The kind of people in EMS

[Sasha]

Do you ever get sick of the people who obviously don't belong in EMS? I am still in awe the kind of personalities it attracts for such an important job. We strive to be medical professionals yet there is no screening process, it's not hard or even mildly challenging to get into. We accept anyone with a pulse. Don't you think there's something wrong with that?

Today we went to pick up a patient who had a bowel movement, the nurse came out "I have to find someone to help me change the diaper" And of course, I offered to help. My partner.. My PARAMEDIC partner went "Eww gross"

Ew gross? Grow up! We are trying to be medical professionals yet we "Eww gross!" at poo?

This is just one instance of what I have been noticing lately, and I guess this thread is a kind of rant. But I really think to be considered a profession we need to start and work on the kind of people and attitudes that are allowed in EMS.

 

[Shishkabob]

Every single job / profession / career attracts people from every walk of life. Do you think nurses and doctors don't get the random oddballs as well?


Get used to it or ignore it. Those are the only two viable options. I say "eww gross" to poo as well, and I do it everyday. Doesn't mean I'm unprofessional, immature, or not cut out for the job.

 

[usafmedic45]

Every single job / profession / career attracts people from every walk of life. Do you think nurses and doctors don't get the random oddballs as well?


Get used to it or ignore it. Those are the only two viable options. I say "eww gross" to poo as well, and I do it everyday. Doesn't mean I'm unprofessional, immature, or not cut out for the job.

Exactly....there are still things in health care that make me want to gag and/or vomit and often provoke comments to the effect of "Oh, that's sick...." after over a decade. Examples: the sound of someone vomiting, vaginal deliveries and the smell of melena. This from a guy who can handle a badly decomped body being chewed on by maggots (although the SOUND of maggots makes my skin crawl) without much problem.

In fact, my tendency to throw up (and pass out outside in two cases) after delivering babies- I've done four field deliveries, including my godson and one on my birthday a few years back which involved an accidental fall from a deer stand, smelling like deer pee and a family of rednecks....don't ask- spawned a joke of sorts: "When you deliver a baby, you start out with one patient and wind up with two. When Steve delivers a baby, you start out with one patient and wind up with three." :lol:

 

[Sasha]

Agreed....there are still things in health care that make me want to gag and/or vomit and often provoke comments to the effect of "Oh, that's sick...." after over a decade. Examples: the sound of someone vomiting, vaginal deliveries and the smell of melena. This from a guy who can handle a badly decomped body being chewed on by maggots (although the SOUND of maggots makes my skin crawl) without much problem.

Yes, but do you go "Eww gross" in that patient's earshot? Perhaps I am just irritable tonight. The same partner is a germaphobe and will look at a patient and turn away going "I don't want to touch that". I am truly appalled by that kind of attitude. If you can't behave maturely and professionaly in the vicinity of patients, then I really don't think you should be in EMS.

It's not even just that. The people with no desire to be medical professionals, rather the burnt out crusty medic who doesn't know more than a textbook. Those who can't be patient advocates. Those that think it is okay to humiliate patients for lifestyle choices. Do we really need those kind of people in EMS?

 

[PapaBear434]

I think a lot of people in EMS live up to the stereotype of us being nothing but adrenaline junkies. That we don't care about the medicine or the people, but only the thrill. And as a bonus, being paid for it.

These nimrods reinforce that, unfortunately. Cowboys with a pair of trauma shears, nothing more.

It's a weird thing I've noticed, and this is just my personal experience: The more a person in EMS gets paid, the more of a &*#$! they tend to be. Lower paid people seem to do it because they want to be there, while the higher paid ones just want to get a paycheck and a thrill.

This is not a strict generalization, mind you, just personal experience.

 

[usafmedic45]

Yes, but do you go "Eww gross" in that patient's earshot?

I have....I've also vomited into that little step area next to the curbside door of the ambulance when a patient vomited on me once several years back.

Those who can't be patient advocates.

Depends on how you define "patient advocate". If you simply mean looking out for a patient's best interest, then I cheerfully agree. If you mean being Mother Teresa to even the most despicable pieces of human detritus (the drug dealers, the child molesters, the rapists, etc) then I think you are overestimating what our job description in EMS entails exactly.

Sometimes a spade is just a spade and you have to call it that and sometimes you have to simply except that it's not everyone's desire to change the world. Many of us are just in EMS as a job because we happen to be good at it and enjoy it enough to put up with the headaches. I get tired of hearing how we are all supposed to injury prevention advocating, human rights protecting, social injustice fixing ubermenschen when in fact all we are required by the profession of EMS is to take care of those in our charge and be the best at it that we can achieve. If you choose to do more, then so be it, but please do not act like it is a mandate that everyone take part.

Anyone who stands in your way when you are trying to strive for goals that do not violate the social mores, laws and other doctrines of our culture is a fool, but the greatest fool is the one who fails to recognize that perhaps they are imbued by genetics, upbringing or some sort of higher power (should one choose to believe in that) with certain gifts or talents that make you specially suited to whatever tasks you find most interesting. This is especially the case when one does not see themselves as special and instead turns it into hate, distrust or disdain for their friends and colleagues. Maybe the ability to see a problem and pursue it with every fiber of one's being and every less molecule of energy is what makes one special: the drive to pursue things other see as pointless or at least not worth the effort. Maybe that is your calling to "the arena" as Roosevelt discussed in his famous Citizenship in a Republic speech. I don't look around my fellow RTs and EMS professionals and go "Why aren't the rest of you lined up to do injury prevention research?" I realize that I'm little weird (ok, very weird) when it comes to my interests but I also recognize that people may not see the same benefit in spending their free time- precious as it is- in the same ways I chose to. To each and to their own....if you see value in something, go for it, but do not expend your time wondering why others may not see your point until it becomes blatantly obvious to them of the knowledge, wisdom or benefits that you have worked so hard to find for your fellow man.

Those that think it is okay to humiliate patients for lifestyle choices.

Once again- and I apologize for sounding like Clinton giving a deposition- but the answer depends on your definition of "lifestyle choices". If you're talking about sexuality, etc then it is wholly unprofessional to humiliate or ridicule someone for that. In fact, it's a huge character flaw to do that and should be a source of shame for anyone that engages in it. Now, if you're talking about things like prostitution, drug use, drug dealing, gang membership, smoking, obesity, etc....perhaps we should be less concerned with "humiliation" and less with fostering a feeling that it's OK to engage in these activities. People should be ashamed of them. Unless people call them on it- and often bluntly so- they don't learn that it's not acceptable to society as a whole. You don't have to be degrading about it, but they should be made to feel self-conscious about such actions in public at very least. One man's humiliation is simply another man's definition of self-awareness. If you feel humiliated for it, then obviously you were doing something wrong in the eyes of your social circle and need to reconsider what you are doing before it harms (or continues to harm) you and those around you.

 

[HNcorpsman]

i honestly dont think anyone does this job for the paycheck... most everybody that gets into EMS at least INITIALLY likes medicine, and enjoys caring for people...

i think it is actually pretty rude to say EWW GROSS!! when the PT can here you... kinda messed up... but at the same time i dont think we need to treat them like a god...

 

[usafmedic45]

i honestly dont think anyone does this job for the paycheck... most everybody that gets into EMS at least INITIALLY likes medicine, and enjoys caring for people...

Well, seeing as a good percentage of us make/made decent money in EMS, I would not doubt that there are a fair number of people who are doing it for money especially in combination departments. It's not a job where you are going to get rich, but most people don't starve doing it either.

However, I do agree that most of us do come into the field with the same lofty aspirations. I was speaking more to those amongst us who have burned out and remain in EMS because it's a job. It's a problem in more fields than just EMS including some that make a lot more money than paramedics do such as respiratory and nursing. It is not an uncommon refrain to hear people in both fields say things about how much they hate their job but they wouldn't give up the paycheck. It seems to be especially common in RT since we lack the exceedingly easy lateral and upward mobility and plethora of opportunities afforded nurses.

 

[DrankTheKoolaid]

re

Whats the T-Shirt say?

Trained to save your ***, not kiss it.

But i agree, if you have to get an oh gross out of your system at least TRY not to do it within earshot of the patient

 

[Hal9000]

Don't think less of me for what I have witnessed.

I know some people on a volunteer service (And I work with them, though I also work for a very large paid professional service.) that are more interested in "power" (Isn't that twisted?) than progressive medicine, proper education, or acceptable patient care. That gets my goat more than anything else.

Here are some quotes that I have heard from them and their students:

"What, are you scared of a little blood?" (Regarding blood on a patient's PCR.)

"They just have to know how to pass the test; it doesn't matter what the studies say."

"It's our policy to go lights and sirens to everything for public perception reasons." (Including IFTs...)

"We show code so that the patient's relatives think we're helping."

"We're not professionals. We're a volunteer service and we're just a group of people."

"Our CPR rate is always 15:2 per our local protocol." (Um, no, it's not, ever.)

"Immediately give anal glucose or vaginal glucose because it absorbs faster and ALS can be avoided." (I believe in regards to D50.)

"We always use PASG per local protocol." (Incorrect again.)

Regarding a student that failed a class and dropped out, coming from the student who I refused to let do observation time...as she showed up three months after failing/dropping from the class:

"The instructors said I could observe until the class next year and I'm just part of the two-year program they said so I can observe anytime I want and you can't stop me. And I'm going to be an instructor for next year's class, they said!" (Um...you're not even an FR. This is NOT acceptable in any way whatsoever. And there is no 2 year program. You failed and now they think you're just going to hop on an ambulance and screw around...well, it's not a game, sorry.)

Another student failed their class and went away for a year to another state on allegations of domestic abuse. He came back a year later to run observation times. He claimed to be 47 and said he had been in the marines, navy, and army, and that he was a Vietnam combat vet. He had no job, no address, and no phone, and stated he was very familiar with illicit drugs. He also looked very shoddy, though you can't accurately judge a person on looks...but three teeth and always smoking and not tying shoes and wearing wife beaters is suggestive. He stated that he had three years of premed, which he most certainly did not.

Anyway, he came back and they said he was going to observe indefinitely, as he "had the appropriate training." Mmmhmmm....

These people also cheated on state practicals for students that would have failed so that they instead passed. This was done by remarking missed critical fails, and by having a proctor take the students outside during testing to teach them how to pass the exams.

Another quote, "The class isn't supposed to teach them how to be EMTs."

I also found out that they've been teaching other services "ALS endorsements for basics." These include basic medications. Amazingly, one of them HAS NO MEDICATION ENDORSEMENT! They also did not know that D50 could cause necrosis and when I demonstrated a LuerLok system stated that they'd never seen it before. Furthermore, they were doing IVs using the same NaCl bag for an entire class and didn't know what a catheter embolism was, and were using catheters expired over 4 years prior.

If you are also wondering, "SharpsShuttles just clutter up jumpkits and are heavy and don't need to be carried."

Ok, so that was for an obviously scary place. I've also seen fairly bad at a professional company. Upon cardioversion of a seizure patient, a paramedic remarked that another paramedic was providing very poor patient care. She was told to never talk about it, because a "paramedic is a paramedic."

Anyway, I've seen some particularly disturbing things occur in both large and small services. If I had time to type them all out...please don't run away from me. I've also worked with some of the best Medics, EMTs, and nurses you could imagine.

 

[irish_handgrenade]

ive almost thrown up a few times in the truck, i have this thing about snot especially with a big glob of it is hanging out of someones mouth or gurgles up out of their trach. Just so you know its not just us that have those insensitive types, I ran into a nurse in Brownwood Texas that is mean and heartless and talks crap about every patient she gets in the ER, sometimes in front of the patient. She disrespected a patient I brought in that had obvious MHMR history and was openly making fun of him, and laughing at him. Then she went to the nurses station today and started talking about a triage patient that came in on the ambulance because he was crying in triage. I have run into lots of RNs, EMTs, and Medics that behave this way and all of them should find another career. The health care industry doesn't need people like that, but understand the occasional slip of the tongue can be excused as long as its not intentional and hateful.

 

[Ridryder911]

I believe if we outlawed l/s we would loose 3/4 of those in EMS. Personally, I feel about 25% chose EMS because they have failed the fry test at McDonald's. True most do not do it for the money but it is a good thing that they don't do it for per basis of patient care and knowledge. Yes, a majority are on company time for many hours but you will notice I did not state they are working. I have seen many work harder to attempt to get out of work, just look at their units and patient compartments. Then look at their uniforms, many times unkempt, wrinkled, shirt tails out, boots scuffed and no that red stain is not blood but rather ketchup.

I agree the majority are in it only for themselves and in comparison to the ratio of other healthcare providers, yes very much more for their self ego. Who else wears their profession in 6'' block letters on the back of their shirt (off duty) and just how many autos do you see that have RT, Radiology Tech or even MD on the back of the car window?

If we really attracted caring and those that wanted to provide medical care, there would be no debate upon a requiring a degree before entering EMS, just alike every other health care profession requires. We would require that our reading level would be greater than 10'th grade and screening would be a normal process and there would never ever be just "one text book" and at that written below college level.

There would be no discussion about placing a patient on a bedpan or questioning the need of foley's, as it is just another warranted medical procedure. Amazing as long as it appears cool we have no problem performing it but see how many would guaiac/hemoccult to verify a GI bleed they would explode..... again majority is just full of ego's.

That's is what EMS usually attracts... ego's or those want to be firefighter (which is usually more inflated ego's).

R/r 911

 

[HNcorpsman]

sure, sure that might be the reason they get INTO EMS, but who says that they cant change? honestly i was attracted to EMS because of the "thrills" so i went to an EMT-B course and i liked it, but not because it was a thrill, i was extremely interested in medicine and i retained the information like nothing else before.. so i joined the navy to be a corpsman, and have done all kinds of medicine, from working in labs, X-ray, neurosurgery, and being with marines taking care of common sicknesses and illnesses, no emergency here, but i still love it. i think its the same with MOST of our EMS. thats my opinion though. i also got into EMS with goal of becoming a firefighter, but i loved medicine so much that i just wanna become a paramedic, maybe a nurse.

 

[Brandon O]

Anyway, I've seen some particularly disturbing things occur in both large and small services. If I had time to type them all out...please don't run away from me.

Hal, I hate to sound bloodthirsty, but have you considered whistleblowing on this group to your state EMS office? I realize there's such a thing as sweeping up the beach, but some of that sounds beyond the pale.

 

[SeeNoMore]

I notice that homophobia and sexism (when a woman is not present) is very prevelant and treated far more casually than say racist remarks and jokes. Not that these are all entirely the same, but the basic idea of respect is.

I don't want to be too hard on people as I have never seen this happen during patient care, and I know the job builds up a lot of stress and humor, often dark, is a good way to blow off steam.

But as a straight seeming Gay man, I have been in some situations already where I felt very uncomfortable. Not to derail the subject, just an observation. Part of the blame must go to me as I should speak up if I feel this way, but somehow outing myself and seeming overly senstiive seems like a bad idea.

In a perhaps similar vein, I have not gotten used to the ridicule that sometimes falls upon patients who abuse substances, have unsavory personal hygiene, mental health issues or are generally in a bad way. Again not during contact, but afterwards. But this I suspect is just part of the job, so I usually just walk away. And as I have not worked in EMS very long, I don't want to second judge those who have dealt with difficult patients day in and out.

 

[el Murpharino]

and just how many autos do you see that have RT, Radiology Tech or even MD on the back of the car window?


R/r 911

Doctors do have license plates they can order...but they are for an actual purpose - you need to provide proof of licensure to the DMV...these are not some sticker to hopefully get out of a speeding ticket or impress 16 year old girls at the volly squad.

The EMS culture is just that, a subculture that is undergoing growing pains. There are the few that take this seriously, as a profession, and treat it as such. On the other hand are the ones who think of EMS as a hobby, train only on car wrecks and cardiac arrests, and show up promptly for only those calls hoping to get their picture in the paper or be the hero of the day so they can look in the mirror the next day and say "damn I'm good" while finding the cleanest wife-beater out of the hamper to wear that day.

 

[VentMedic]

i honestly dont think anyone does this job for the paycheck... most everybody that gets into EMS at least INITIALLY likes medicine, and enjoys caring for people...

It takes very little training to get a job on an ambulance so yes it is an easy paycheck for someone who doesn't want to flip burgers right out of high school. For some the idea of actually having to go through 2 or 4 years of college is ridiculous when EMT(P) mill ads say "you too can do all this cool stuff in just a few weeks of training". Some even come out of these PDQ marts believing they are on par with a doctor and way above the RN.

Doctors do have license plates they can order...but they are for an actual purpose - you need to provide proof of licensure to the DMV...

Those are usually quickly removed after the first time the doctor or their spouse who happens to be driving the car with those plates are victims of a carjacking or robbery. Many spouses have been seriously injured by the doctor's vanity plate. Thus, if you look in many physician parking lots, you will not see very many of these plates. Some don't even like the parking lot decal and will opt for the one that can be removed from the dash when not on hospital property. Many lots will have an entry card for the doctors to carry and eliminate the whole tagging of the car situation.

these are not some sticker to hopefully get out of a speeding ticket or impress 16 year old girls at the volly squad.

But the stickers do serve a great identifying purpose when one must do their civic duty and report someone driving like an idiot in their POV to the PD. They are usually just showing off for their passengers because they are an "ambulance driver" or they want to feel important to others on the highway. One can only imagine what they do behind the wheel of an ambulance.

 

[VentMedic]

It seems to be especially common in RT since we lack the exceedingly easy lateral and upward mobility and plethora of opportunities afforded nurses.

That is not exactly true today. Now that the degree is required, few are viewing RT as just an easy job to get when nothing else is available. As well, the educational foundation does give them the opportunity to easily go into another field or be upwardly mobile. We even have RTs who are managers over various nursing units. As well, we now have more opportunity to specialize. When the Bachelors in RT is recognized by the legislation for the insurances, even more opportunities will come about. I do believe the plans laid out for it as presented to the legislators will fit nicely into any future healthcare plan.

But, again, it is the education that has set the professionals apart from those that just want to do their job and get a paycheck. If you want to be upwardly mobile, get an education.

As far as other mobility, the RRT can travel anywhere in the U.S. just as the RN. Canada is more difficult unless you have the Bachelors since their education stanards are still higher than the U.S.

 

[Cory]

I think the problem would be solved if more EMT-B's just followed through with all of their training to beocme EMT-P. Like I have said before, I have no interest in speeding down the freeway in my shiny red truck, I just wanna help people when they need it most. Being a prarmedic is a dream of mine, being an EMT who gets sent out to fight fires is not. I have plenty of family who are fire fighters, hell I practically grew up in a fire house for a few years when I was younger. But even then my want is to be a paramedic. And if I could join a good private company around here, I would. But sadly the ones in my area only do IFT, which I do not want.

As for volunteers, they have saved the buisness in many ways. Here in Cincinnati, they are going to lay off almost all paid FD employees at the end of this year if they don't agree to work 3 day weeks. But the volunteers stay. IF it wasn't for them, the city would have to burn down if there was a fire.

 

[medic417]

As for volunteers, they have saved the business in many ways. Here in Cincinnati, they are going to lay off almost all paid FD employees at the end of this year if they don't agree to work 3 day weeks. But the volunteers stay. IF it wasn't for them, the city would have to burn down if there was a fire.

Actually the volunteers are hurting the profession. Them being there is allowing the city to play hardball with peoples lives and livelihood. If there was no one saying hey I'll do it free you can bet the city would find the money to keep the paid people on 24/7. Why should they pay when people do it for free?