Want professional respect?

[mycrofft]

Then we need to lose the paramilitary/fire dept image and thought streams. The second step (after appropriate education/certification) is to act like it.

I know the chances to play dress-up, "run hot" to "code-3 dispatches", buy and carry knives and surgical instruments to perform heroic rapid dramatic action are strong recruitment incentives, as well as tossing around unnecessary macho jargon and driving like banshees. But do they promote internal, public and profesional respect? Are they the signs of someone who will drive and act responsibly, mindfully?

Yes, sometimes some jobs require boots, Kevlar knee protectors, helmets, maybe even SCBA, but what if these were alternatives and adjuncts to say khaki pants, a button-front shirt (maybe a good clip-on tie), and a short lab coat?

Who will management tend to take more seriouusly, people with the piercings and tattoos from "Pirates of the Carribean" or someone who looks like they carry their respect within?

Want to see two of the most historically successful uniforms ever? Here they are:

Here's another couple:

I'm not saying go with cassocks and habits, but The Image and the care and wear of the uniform, the conduct, the language give the bearer strong "psychological judo", and tend to confer respect (if sometimes only respectful curiosity).

Act, drive and look mindful.

 

[DrankTheKoolaid]

Absolutely, ive always thought the paramilitary structure was an absolute joke and insult to real soldiers. They want to play Captain then pick up a weapon and get off their arse and easy chair and go do something truly worthy of using the title.

Nobody else in medicine uses anything like it and that is probably for a reason....

 

[Outbac1]

Well put!

 

[Christopher]

...(after appropriate education/certification)...

Taken from a public comment regarding loss of scope with transitions to new provider levels:

"Don't get me wrong I don't have a problem training learning is a good thing .but you have to see our side to ,I have been certified in ACLS for 8 yrs and running codes,and pushing morphine for when my pt's are in extreme pain.And now all of a sudden I am not going to be able to do these things."

Yeah...we probably need to fix the educational standards and with it we'll get some more professionalism.

 

[NYMedic828]

Taken from a public comment regarding loss of scope with transitions to new provider levels:

"Don't get me wrong I don't have a problem training learning is a good thing .but you have to see our side to ,I have been certified in ACLS for 8 yrs and running codes,and pushing morphine for when my pt's are in extreme pain.And now all of a sudden I am not going to be able to do these things."

Yeah...we probably need to fix the educational standards and with it we'll get some more professionalism.

My word. Certified in ACLS 8 years? That is one heck of an accomplishment.

 

[Veneficus]

a worthy topic indeed (no sarcasm)

I think it is interesting that you managed to pick 2 of the 3 classic professions. (lawyers being the 3rd)

I recently had a discussion with a colleague that uniforms and name tags do not make up for low quality medical care. It is just a gimmic to try and cover it up.

I think the same could be said about uniforms and paramilitary emergency organizations. But I think there are 2 things worth considering here that may mitigate that.

1. Whether government or private, EMS providers are seen as public officers by virtue of their uniform and being part of the 911 system. People would react far differently if 2 people without a uniform showed up in an unmarked truck they dialed a regular number for.

2. Whether we like it or not, or admit it or not, EMS does have strong ties to the FD. (In some places the PD) those are public services. As in "servants." A doctor or a lawyer serve people, certainly a priest does. But society doesn't consider them such.

It is an exclusive club. I would even call it a guild. I have been to places where paramedics do not exist. Neither do RTs, PAs, etc. But a doctor, lawyer, and clergy of any religion is universal. (so is a nurse for that matter, but not considered a classic profession) Not based on some school or job description, but on the sociological value and universal respect.

This very evening I was discussing the lack of comraderie in EMS. Think about it, if an EMS provider is a substandard, they are targeted by other EMS providers and in the event of influence outside of EMS, such as a court or licensing body, they are cut loose on their own. Contrast this to the classic professions. A priest could molest a little kid but other priests protect them. An assault on the ability or position of even the most incapable doctor is treated as an assault on all doctors, and defended as such. Lawyers are probably one of the least liked members of society, but from President, to lawmakers, to "paper attorneys" they are almost impossible to disbar. In the case of politicans, it is more common I'll admit, but at that point they are also public servants and the public can hold them to account to their standards, not just lawyers.

Here in Europe, in many countries, paramedics and EMS professionals wear high visibility clothing designed for safety. Ugly as sin, but certainly functional. During conferences I have attended, award ceremonies, etc. they give this up to don formal wear. 3 piece suit and tie (just like a lawyer) is the proper attire.

I have nothing against uniforms, I have worn more than a handful. But now I cannot even tell you the last time I put on a white coat. There really is no reason to other than outsider recognition. (more on this later)

I think uniforms are ingrained in US EMS tradition. At the last place I taught as an EMS instructor a new instructor (who was also a fire officer) even formally wrote me up for not wearing my "instructor shirt." (which is nothing more than a Polo that says "faculty" on it.) His comment when the write-up went nowhere was: "I didn't even know he was an instructor until he started talking, I thought he was a student."

(back to recognition) When I started doing my job, despite lack of a "uniform" there was no doubt what my role was and my ability at it.

The uniform of EMS is simply for illusion. The illusion of a public safety officer. (when in fact they are acting as healthcare providers) The illusion of excellence. (when in fact many of the practices are actually questionable if not outright detrimental) The illusion of power (this person is in command or control of what is happening on scene or what a disease does to a patient) The illusion of professionalism. (even the most liberal protocols are dictates from a physician in the US) For that matter ( there is no large body of knowledge required to be a US EMS provider and all paths end in transport to a hospital or refusal)

I do not agree that only soldiers should be paramilitary. The FD needs to be. A police force needs to be. Even a band of mercenaries needs to be. Militia Captians, Fie Captians, Police Captains, Airline Captians, and Ship Captains, were not only called such from their inception, but still are today. In environments where there has to be an authority for the benefit, safety, and filling the "mission" requirements, somebody has to be the captain.

 

[JPINFV]

This very evening I was discussing the lack of comraderie in EMS. Think about it, if an EMS provider is a substandard, they are targeted by other EMS providers and in the event of influence outside of EMS, such as a court or licensing body, they are cut loose on their own. Contrast this to the classic professions. A priest could molest a little kid but other priests protect them. An assault on the ability or position of even the most incapable doctor is treated as an assault on all doctors, and defended as such. Lawyers are probably one of the least liked members of society, but from President, to lawmakers, to "paper attorneys" they are almost impossible to disbar. In the case of politicans, it is more common I'll admit, but at that point they are also public servants and the public can hold them to account to their standards, not just lawyers.

...and the Catholic Church has distanced themselves from numerous faithful and have made themselves almost a social pariah due to them hiding child molesters. When medicine sticks together, it's almost always for the benefit of those not under suspicion. For example, in the Dr. Conrad Murray/Michael Jackson case, no one was defending Dr. Murray against any malpractice complaint. Just that his level of incompetence didn't amount to a crime. He was still going to kiss his medical license bye bye though.

 

[DrParasite]

Yes, sometimes some jobs require boots, Kevlar knee protectors, helmets, maybe even SCBA, but what if these were alternatives and adjuncts to say khaki pants, a button-front shirt (maybe a good clip-on tie), and a short lab coat?

yeah, it might look good during a a conference, but how functional is it for daily work?

Who will management tend to take more seriouusly, people with the piercings and tattoos from "Pirates of the Carribean" or someone who looks like they carry their respect within?

I counter that with

and http://www.istockphoto.com/stock-photo-20420110-portrait-of-a-tattooed-doctor.php

Want to see two of the most historically successful uniforms ever? Here they are:

Here's another couple:

I'm not saying go with cassocks and habits, but The Image and the care and wear of the uniform, the conduct, the language give the bearer strong "psychological judo", and tend to confer respect (if sometimes only respectful curiosity).

And yet, the "doctor's" uniform is actually the white coat, and nothing more. you can wear a tshirt and jeans under it, and as long as you have the lab coat on, it's "uniform." not only that, but that's more of the "dress" uniform. want to see their work uniform?

no tie, no suit, not even a collar.

Cops have the blue wall of silence, and in recent years, have been getting a lot of crap for covering up negative events. Ditto the Catholic church. While they did protect the molesters, when the news did break, how much :censored::censored::censored::censored: were they given?

You know why a doctor's labcoat confers respect? it's not because of all the schooling the wearer went through. it's not because he wears a tie underneath it. it's because of what doctors hundreds of years before him did, and went through, and society has found value in the services his kind and those before him offers. He's just a large lab coat, and easily replaceable with someone else in a large lab coat, but the idea is that everyone you replace him with is just as much an expert as the person before him, and the doctors who wore that same coat 100 years ago. Great mental conditioning if you ask me.

 

[VFlutter]

I think the EMS "mentality" is holding us back much more than the uniforms. I do not think the current uniforms have anything to do with it. There is nothing wrong with EMS pants and a polo work shirt.

Professionalism is much more than what a person wears. I wear scrubs at work, which is more casual than an EMS uniform, and have never had someone question me being a professional. That is because my patients recognize that I am competent and skilled provider by the way I carry myself. My patients would quickly realize if I was substandard. I do not see how wearing a dress shirt and tie would add anything to that. You can't polish a turd and now matter how professional a person appears they still must be able to communicate and perform their job at an acceptable level.

^ If this guy jumped in the back of an ambulance to take care of me I would think that he looks like a "professional" but that attitude would quickly change when he asks to backboard me for some stupid reason or wants to slap a NRB on me because its protocol.

 

[medic417]

Mycroft your wasting your time. As seen in the ridiculous prank threads there are to many unprofessional people in our field to ever get things cleaned up.

 

[DrParasite]

This very evening I was discussing the lack of comraderie in EMS. Think about it, if an EMS provider is a substandard, they are targeted by other EMS providers and in the event of influence outside of EMS, such as a court or licensing body, they are cut loose on their own.

guilty until proven innocent is very common in EMS. if someone files a complaint against you, it's up to you to prove the complaint is false, and if its your word vs an outsider (or worse, your partner), if you can't prove you did nothing wrong, than you will be subjected to discipline. Than again, many of those "other professions" week out substandard providers, either in the initial training or probationary period.... not so in EMS.

Here in Europe, in many countries, paramedics and EMS professionals wear high visibility clothing designed for safety. Ugly as sin, but certainly functional. During conferences I have attended, award ceremonies, etc. they give this up to don formal wear. 3 piece suit and tie (just like a lawyer) is the proper attire.

you know, the last two conferences I attended (for a non-emergency services item), there were some people in t-shirts, some in polos, some in button downs and some in 3 piece suits. As an attendee, especially as an anonymous attendee, wear a t shirt and jeans, learn what you can, it doesn't matter.

If you are wearing a polo shirt in at an EMS conference, I think that's appropriate. if you want to wear a T-shirt from your agency (and I have), that's not as professional, but still acceptable, especially if that is your uniform. Very few were actual button down shirt uniforms.

I have nothing against uniforms, I have worn more than a handful. But now I cannot even tell you the last time I put on a white coat. There really is no reason to other than outsider recognition. (more on this later)

and yet, that is how one historically recognizes a doctor.

I think uniforms are ingrained in US EMS tradition. At the last place I taught as an EMS instructor a new instructor (who was also a fire officer) even formally wrote me up for not wearing my "instructor shirt." (which is nothing more than a Polo that says "faculty" on it.) His comment when the write-up went nowhere was: "I didn't even know he was an instructor until he started talking, I thought he was a student."

(back to recognition) When I started doing my job, despite lack of a "uniform" there was no doubt what my role was and my ability at it.

He was right. As an instructor/educator/professional, you should ALWAYS be dressed equal or one step above your students. If your institution requires a polo that says instructor, wear it, so everyone knows you are the instructor (duh).

The last class I ran I came the first day in a suit and tie. standard uniform was khakis and the agency polo. I felt like dressing up, so everyone knew I was not a student. Not only that but almost every professor in college (well, the phd ones, not always the adjunct) wore a button down shirt, and the history ones were almost always in ties and a jacket. Maybe they were onto something? Appearances do matter in this world, whether you want to admit it or not (hence most people wear suit and ties to job interviews, depsite being completely qualified).

The uniform of EMS is simply for illusion. The illusion of a public safety officer. (when in fact they are acting as healthcare providers) The illusion of excellence. (when in fact many of the practices are actually questionable if not outright detrimental) The illusion of power (this person is in command or control of what is happening on scene or what a disease does to a patient) The illusion of professionalism. (even the most liberal protocols are dictates from a physician in the US) For that matter ( there is no large body of knowledge required to be a US EMS provider and all paths end in transport to a hospital or refusal)

ehhh, can we agree to disagree based on current standards and practices set by the doctors who oversee programs and set protocols?

I do not agree that only soldiers should be paramilitary. The FD needs to be. A police force needs to be. Even a band of mercenaries needs to be. Militia Captians, Fie Captians, Police Captains, Airline Captians, and Ship Captains, were not only called such from their inception, but still are today. In environments where there has to be an authority for the benefit, safety, and filling the "mission" requirements, somebody has to be the captain.

what he said.

 

[RocketMedic]

I personally like the dress shirt/trauma pants "uniform", patches and all. I think that we should have visible affiliation with our agency, name, and position details, and I think that those standards should be maintained (both crew members should generally match).

Mycrofft, your statement is correct, but doctors, lawyers and clergymen do not often find themselves in uncontrolled environments. Being able to tell who someone is by reading patches and a nametag is a valuable organizational tool that the fire service, police and EMS have established. Even the military does this.

Is it overdone? Absolutely. But in the grand scheme of things, I think that EMS should concentrate on bringing respect to the uniform instead of sucking respect from another profession.

Also, lab coats suck.

 

[Veneficus]

.He was right. As an instructor/educator/professional, you should ALWAYS be dressed equal or one step above your students. If your institution requires a polo that says instructor, wear it, so everyone knows you are the instructor (duh).

Who said I wasn't dressed equal or better?

Actually, the reason it went nowhere is because it is a very large institution with many departments and there is a policy for "suitable teaching attire" which is spelled out and permits a division Polo shirt as well as several other options.

I had taught previously that day at another part of the institution and had no intention of brringing an extra shirt when I was well within the SOP.

I really think it was an ego thing on his part.

.ehhh, can we agree to disagree based on current standards and practices set by the doctors who oversee programs and set protocols?.

If we must, but fear and laziness do not excuse them in my view.

 

[DrParasite]

my apologies, based on your description of the complaint, I assumed the policy required the instructor shirt to be worn, and based on his statement that he thought you were a student, I figured you were in a t-shirt and jeans (or whatever else the students were wearing that day). With the additional information, it definitely sounds like ego on his part, esp if you were in compliance with the policy.

 

[mycrofft]

I think the EMS "mentality" is holding us back much more than the uniforms. I do not think the current uniforms have anything to do with it. There is nothing wrong with EMS pants and a polo work shirt.

Professionalism is much more than what a person wears.

^ If this guy jumped in the back of an ambulance to take care of me I would think that he looks like a "professional" but that attitude would quickly change when he asks to backboard me for some stupid reason or wants to slap a NRB on me because its protocol.

Can't disagree with you, but how you dress and act elicits reactions from others. Also, it can engender a type if mindset; I feel different in a buss full of people (myself included) in BDU's than a bus full of folks wearing dress blues.

Bernie Madoff had some really fine suits and it made him millions, without substance at all.

 

[mycrofft]

I personally like the dress shirt/trauma pants "uniform", patches and all. I think that we should have visible affiliation with our agency, name, and position details, and I think that those standards should be maintained (both crew members should generally match).

Mycrofft, your statement is correct, but doctors, lawyers and clergymen do not often find themselves in uncontrolled environments. Being able to tell who someone is by reading patches and a nametag is a valuable organizational tool that the fire service, police and EMS have established. Even the military does this.

Is it overdone? Absolutely. But in the grand scheme of things, I think that EMS should concentrate on bringing respect to the uniform instead of sucking respect from another profession.

Also, lab coats suck.

Like the New World and African and Asian missions, inner city and frontier areas? WHen public health nurses wore a distinguishable uniform (flight cap, slacks and a coat over a shirtwaist) they used to experience a near-immunity from rape, assault and theft. Now, they're easy pickin's.

 

[mycrofft]

You know why a doctor's labcoat confers respect? it's not because of all the schooling the wearer went through. it's not because he wears a tie underneath it. it's because of what doctors hundreds of years before him did, and went through, and society has found value in the services his kind and those before him offers. He's just a large lab coat, and easily replaceable with someone else in a large lab coat, but the idea is that everyone you replace him with is just as much an expert as the person before him, and the doctors who wore that same coat 100 years ago. Great mental conditioning if you ask me.

LOVE the "Dr Lex Luthor" photos!
As for the above, not every doctor is the same (replaceable), and phoneys like Bernie Madoff used clothing to convey an image of respectability and trustworthiness with great success; ehat if we can use that tool "for the Good of Mankind"?

And yeah if you are going to get covered with mud, diesel fuel, brains and vomit, you ought to wear something over or as well as "business casual". I frankly hate working in polos, they snag and stretch and show sweat. The lab coat IS a form of PPE, just not adapted for SAR or extrication.

 

[RocketMedic]

I'm fairly certain that mass rape of female health care providers is a lot more about broken cultures than it is about uniforms.

It's a lot easier to direct traffic at an MCI or know who is a member of what unit with a patch, and like it or not, the current EMS 'uniform' is actually pretty practical for the job we do.

 

[mycrofft]

I'm fairly certain that mass rape of female health care providers is a lot more about broken cultures than it is about uniforms.

It's a lot easier to direct traffic at an MCI or know who is a member of what unit with a patch, and like it or not, the current EMS 'uniform' is actually pretty practical for the job we do.

2. ANSI vest? Not Kevlar, belts studded with titanium folding tactical tomahawks, or EMS stars tattoos on the neck. There IS no uniform, it is a district by district deal and unevenly enforced at that.

1. You have a point, but even in "the good old days" there were drunks and sociopaths galore. It was a point of cultural conditioning, and that's undercut every time someone with the uniform does something unprofessional.

My point still stands. If you want absolute personal freedom in appearance, be a hobbyist. If you want to elicit respect, you have to create an image and live up to it. Even "Johnny and Roy" didn't run around in turnouts or bunkers.

 

[RocketMedic]

2. ANSI vest? Not Kevlar, belts studded with titanium folding tactical tomahawks, or EMS stars tattoos on the neck. There IS no uniform, it is a district by district deal and unevenly enforced at that.

1. You have a point, but even in "the good old days" there were drunks and sociopaths galore. It was a point of cultural conditioning, and that's undercut every time someone with the uniform does something unprofessional.

My point still stands. If you want absolute personal freedom in appearance, be a hobbyist. If you want to elicit respect, you have to create an image and live up to it. Even "Johnny and Roy" didn't run around in turnouts or bunkers.

Oh, you mean those people. Tattoos, (im)practical Kevlar, tool belts heavier than Batman's, and ineffective/impractical weapons are silly things to have. I have a white shirt with certification and agency patches, pockets of which have a few note cards, pens, a penlight, cell phone, a carpuject (lucky charm from Iraq). Pants are trauma pants with trauma shears (normal ones), a tape roll, a hemostat (for splinters), a small reference guide, my pager and wallet, and a spare pair of gloves, and keys. I also carry a knife in my pocket for utility things.