I no longer speak EMT

[Veneficus]

Today in order to give the best reply to a thread in the effort to help, I tried to look up something in an EMT text. (Emergency Care)

I most expertly flipped to the index, and started searching for the entry on "hemorrhage."

I had to scan the page twice to find it. (unheard of)

The entry read: "See also bleeding."

It never occured to me to look up "bleeding" until I saw that.

I have pondered for some time when my last efforts regarding EMS would come. Reviewed my last textbook last spring, resigned my teaching position this past fall, and now I wonder if it is even worth the effort to mail in my renewals for my medic and instructor certs?

How does a person know when they are nolonger a part of something and it is time to finally move on?

 

[MrBrown]

How does a person know when they are nolonger a part of something and it is time to finally move on?

When you get your MD/MBChB/MBBS/BMed/BMedBSurg or local equivalent thereof.

 

[abckidsmom]

Don't hang it up yet. You've got at least one more cycle of relevance in you.

 

[firetender]

My condolences, Vene!

It's much more primal than that, my Brother: EMS has you by the balls!

And, if you take it one step deeper (Sure, I know, it's all about the delivery of appropriate services) you'll find that what is really gripping you is what EMS should or does stand for. What's got you is not about EMS, but is ALL about EMS as a reflection of a much bigger picture; that of medicine.

Once you stop beating yourself up (and us!) about the failure of our approaches, modalities, drugs and whatnot, you'll see the things that bug you most are the things about how human beings choose to interact with each other while attempting to overcome death.

I think you'll sleep better once you accept your involvement in EMS as a useful metaphor to explore the experience of life.

You may not be able to see it right now, but the conversations you are stimulating are of immense service to a whole lot of people who really WILL bring this whole mess into a completely new realm!

So, here's my thanks, anyway.

 

[lampnyter]

Today in order to give the best reply to a thread in the effort to help, I tried to look up something in an EMT text. (Emergency Care)

I most expertly flipped to the index, and started searching for the entry on "hemorrhage."

I had to scan the page twice to find it. (unheard of)

The entry read: "See also bleeding."

It never occured to me to look up "bleeding" until I saw that.

I have pondered for some time when my last efforts regarding EMS would come. Reviewed my last textbook last spring, resigned my teaching position this past fall, and now I wonder if it is even worth the effort to mail in my renewals for my medic and instructor certs?

How does a person know when they are nolonger a part of something and it is time to finally move on?

All of this for looking up the proper term?

 

[Veneficus]

All of this for looking up the proper term?

Not exactly, looking up the proper term and then not finding it is just a catalyst for something I have been wrestling with for a few years now.

As I have pointed out, many physicians do not really respect or value EMS. As a favored student of many of these physicians I have been under constant pressure to put my time and talents to something more meaningful. (a more polite paraphrase than many of the comments) During this I tried to uphold that EMS providers were part of medicine, and a valuable part at that. That whole "M" part of EMS.

For the better part of 2 decades, I have lived the fire and EMS life, I have professed it's positions, I have tried to help improve it. Sometimes kindly, other times not, as a way to perhaps give back something in return for I have gotten out of it.

When I started medical school I was shocked that medical terminology was not part of the curriculum nor a prereq. I asked about it. I was told there was no need because the language of medicine would be taught by total immersion. That coupled with a rather stirring speech on matriculation from our dean, has turned out to be more than true. Medicine is not just a job, or a language, it is a way of thinking, both a philosophy and a religion. You do not learn it, you become inseperably part of it. No moment in your life is ever without it again, no matter how hard you hope or try.

So it occured to me that if the very first EMS book providers ever see is set up not as an introduction to medicine, not to be immersive, but to be basically an emergency guide to laypersons, are EMS providers really medical (or healthcare, not the literal definition of medicine as applied to physicians) providers at all?

The paramedic texts are only moderately better in their setup.

Being a paramedic is immersive, but it seems not in the same way or with the same focus as medicine. So what exactly is it that I have helped create? Was I wrong that EMS providers are medical at all? Did I blindly give others the impression they were and failed to deliver?

What if the anti EMS docs are right and I was wrong?

I think I finally see that all the things that make medicine what it is are lacking in the EMS system that I knew and at times gave my very blood to.

For a while now, it felt like I was caught between two worlds. Not really part of either. I think I have realized today that I cannot bring EMS in to my world of medicine no matter what the argument I make, to who, or in any other way drag it or mold it to be anything like what I want it to be. What I thought EMS was and my contributions as part of it seems to have been a fantasy. A positive spin to make myself feel like I was really contributing to something grand.

It wasn't that I had planned to quit, it is I now wonder what happens next. I once thought I would always somehow be involved with fire and EMS. I thought furthering myself would help me to further what I valued in those occupations as well. But it didn't and it won't.

I just don't see what spending any more time with it would hope to accomplish. I know what EMS is not. It is not medical. Not a hybrid, not partially, not pseudo.

Perhaps it is medicoid. (oid is a suffix that means: looks like but isn't)

Emergency Medicoid Services. I think there is a lot of truth to that. What could I possibly offer such a thing?

 

[lampnyter]

Your a doctor??

 

[Veneficus]

Your a doctor??

Not for 2 more semesters.

 

[firetender]

EMS or EIS?

Emergency Medicoid Services. I think there is a lot of truth to that. What could I possibly offer such a thing?

You may be right, but there is a medical component to how EMS really functions. Perhaps you could further define that within the context of what is really going on out there:

Emergency Intervention Services (EIS)

 

[usalsfyre]

Yours is not an unusual dilemma. Nearly every provider I know who elevates themselves above mediocre ends up leaving the field, whether it's to fire, nursing, other allied health fields, PA or medical school. The few who stay don't always end up in clinical leadership positions either, those seem to be more about who, rather than what, you know. The fact is, once you reach a certain point, there is nothing for EMS to offer you, nor you it. How many other medical professions resent those with a high level of knowledge, and automaticly assume your didactic knowledge is inversely proportional to your ability to apply said knowledge.

Your situation sounds slightly different, you got out and with some objectivity are seeing what a wasteland EMS is/has become. I appreciate your effort, and what you've done here is commendable. I for one have benefitted hugely from the knowledge you've passed on. My hope is that you continue to pass that on, perhaps acting in a Bledsoesque role. However, if you chose to leave completely it's entirely understandable. At the end of the day, you should do what's best for your family and career. Certainly don't let EMS hold you back.

​

 

[mgr22]

How does a person know when they are nolonger a part of something and it is time to finally move on?

Very good question. I've asked myself the same about EMS, but my way and your way of finding an answer have to be different, I think, because you're on your way to becoming a doctor and I'm not. Once I'm done being a medic, I'm done with all things medical. That feels pretty scary.

I think your situation is sort of like when I was playing hockey in, say, a "B" league, then moved up to an "A" league; I really didn't want to play in the B league anymore. I wanted to improve as a player, and that wasn't going to happen as quickly -- if ever -- in the B league.

It's not a perfect analogy; I'm just saying I think it's ok to leave the B league behind. You'll be playing/practicing at a higher level. I think you'll find something very similar to your "EMS fix" at that level, but I guess I'd have to be a doctor to know for sure.

 

[rescue99]

Not exactly, looking up the proper term and then not finding it is just a catalyst for something I have been wrestling with for a few years now.

As I have pointed out, many physicians do not really respect or value EMS. As a favored student of many of these physicians I have been under constant pressure to put my time and talents to something more meaningful. (a more polite paraphrase than many of the comments) During this I tried to uphold that EMS providers were part of medicine, and a valuable part at that. That whole "M" part of EMS.

For the better part of 2 decades, I have lived the fire and EMS life, I have professed it's positions, I have tried to help improve it. Sometimes kindly, other times not, as a way to perhaps give back something in return for I have gotten out of it.

When I started medical school I was shocked that medical terminology was not part of the curriculum nor a prereq. I asked about it. I was told there was no need because the language of medicine would be taught by total immersion. That coupled with a rather stirring speech on matriculation from our dean, has turned out to be more than true. Medicine is not just a job, or a language, it is a way of thinking, both a philosophy and a religion. You do not learn it, you become inseperably part of it. No moment in your life is ever without it again, no matter how hard you hope or try.

So it occured to me that if the very first EMS book providers ever see is set up not as an introduction to medicine, not to be immersive, but to be basically an emergency guide to laypersons, are EMS providers really medical (or healthcare, not the literal definition of medicine as applied to physicians) providers at all?

The paramedic texts are only moderately better in their setup.

Being a paramedic is immersive, but it seems not in the same way or with the same focus as medicine. So what exactly is it that I have helped create? Was I wrong that EMS providers are medical at all? Did I blindly give others the impression they were and failed to deliver?

What if the anti EMS docs are right and I was wrong?

I think I finally see that all the things that make medicine what it is are lacking in the EMS system that I knew and at times gave my very blood to.

For a while now, it felt like I was caught between two worlds. Not really part of either. I think I have realized today that I cannot bring EMS in to my world of medicine no matter what the argument I make, to who, or in any other way drag it or mold it to be anything like what I want it to be. What I thought EMS was and my contributions as part of it seems to have been a fantasy. A positive spin to make myself feel like I was really contributing to something grand.

It wasn't that I had planned to quit, it is I now wonder what happens next. I once thought I would always somehow be involved with fire and EMS. I thought furthering myself would help me to further what I valued in those occupations as well. But it didn't and it won't.

I just don't see what spending any more time with it would hope to accomplish. I know what EMS is not. It is not medical. Not a hybrid, not partially, not pseudo.

Perhaps it is medicoid. (oid is a suffix that means: looks like but isn't)

Emergency Medicoid Services. I think there is a lot of truth to that. What could I possibly offer such a thing?

Holy Cow! We get it..you're smarter than the rest of the world and the U.S. must burn because it'll just never measure up! For cryin out loud, stop the pay-attention-to-me diatribes. Making a real contribution does not have to include constant raging frustration. It's so unhealthy.

Please take a good ole fashioned course in stress management and add a course on humility just for kicks. As one very insightful EMT student noticed, some people must have been absent the day they taught well being of the EMT. If anyone has not yet done so, and can find the time, read chapter 2 of pretty much any EMS text. That is usually the well-being chapter. I honestly think a whole lot of people may have skipped that part, a very important part of the healthcare provider education. And I do hope for your sake, Ven, that you don't get as burned out as a "real" healthcare provider as you have as an EMS provider/educator. That would be a shame because you do have so much to offer. If you cannot see that a good auto mechanic is as valuable to society as a good thoracic surgeon, then you still have so much to learn in med school. Education comes with time and the world does not run on EMS Time. We are however, the only occupation outside of the goteverythingatmydisposalandallthehelpIcanuse hospital that is expected take no more than a mere 10 minutes to spare a life! Heck, I've met a few some Doc's who can kill 3 in that amount of time! Imagine...all that education and still stupid! Growth in EMS education is occurring as with all other occupations... over time so just relax. You have plenty to be pleased about and nothing to rant over.

 

[Anjel]

rescue99....You are not very nice. Sorry just saying. He obviously is troubled with something, not trying to say oo look at me.

Ven....

If you remember to back when you first started it was all about the love of ems. The desire to help someone and postpone the inevitable.

I have only been an EMT for a month now, but I still have that fire. I would do the job for free if I could afford it. I absolutely love it and can't get enough.

When the fire is gone. I will move on. You were apart of one of the greatest things anyone can do pre hospital. Now you can be in the hospital to pick up where ems leaves off. Consider an ER doc. You will get the best of both worlds. Or work your way up to a medical director and from there help improve the slowly deteriorating current ems education.

You can make a difference in whatever you do. Just don't get "burned out" and turn your back to the one thing you know you love deep down.


That's just my opinion.

 

[harryb714]

It never occured to me to look up "bleeding" until I saw that.

I find it worrisome that you are unable to remember the layperson definitions of medical terminology. It might be tough to communicate with patients if you can't translate "doctor talk" into "everyday person talk."

 

[lampnyter]

I find it worrisome that you are unable to remember the layperson definitions of medical terminology. It might be tough to communicate with patients if you can't translate "doctor talk" into "everyday person talk."

Talking to somebody is different than looking in a medical book.

 

[PotashRLS]

It's much more primal than that, my Brother: EMS has you by the balls!

And, if you take it one step deeper (Sure, I know, it's all about the delivery of appropriate services) you'll find that what is really gripping you is what EMS should or does stand for. What's got you is not about EMS, but is ALL about EMS as a reflection of a much bigger picture; that of medicine.

Once you stop beating yourself up (and us!) about the failure of our approaches, modalities, drugs and whatnot, you'll see the things that bug you most are the things about how human beings choose to interact with each other while attempting to overcome death.

I think you'll sleep better once you accept your involvement in EMS as a useful metaphor to explore the experience of life.

You may not be able to see it right now, but the conversations you are stimulating are of immense service to a whole lot of people who really WILL bring this whole mess into a completely new realm!

So, here's my thanks, anyway.

This really sums it up a lot. Good post.

Your frustrations have largely been seen as aimed at EMS when really deep down, the "real medical societies" and such have been your problem the whole time. Personally in my experiences at home, physician oversight is intertwined and the backbone of EMS in Wisconsin. We have been an extension of them as best can be through their teachings and protocols and direction. I am sure there are some that don't value EMS as medicine and thats okay. Tell those nice folks that when they have a heart attack, stroke or other "medical" emergency while out and about this great nation, they should call the local funeral home instead of 911!

 

[enjoynz]

EMS is a way of life.
Something that once you have been touched by the bug, never leaves you, even if you leave it.
That is one of the main reasons I'm still a member of this site!
Let me tell you my story...then you might understand what I mean.
I remember in my teens wishing to be an ambulance driver (that's what they were called back then), but I could not, because it was a man only zone in the late 1970's.
Instead I joined St John and became a First Aider...even then, I was only allowed to stand on the sideline at rugby football ...
women were not allowed to go on field to attend the players, because they would be too :blush: if you should see anything you shouldn't...heaven forbid.:wacko:

When I finally had the chance to move to a small town in my late 20's and join the volunteer ambulance service there, I was over the moon.
Unfortunatly the dream of going through all the training was short lived due to a marriage break up.
I moved away to a large city again,to escape.....thing is, in a large city the ambulance service is overrun by paid staff and they were spoilt for choice of willing volunteers as well...
a female vollie from a small country station had little, or should I say no chance, of carrying on her EMS training.
Instead the ambulance operations told me to go back to the community service (First Aiders) and just maybe they would look at me in the future.(Yeh right!-_-).

I'll never forget sitting with all the other First Aiders at a lecture (training session) run by one of the Paid Staff.
We were going through a scenario....I listed all the first things you must do at the scene...Scene safety, ABC's, etc etc.
"There is something important you have missed' he said to me.
For the life of me, I couldn't figure out what that was....until he said.
"You call for an ambulance!"
Well how silly am I.....up until then 'I WAS THE AMBULANCE!'
I decided there and then I couldn't go back the Community Service. Call it silly pride if you like.. I felt the pangs, that I had lost my career goal forever.

15 years, a new husband and 2 children later, we moved to a small country town. Finally my chance to start over again,(they were very short on vollie ambulance officers)...and I did rejoin, in the hope that I could retrain and get my paid career in EMS.
But alas, too much water had past under the bridge...I had got over the politic's side of EMS...
the close knit service I worked with in the 80's, had gone...it was every man to himself and blow the rest.
At my age, I felt that I didn't need the stress working for free and getting no supoort from the powers that be.
So I made the hard decision to leave for good and forget me teenage dream, once and for all.
Do I miss EMS...almost every week...every time I see an ambulance go by, there is a pang of regret deep inside.

Ok....so what I'm trying to say Vene is....even if you become the best doctor in the world. The root (EMS) that started you quest for success,
will always live deep within you, no matter what you decide to do.

Cheers Enjoynz

 

[Seaglass]

Sometimes you outgrow things. Whether there's anything left in it for you afterward is entirely your call to make. Take some time and think about it.

Regardless, I'd hold onto those certs until you graduate.

I for one have benefitted hugely from the knowledge you've passed on. My hope is that you continue to pass that on, perhaps acting in a Bledsoesque role. However, if you chose to leave completely it's entirely understandable. At the end of the day, you should do what's best for your family and career. Certainly don't let EMS hold you back.

This. EMS really needs more Drs. Bledsoe, whether it currently accepts it or not. And once you've got those shiny postnominals, it seems you'll be as well-positioned to do it as anyone.

 

[Veneficus]

I feel compelled to address this

Holy Cow! We get it..you're smarter than the rest of the world and the U.S. must burn because it'll just never measure up! For cryin out loud, stop the pay-attention-to-me diatribes. Making a real contribution does not have to include constant raging frustration. It's so unhealthy.

Smarter than the rest of the world? That is very overly generous. While I admit I am frustrated about some things, I don't see this post as raging. I see it as a reflection and a problem.

At some point in everyone's life, something forces them to reflect on what it is they have done, where they are, accept responsibilities for mistakes and failures, and really measure what it is they are proud of.

For a long time, I have failed to see what EMS is because I wanted to believe it really was more. It is a difficult position to be proud of something the people who are responsible for your future success keep putting down. I have not yet figured out how to reconcile that. I had hoped by bringing attention to it, some of the people here might offer some aid or insight I had not considered.

You have to figure, if it was an entry level text that identified the problem, then even an entry level person might be able to solve it. But there are considerably wiser people than that here too.

Please take a good ole fashioned course in stress management and add a course on humility just for kicks.

I'll put it on my "to do" list, but I still plan to take a welding class first. Sometime in about 12-14 years.

As one very insightful EMT student noticed, some people must have been absent the day they taught well being of the EMT. If anyone has not yet done so, and can find the time, read chapter 2 of pretty much any EMS text. That is usually the well-being chapter. I honestly think a whole lot of people may have skipped that part, a very important part of the healthcare provider education.

Are you suggesting that my life is a bit stressful and that changing my shift, spending more time with my family, having a hobby to relieve stress, and lightening my workload would help?

It sure would. However, as part of that having my schedule dictated to me in the effort of intensive training meant to push people to their breaking points, I think one of the surgeons said it best. "Eat when you can, sleep when you can, and stay the hell away from the pancrease."

To just point out how intense medical training can be, you can succeed or you can die. But if you fail, your unforgivable, even in bankruptcy, debt for the training will be insurmountable not having the earning power of a physician and that will cause considerably more stress all around than the intermediate stress of the demands of school.

And I do hope for your sake, Ven, that you don't get as burned out as a "real" healthcare provider as you have as an EMS provider/educator.

I didn't really consider my frustrations as burnout. I have reduced my EMS responsibilities and time in order to be able to cope with other responsibilities. I have always made every effort to give patients and students 110% and enable them.

I admit I may demand a bit higher level of results both of providers and of the system. Mostly because it should be as good as anywhere else, it can be as good as anywhere else, and the only thing stopping it is laziness. Remember the phrase when teaching, I don't want any student to pass who I would not want working on my family?

It is not the new people holding EMS back, it is the old people, I a now realize and accept I have some responsibility in that for not demanding as much of myself, my agencies, and my peers earlier as I did of students.

That would be a shame because you do have so much to offer.

I am frequently told that, but right now the dilemma is what can I offer to EMS?

Because I am not sure, and it is not like I can go to the superiors who are always bashing it and ask them. Like I said, I don't want to quit, but I don't know how to move forward.

If you cannot see that a good auto mechanic is as valuable to society as a good thoracic surgeon, then you still have so much to learn in med school.

Lol, there may be some misconception abot what med school is. It does not teach you about life, it makes you inseperable to a long defined philosophy, knowledge body, and skill set.

Some of the most important people in my day are the coffee shop employees. For they keep the whole world moving.

But I think the problem is not seeing the value in EMS providers. At least in my mind, it is seeing people who could be world class resign themselves to being the bottom feeders.

Education comes with time and the world does not run on EMS Time. We are however, the only occupation outside of the goteverythingatmydisposalandallthehelpIcanuse hospital that is expected take no more than a mere 10 minutes to spare a life!

I find no truth to this statement at all though I once not only believed it, but professed it. Nobody is asking you to spare a life. They are simply asking you to deliver the person to somebody else. If you were being asked to spare a life, you would have the resources to do it.

Heck, I've met a few some Doc's who can kill 3 in that amount of time! Imagine...all that education and still stupid!

I cannot imagine where you found them. That is rather an impressive feat. But it does demonstrate the more ability you have to do good, the bigger mistakes you can make.

Growth in EMS education is occurring as with all other occupations... over time so just relax. You have plenty to be pleased about and nothing to rant over.

The same arguments being rehashed as when I started in 89 is not growth or anything to brag about. There is plenty to rant over and plenty of responsibility to go around for it.

In fairness, when I openly and directly accuse physicians (many of them EMS medical directors) of abandoning and neglecting EMS and then complaining about what EMS is, you don't see the conversation here. You only see the ranting on what EMS does have the ability to influence here.

It most certainly makes me angry when I try to go to bat for EMS as professionals and then they mindlessly replay the very same mistakes that lost them the respect they rightly deserve in the first place.

It is my deeply held belief that while perfection is unobtainable, it is always the measure which any health or emergency related provider should be held to. To accept the measure of "better than yesterday" is the sure path to being unacceptably lazy and substandard.

For the record I do not think the US should burn. I see that it is burning and needs to do something about it other than try to find a scapegoat or pretend it is not.

 

[JPINFV]

I find it worrisome that you are unable to remember the layperson definitions of medical terminology. It might be tough to communicate with patients if you can't translate "doctor talk" into "everyday person talk."

If I'm looking up a quote in a medical/health care text book, I don't think it's an unreasonable expectation for the language to be used to be medical in nature. I would expect "fracture" to be used instead of "broken bone." Similarly, I expect books directed to, say, paralegals to use the term "tort" instead of "lawsuit."