Who knew?

[eprex]

Just a rant here. I had debated becoming an EMT before because I thought it would be fun- so far it has been. But I had originally decided against the endeavor because I had read some shocking stories online. Responding to a rape victim and it's your friend, things of that nature.

Instead the only trials and tribulations I've dealt with at a private EMS company are an incredibly incompetent group of individuals and all the serious, exciting calls being sent to the fire department.

Don't get me wrong, I don't have to put up with half the stuff newcomers do in fire departments; there are no call quotes nor hazing or slave-driving. But it's going to take everything I can give to raise the bar and fight complacency.

Anyone in a similar situation? I'm a volunteer so I know paid positions are more professional.

 

[mycrofft]

Pick your fights, and remember that you may still have a lot to learn; is this the place to learn it?

 

[leoemt]

Not all "exciting fire calls" are exciting. They go to more BS then we do - we just transport their BS patients.

 

[Veneficus]

Even though it may seem like the grass is greener on the other side, permit me to give you some perspective.

Even the "exciting 911" service gets really monotonous after about 2 years.

In all of EMS in the US and infact Emergency Departments (which see much higher volumes of patients than ambulances) only about 5% are life threatening emergencies on average.

In the modern developed world, we see more exacerbation of chronic conditions than acute conditions. Which means you are more likely to see "sicker" patients while doing interfacility work than 911 response.

Those patients will also be more complex cases. (I like complex cases)

The area you work in also makes a difference. The lower the socio-economic level, the more emergencies you will see. However, many providers don't like these populations because they call often for everything because they do not have the knowledge to know what is an emergency and what is not. They are generally non-compliant with treatment for a variety of reasons, and most of their problems are either preventable or socially unacceptable in middle and higher levels of society.

Very few have the fortitude to have long term careers in such an environment. They are usually very admired by most of their peers and colleagues.

If you got involved with EMS for the exciting guts and glory, I think you will be very disillusioned.

You cannot change what you have gotten into, but you can change your perspective of it.

Look for small victories. A great success is best measured by how much you help somebody, not what medicine you provide. The most amount of help doesn't come from a drug or a procedure, it comes from making people feel better. What you say, how you say it.

People never remember providers for their medical capability, patients remember and celebrate how the provider made the patient feel.

Welcome to medicine.

 

[mgr22]

You volunteer at a private EMS company? I've never heard of that.

I see you're a student. You might be right about everything you're saying, but it's also possible that you don't know enough yet to judge the competence of your coworkers. On a more practical level, how do you see yourself being able to "raise the bar"? Wouldn't you need to build some relationships and acquire some knowledge first?

Perhaps you just need to give your current job more time.

 

[chillybreeze]

Even though it may seem like the grass is greener on the other side, permit me to give you some perspective.

Even the "exciting 911" service gets really monotonous after about 2 years.

In all of EMS in the US and infact Emergency Departments (which see much higher volumes of patients than ambulances) only about 5% are life threatening emergencies on average.

In the modern developed world, we see more exacerbation of chronic conditions than acute conditions. Which means you are more likely to see "sicker" patients while doing interfacility work than 911 response.

Those patients will also be more complex cases. (I like complex cases)

The area you work in also makes a difference. The lower the socio-economic level, the more emergencies you will see. However, many providers don't like these populations because they call often for everything because they do not have the knowledge to know what is an emergency and what is not. They are generally non-compliant with treatment for a variety of reasons, and most of their problems are either preventable or socially unacceptable in middle and higher levels of society.

Very few have the fortitude to have long term careers in such an environment. They are usually very admired by most of their peers and colleagues.

If you got involved with EMS for the exciting guts and glory, I think you will be very disillusioned.

You cannot change what you have gotten into, but you can change your perspective of it.

Look for small victories. A great success is best measured by how much you help somebody, not what medicine you provide. The most amount of help doesn't come from a drug or a procedure, it comes from making people feel better. What you say, how you say it.

People never remember providers for their medical capability, patients remember and celebrate how the provider made the patient feel.

Welcome to medicine.

What Vene said.....I couldnt of said it better!

 

[eprex]

You volunteer at a private EMS company? I've never heard of that.

Yes, I do.

I see you're a student. You might be right about everything you're saying, but it's also possible that you don't know enough yet to judge the competence of your coworkers. On a more practical level, how do you see yourself being able to "raise the bar"? Wouldn't you need to build some relationships and acquire some knowledge first?

Perhaps you just need to give your current job more time.

I'm not complaining that my colleagues aren't stellar EMT's who know exactly what's going on with the patient when we do our assessment or that they don't have the knowledge a nurse or doctor may have. I'm talking about certified techs who don't know how to use the radio, locate equipment on the ambulance, don't call medcom half the time, don't know how to use equipment, stand and watch as other people struggle to help the patient, forget to get medications... I mean the list goes on and on. That's besides all the personal issues going on but I know that happens everywhere.

I don't need to be a certified tech to see that this is an issue. It comes down to the company having poor leadership, little to no rapport, and no personal motivation to raise the bar.

How can I raise the bar? Instead of watching movies on my shift I can make sure the rigs are checked, I can continue to study, I can set an example and train newcomers, I can do my best to notice bad habits from others and not take part.

 

[eprex]

Even though it may seem like the grass is greener on the other side, permit me to give you some perspective.

Even the "exciting 911" service gets really monotonous after about 2 years.

In all of EMS in the US and infact Emergency Departments (which see much higher volumes of patients than ambulances) only about 5% are life threatening emergencies on average.

In the modern developed world, we see more exacerbation of chronic conditions than acute conditions. Which means you are more likely to see "sicker" patients while doing interfacility work than 911 response.

Those patients will also be more complex cases. (I like complex cases)

The area you work in also makes a difference. The lower the socio-economic level, the more emergencies you will see. However, many providers don't like these populations because they call often for everything because they do not have the knowledge to know what is an emergency and what is not. They are generally non-compliant with treatment for a variety of reasons, and most of their problems are either preventable or socially unacceptable in middle and higher levels of society.

Very few have the fortitude to have long term careers in such an environment. They are usually very admired by most of their peers and colleagues.

If you got involved with EMS for the exciting guts and glory, I think you will be very disillusioned.

You cannot change what you have gotten into, but you can change your perspective of it.

Look for small victories. A great success is best measured by how much you help somebody, not what medicine you provide. The most amount of help doesn't come from a drug or a procedure, it comes from making people feel better. What you say, how you say it.

People never remember providers for their medical capability, patients remember and celebrate how the provider made the patient feel.

Welcome to medicine.

You're absolutely correct, I agree, and that's why that was a side comment in my rant. I joined EMS because it looked fun and it is. No I didn't go in expecting to save lives or to be a hero specifically because I did my research before joining. I was on this forum before I even started the EMT course.

But to be fair, my company gets little to no trauma. It all goes to the fire departments and I know because we hear it over the radio. It's only after 11pm that we are on the 911 system and those calls are largely sick patients.

 

[Veneficus]

But to be fair, my company gets little to no trauma. It all goes to the fire departments and I know because we hear it over the radio.

So?

What do you think they do for it?

Basically nothing that maks a difference other than give the patient a lift to the hospital.

It's only after 11pm that we are on the 911 system and those calls are largely sick patients.

Did you know that 1/2 of trauma is the effects of systemic inflammatory process?

If you are taking septic patients out of nursing homes, you are actually seeing more exposure to the illness caused by trauma than the guy trying to maintain O2 delivery.

If you get a septic shock patient from that nursing home, you are getting 100% ofthe pathology caused by trauma.

I'll even go one further and say that because of the amount of trauma involved in complicated OB, both to the mother and the child, Specialty Neonatal Transport probably sees more trauma and does more for it than any other subdivision of EMS.

If trauma excites you, EMS is not the vocation to get involved with it in.

 

[Jambi]

How can I raise the bar? Instead of watching movies on my shift I can make sure the rigs are checked, I can continue to study, I can set an example and train newcomers, I can do my best to notice bad habits from others and not take part.

Goto school and realize the lasting impact of EMS is limited.

 

[eprex]

So?

What do you think they do for it?

Basically nothing that maks a difference other than give the patient a lift to the hospital.



Did you know that 1/2 of trauma is the effects of systemic inflammatory process?

If you are taking septic patients out of nursing homes, you are actually seeing more exposure to the illness caused by trauma than the guy trying to maintain O2 delivery.

If you get a septic shock patient from that nursing home, you are getting 100% ofthe pathology caused by trauma.

I'll even go one further and say that because of the amount of trauma involved in complicated OB, both to the mother and the child, Specialty Neonatal Transport probably sees more trauma and does more for it than any other subdivision of EMS.

If trauma excites you, EMS is not the vocation to get involved with it in.

I absolutely appreciate your comments so please keep them coming. But I do want you to know that you're running with something that isn't really the main idea here. It was a side comment. My issue is with the quality of service my company
offers.

Someone made a good point to me- EMS only takes 6 months to 2 years of schooling to get involved. No bachelors required or any overly difficult exams. It might not attract the most professional or studious group of individuals. Not to sound arrogant but it's worth noting

 

[Jambi]

What Vene said.....I couldnt of said it better!

Ditto

So?

What do you think they do for it?

Basically nothing that maks a difference other than give the patient a lift to the hospital.



Did you know that 1/2 of trauma is the effects of systemic inflammatory process?

If you are taking septic patients out of nursing homes, you are actually seeing more exposure to the illness caused by trauma than the guy trying to maintain O2 delivery.

If you get a septic shock patient from that nursing home, you are getting 100% ofthe pathology caused by trauma.

I'll even go one further and say that because of the amount of trauma involved in complicated OB, both to the mother and the child, Specialty Neonatal Transport probably sees more trauma and does more for it than any other subdivision of EMS.

If trauma excites you, EMS is not the vocation to get involved with it in.

I'm afraid that this will be lost on many people...

 

[eprex]

And it's not so much that trauma "excites" me- I don't like see anyone injured or sick to be honest. It's just a little bit more intense compared to other calls. But again we're getting off track.

 

[Jambi]

I absolutely appreciate your comments so please keep them coming. But I do want you to know that you're running with something that isn't really the main idea here. It was a side comment. My issue is with the quality of service my company
offers.

Someone made a good point to me- EMS only takes 6 months to 2 years of schooling to get involved. No bachelors required or any overly difficult exams. It might not attract the most professional or studious group of individuals. Not to sound arrogant but it's worth noting

EMS only takes one semester to get involved with (16 weeks), has no barriers to entry, and is relatively cheap. This is why the quality people is what it is. This quality is supported by the model of the typical ambulance company being motivated by profit. The customer of an ambulance company is not the patient, it's the person ordering the service. The drive is how fast and how often a meat wagon can show up, not how competent the meat wagon operator is.

 

[Jambi]

And it's not so much that trauma "excites" me- I don't like see anyone injured or sick to be honest. It's just a little bit more intense compared to other calls. But again we're getting off track.

Don't take this the wrong way, but you've never run a truly critical medical patient then. Classical trauma is easy. critical medical patients make me pucker because that's where the knowledge and competency of a provider becomes important, and deficiencies plain to see.

 

[eprex]

Actually I apologize ven, I wasn't really as verbose in my first post as I thought I had been. So to clarify, what's really getting me down is my company. I'm absolutely grateful to be able to volunteer when i want and have no quotas, but it's frustrating to work in what I consider to be a serious job (and we can agree to disagree) with people who are so lazy and apathetic.

 

[Jambi]

but it's frustrating to work in what I consider to be a serious job (and we can agree to disagree) with people who are so lazy and apathetic.

I think you managed to sum up a large number of people's experience in EMS, mine included.

 

[eprex]

I think the problem is I did a couple of overnight shifts with two medics in NYC and they were absolutely stellar. Now I look at
my crew and the inefficiency blows my mind.

 

[RocketMedic]

So?

What do you think they do for it?

Basically nothing that maks a difference other than give the patient a lift to the hospital.



Did you know that 1/2 of trauma is the effects of systemic inflammatory process?

If you are taking septic patients out of nursing homes, you are actually seeing more exposure to the illness caused by trauma than the guy trying to maintain O2 delivery.

If you get a septic shock patient from that nursing home, you are getting 100% ofthe pathology caused by trauma.

I'll even go one further and say that because of the amount of trauma involved in complicated OB, both to the mother and the child, Specialty Neonatal Transport probably sees more trauma and does more for it than any other subdivision of EMS.

If trauma excites you, EMS is not the vocation to get involved with it in.

Learning moment for me- can you explain this in layman's terms, Vene?

IMO, "dramatic acute rearrangement" of anatomy via high-energy events is far, far *easier* to manage than systemic organ damage. One gets you a surgeon. The other gets a shortened lifetime filled with medical visits, attention, and the gradual collapse of your body's capabilities.

 

[firetender]

At this stage of your game, you'd serve EMS a whole lot better if you took your focus off of them and place it back on yourself. You're the one who has to get good. You're the one who has to get proficient in the field. Do whatever is in your control to build your skill levels and leave them to their own incompetencies.

Someone said choose your fights carefully. +1 to that!