however, each of us, regardless of our position, represent EMS as a whole. Shaking your head, or condemning "the times" is simply insisting that we cannot see the others point of view. None of us have exclusive rights to EMS, we share this profession in its perception. This is very important, especially for a profession in its infancy -- if you are not sure what I mean, do a little research on EMS history. We are creating what many generations that succeed us will either praise or resent, at this very moment -- today -- the opportunity is ours and ours alone. Be friendly, because when you are responding to those disasters, you are also working along others, "vollies" or "pros", be sure they are your still on your side, our side, the same side -- those expressions should be synonymous, I hope they are.

 

[Flight-LP]

Well said Anomolous ,
Point of order ; Volunteers kicked butt over the most powerful army in the world at the time to grant this country our freedom . Another point ; How many of you who say vollies have no place in EMS have ever worked a large disaster ? When the big one happens , there's not enough of you to go around and who's working alongside you ? Vollies . I'd say there's probably a lot like me who can't or choose not to work the field work the field professionally anymore but have a pro background . This is a valuable resource especially when you're stretched thin . You should be helping them improve , not putting them down . Vollies are in it not for glory , or a fun hobby , but to help thier community . In forums on this site and others , I've read threads from pros that would drive by accident victims off duty rather than help because they're not on the clock or scared silly of getting sued . I believe EMS is a calling , not just a job . Not everybody can or should do it , but if you do , it should mean more than a paycheck and looking down on others . It's a life of service to your community . Times must've really changed because some of these threads really make me shake my head .

I wish that were truly the case. Not everyone holds the view, integrity, and dedication that you possess. First let me say "thank you" for that service. The problem lies in the fact that many volunteers do find our career and livelyhood a hobby and nothing more. They are the whackers that we see day in and day out, with their POV lights and sirens, the "EMT's save Paramedic's" T-shirt, and belong to the local "good 'ol boy club that houses an ambulance. There are wonderful volunteer organizations out there, DMAAT's, CAP, USCGA, and yes some EMS organizations. But the few professional volunteers out there are trumped by the idiots. Sad but true!

Unfortunately, your assertation that disaster's require volunteers because we are stretched too thin is false. I'll use the largest natural disaster in U.S. history as an example. When "K" hit the gulf coast, many agencies responded. The primary EMS workers were career PAID employees, mostly employees from Acadian Ambulance. In proportion, there were very few volunteers. The members of the 82nd Airborne Division that were there were not volunteer, nor is any other member of the U.S. Military. As Rid stated they chose their profession, its apples to oranges..........

One month later when Rita hit, we did have a higher influx of volunteers and honestly, I have never seen more of a cluster f@#* in my entire life. Professional would not be the word used to describe them. In fact, one tactical response team had to come in and restore an organized form of order because there was no coordination and the largest hospital in East Texas was not completely evacuated until after the storm came through. There was a lot of free lancing going on as people were doing whatever they pleased. It was not until Houston area PROFESSIONAL, PAID agencies came in, that a coordinated effort was undertaken. So I'm sorry, I've seen first hand how "professional" some volunteer EMS'rs are.

As far as the driving by scene's aspect goes, I guess I am being selfish. I suppose in the future, I could stop more often. But, should I stop in the future, would you be willing to pay for my expenses should I be injured or killed on the scene of that accident since I am not covered under anyone's liability policy? If your not, then I'll keep on driving thank you. My family is my number one priority, always will be.

I wish it were different, but alas as our society changes, so will our industry. As long as our future holds kids with no work ethic and a self-perceived view of entitlement, I doubt it will ever change.

Heck, the more I think about it, the more attractive Canada appears!

 

[certguy]

ems pros

One of the great things about this site is that we can all exchange info and opinions , hopefully without offense . If I ever offend anyone , please keep in mind it's not intentional . I think I look at things from a different perspective than most of you . I worked EMS and FD in the 80's and early 90's , took a long hiadus , partially due to burnout , and got recerted in june . I can't work pro anymore due to a knee replacement , but I've got background that'd be helpful in an emergency , which is why I recerted . Maybe I'm more gung ho than others , but I've always believed in helping your community with the gifts God gives you . I've seen good and bad on both sides of the issue , paid and vollie . Don't judge either side too harshly because there's boneheads on both sides , just as there are pros ( whether paid or not ) .


As disasters go , they're ALL messes , for everyone involved . Keep in mind Katrina covered several states and undoubtedly had a huge vollie effort as well as paid . Our ham club had 2 guest speakers from Florida OES who were sent to Missisppi to help with communications . When they arrived , they found a county emergency manager whose entire paid staff took off to be with family . The poor guy was trying to coordinate ops by himself . The vollies stepped in and gave him the support he needed . One new ham found himself the FD/EMS dispatcher for the entire county and we were told he did a very good job . Vollies provide a very important role . I posted an earthquake scenerio on another site and I was amazed at how many folks said they wouldn't respond and just take care of family . Keep in mind , take care of family first , make sure they're safe , but once they're safe , people will die without your help . CERT is trained to start ops till you can get there , then work under you , but if you don't respond and the duty crews are overwhelmed or become casualties , we have a big problem .


The EMT's I worked with thought nothing of stopping and helping if there were no resources on a scene , we did it all the time and never had legal or work comp problems , we didn't even think about it most times . We also wouldn't hesitate to respond in a disaster once our families are being taken care of . Sadly , I do believe times have changed .

 

[TransportJockey]

Certguy, it seems like anyone with a ham operator license seems to view vollie a little differently. I know for me part of that is because I was active in emergency responses long before I got my EMT-B (I've been a ham since I was 11), all for no pay.
I agree that you can be a professional even with no pay.

 

[BossyCow]

I was raised with the expectation that everyone needs to participate in their community. I have been actively involved in assorted volunteer organizations for 38 years. But I agree with Rid on this one. He makes a valid point. Too many agencies are using the desire for Joe Whacker to put flashing lights on his POV and be able to play hero on weekends (oh come on, we all know that guy) to avoid staffing their agencies sufficiently. It's a numbers game. Inflating the number of responders, without increasing salaries, keeps agencies in compliance with insurance baselines without incurring additional cost.

There are many dedicated volunteers who work to provide service where there would be none. There are basics who do not quit learning once they get their cert in the mail. There are those who's certification and credentials are a minor part of their knowledge and experience. Sadly, it seems that these are in the minority and are rapidly becoming extinct.

I see over and over again, new volunteers joining and organization for what they can get from it and resenting everything the agency asks from them.

The society of volunteerism is changing, and I'm not sure I like where its going.

 

[VentMedic]

Unfortunately, your assertation that disaster's require volunteers because we are stretched too thin is false. I'll use the largest natural disaster in U.S. history as an example. When "K" hit the gulf coast, many agencies responded. The primary EMS workers were career PAID employees, mostly employees from Acadian Ambulance. In proportion, there were very few volunteers.

Actually, you may not have any idea how many volunteers are working a disaster of that magnitude. You also seem to be looking at a disaster, Katrina or any, from a very narrow prospective. There are many, many people from all parts of the country and the world working in their home area that are involved in getting things mobilized. There were healthcare workers both paid and volunteer helping get patients established in other facilities in several states. Arcadian is big but not that big. You may have only witnessed what you saw in your area. I know you did not see me unless you came to the Florida border where we were assisting.

Even in 2004 in Florida, we had to move patients from parts of South, Central and SW Florida to neighboring states in the north due to the damage to our hospitals and long term facilities. It takes many, many people both paid and volunteer to make that happen. The little volunteer services from all areas put any vehicle they had or could spare in motion to assist the paid services in our neighboring states to get 2 planes full of pts (120+) unloaded and to hospitals or care facilities.

In 1992 after Andrew, I was never so glad to see volunteers of all types come to Miami to provide whatever assistance they can. There are so many things that can be done and must be done. Even providing some relief from your post for an hour or 2 to make sure your family is safe or get them to safety can mean alot. I know our staff welcomed people from many states, both paid and volunteer.

So no, do not underestimate volunteers or just kind hearted neighbors in a disaster. Yes, it helps when things are organized but it also helps when the paid people don't act like they are the only ones that can do anything for anyone.

I don't know if you yourself have ever lost property or a loved one in a disaster, but just having someone there to comfort you for a few minutes ever if a total stranger can make things seem a little better. It is comforting to know there are people willing to help in any way they can. If you haven't experienced a loss first hand, I hope you don't. I can speak from my own experiences with hurricanes from both a professional and personal view, it is not a time for egos to get in the way.

 

[certguy]

ems pros

I wish that were truly the case. Not everyone holds the view, integrity, and dedication that you possess. First let me say "thank you" for that service. The problem lies in the fact that many volunteers do find our career and livelyhood a hobby and nothing more. They are the whackers that we see day in and day out, with their POV lights and sirens, the "EMT's save Paramedic's" T-shirt, and belong to the local "good 'ol boy club that houses an ambulance. There are wonderful volunteer organizations out there, DMAAT's, CAP, USCGA, and yes some EMS organizations. But the few professional volunteers out there are trumped by the idiots. Sad but true!

Unfortunately, your assertation that disaster's require volunteers because we are stretched too thin is false. I'll use the largest natural disaster in U.S. history as an example. When "K" hit the gulf coast, many agencies responded. The primary EMS workers were career PAID employees, mostly employees from Acadian Ambulance. In proportion, there were very few volunteers. The members of the 82nd Airborne Division that were there were not volunteer, nor is any other member of the U.S. Military. As Rid stated they chose their profession, its apples to oranges..........

One month later when Rita hit, we did have a higher influx of volunteers and honestly, I have never seen more of a cluster f@#* in my entire life. Professional would not be the word used to describe them. In fact, one tactical response team had to come in and restore an organized form of order because there was no coordination and the largest hospital in East Texas was not completely evacuated until after the storm came through. There was a lot of free lancing going on as people were doing whatever they pleased. It was not until Houston area PROFESSIONAL, PAID agencies came in, that a coordinated effort was undertaken. So I'm sorry, I've seen first hand how "professional" some volunteer EMS'rs are.

As far as the driving by scene's aspect goes, I guess I am being selfish. I suppose in the future, I could stop more often. But, should I stop in the future, would you be willing to pay for my expenses should I be injured or killed on the scene of that accident since I am not covered under anyone's liability policy? If your not, then I'll keep on driving thank you. My family is my number one priority, always will be.

I wish it were different, but alas as our society changes, so will our industry. As long as our future holds kids with no work ethic and a self-perceived view of entitlement, I doubt it will ever change.

Heck, the more I think about it, the more attractive Canada appears!

To make a point , I'll use our local resources as an example . In our valley we have 3 fire stations each with a 3 man crew covering several communities each . We have 2 ambulance stations with 3 rigs each . Seasonally , we have Forest Service and BLM resources too , and in tourist season , our population swells to 2 - 3 times normal . The nearest outside help is roughly50 miles away through a windy canyon road that often has rockslides . Do they have enough resources to be effective in a disaster without help ?

 

[Anomalous]

You, sir, have just commited the crime of using the following logical fallicies:

1. Use of a red herring (when, exactly, did the military become important in this discussion?).

2. An appeal to emotion (Regardless of how it makes people feel, the truth is the truth).


How do you plead?

To point 1, I plead not guilty. The only point is that volunteer and professional are not opposites. I work for a Class A railroad for pay (of course). If I volunteered at Brookfield Zoo to run the steam engine around the park I could do it in a professional manner while still being a volunteer. On the other hand I could take a 8000', 10,000 ton freight train, get paid for it and still run it in an unprofessional manner.

As to point 2, I plead insanity.

The ONLY point is that volunteer and professional are not opposites. You can be an EMT-B and be a professional and you can also be an EMT-P and be unprofessional.

And....yes I still consider the 101st volunteers...

 

[Anomalous]

I work for a Class A railroad

Oops make that Class I. Sorry for double post but I don't know how to get rid of it.