Posts Tagged ‘compassion’


I ran my first EMS call in 1974 as an explorer scout. When we arrived on the scene of the car crash, the lead paramedic handed me three flares and told me to set them up down around the corner. When I walked down there, it was dark and I had no idea how to light the flares. I tried everything to get them lit, but I didn’t have a flashlight, there was no light, and I’d never lit a flare before. My biggest fear wasn’t approaching traffic, my biggest fear was not looking stupid. So, of course, I didn’t walk back and ask for help, I just figured it out and got them lit.

20 years later, in 1995, I was working as the EMS operations manager of a large, suburban fire district. I was serving on various committees, task forces, and advisory roles. I left that rewarding an successful career to pursue other avenues, but in 2010, partly due to the economic downturn, I found myself unemployed. It seemed the easiest way to find employment and keep our house was to regain my paramedic license and find EMS employment. Six months later I was employed by a large corporate ambulance transport agency.

At first it was quite challenging. Much had changed, yet much remained the same. Essentially I’d been out of the field for 20 years, though I still ran calls and did a lot of teaching in the 90s, I was mostly a desk jockey. And though I worked for a non-transport agency,  my previous experience included both air and ground EMS. The hardest part about returning was the pace. I soon learned how busy system status EMS takes it’s toll on medics and EMTs.

After getting through FTEP and settling into the role, I had a period of joy. It was really fun being back into the career I always loved. It was great to run calls again, solve problems, and take care of people with needs. But that joy quickly wore off. EMS is different now.

When I first worked in EMS, prior to the implementation of the 9-1-1 system, the ambulance company I worked for ran without first responder support. My partner and I were often the only ones on scene, and the calls seemed to go much smoother. We were able to establish rapport with our patients, comfort family members, and reduce the chaos and confusion we found. After EMD was implemented and communities decided to send firefighters as EMS first responders, things started to get more complicated on scenes.

There were attempts in the 1980s and 90s to streamline our EMS systems by awarding ambulance serve contracts and eliminating the duplication of agencies, but from what I can tell, far too few communities have accomplished this. To me, this is one of the most disappointing aspects of our current systems.

About six months ago I found myself working the graveyard shift on a system status ambulance. The county I worked in had no quarters and we covered thousands of square miles with just a few rigs. We spent the night moving from post to post. Sometimes we would be at a post for hours, sometimes we never sat still. This began to take its toll on me. I began to realize that this shift, combined with the claustrophobia of the ambulance cab, was killing me – and killing my family.

I’m convinced that system status is taking an abnormally high toll on EMS workers. The stressors of the job, considered one of the more stressful careers in the US, and the long hours, are killing our paramedics and EMTs. It’s a shame really. People come into EMS excited and with high hopes of making a difference. But after about 5-10 years, they grow demoralized and depressed. I’ve never worked with so many discouraged people in my life as I have in the last two years.

I worked hard to stay healthy, keep a positive focus, and improve the lives of my coworkers. But I’m afraid the task is too big. There are several agencies and communities around the country who do EMS really well. They not only offer quality patient care, but they treat their employees well. Other communities have not been so quick to adapt. Sure, paramedics are being paid much better than in the early 80s – back then I made $4.10 an hour and I was working one of the busiest ambulances in the country.

Somehow, our society has forgotten to take care of its EMTs and paramedics. Unless they find employment in a well-funded public agency, I would not recommend people seek EMS as a lifelong career. This pains me to say, as I love my coworkers and the job, but I don’t see changes happening anytime soon.

Last week, after a two month break, I resigned my position. I’m too old for this, and I’m not a good fit. I’m not a bad paramedic, but I wasn’t getting enough sleep. After reading this article (Life in high gear takes toll), I realized I was taking too big of a risk. If I mess up on a drug administration, which according to David Marx, happens one out of 700 times, it is my career and livelihood on the line. I know my employer wouldn’t stand behind me.

The sleep deprivation, the pressure to make scene times, the lack of quarters, and the lack of focus on quality patient care have made me realize I need to move on. I don’t know where I’m going next, but I feel peace. I would gladly work at an agency that cared about their employees, put customer service and patient care needs above the desire to make a profit, and used their resources to improve the local system.

Just like when I was a 15 year old kid, I just want to make a difference by caring for people in need. I’m not in it for the money – I gave up that pipe dream a long time ago. I just want to serve my patients and their families. It is my hope that paramedics, EMTs, physicians, nurses, and system leaders will continue to improve our fledgling profession. There is still great potential, but it won’t be cheap. It will take a great influx of energy, desire, and vision.

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I’ve seen things you people wouldn’t understand.  I have images burned into my brain – that have wounded and scarred me to the core of my being.  I’ve seen things that no caring person should ever have to see.

The other day, a cop friend of mine was talking about some of the things she has seen.  She mentioned how they joke about using the MIBflashy thing” when they retire – to erase all the things they’ve seen.

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3D Team Leadership Arrow Concept

Image by lumaxart via Flickr

It’s easy to complain about stuff.  In fact, without trying to hard, you can find something wrong with almost everything.  So, when one stops to think about it, complaining doesn’t take much skill, art, or imagination.  And yet, everyone seems to want to outdo everyone else in their powers of complaint.  Why is this?  What is it about our culture that makes complaining so ubiquitous?  What is it about our lives that make us unable to appreciate the good and instead focus on the negative?

If you are reading this, most likely you live in the United States – the most prosperous and richest nation in the world.  According to some researchers, even the poorest Americans are richer than 99% of the world’s population.  Yet, we still grumble, bitch, and moan.

We attribute our lack of happiness to our employers, our spouses, or our government. We seem to think that if we made more money, had a better job, or had lower taxes, our lives would suddenly become pristine journey’s of joy.  I don’t believe this is true however.  I don’t think higher wages, a better boss, or the perfect government is going to solve your problems.  Indeed, the issues of happiness probably go much deeper than this – and I’m not going to try to address them here.  However, I would like to propose one simple idea that we can all employ to better our home, work, and social lives.

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CPR training

Image via Wikipedia

As I walked into the bedroom, it looked like there was more drama than necessary – more than I cared to deal with on this laconic Thanksgiving Day.  Our 55-year-old female patient was sitting on the floor, propped against her bed.  She was breathing fast and her CO2 levels were down – it looked like an anxiety attack, so I squatted down and tried to convince/coach her to slow her breathing down.  But something didn’t look right.

She was trying to cooperate with me, but there was no way her breathing was slowing down.  It was fast, about 40 respirations a minute, and deep.  Her eyes were closed and I discovered she had some chest pain – which she was unable to describe.  In fact, all of her concentration went into her breathing and I, as with the other medics in the room, were just a distraction.

It was at this point that I got very concerned.

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Dante and Virgil in Hell

Image via Wikipedia

In the old days, we would have quarters to retreat to and many distractions from one-on-one interaction. Whether it be chores, fire inspections, drills and training, or just TV – at least one wasn’t forced to interact with their partner all day.  Times have changed and employers are getting more calls out of their medics through that great invention of System Status Management.  Consequently, we spend our entire shift locked in a cage and chained at the hip to our partners.  Depending on the situation, this can be a good thing, or a bad thing.

Assuming you draw a good partner, a friendship usually unfolds and going to work can  be quite pleasant.  However, given the opposite situation, this doesn’t always work out so well.  How does one deal with endless minutes, hours, and shifts with the partner from Hell?  Dismiss the fact that we all have bad days, and overlooking some minor personality defects – which we all possess, what do we do with people who are just plain hard to be around?

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The real you by =Sha-X-doW on deviantART

There used to be a downtown “hotel” that was notorious to street paramedics.  Located on N 2nd Street, between Main and Oak, across from the Salvation Army.  We knew the address well, and unfortunately, we were often there at least once per shift.  Paramedics in large cities probably have numerous places like the Home Hotel, but in our city, during the 70s and 80s, few places rivaled the desperation one would find on the second floor of this transient venue.

As a young, naive EMT (not quite a paramedic), I had much to learn.  My first call to the Home Hotel was an eye opener.

The call came in just before shift change, about 7:00am. My partner and I were in a bleary-eyed stupor from a night of sleeplessness, brought on by the constant needs of a city that never sleeps.  She gave me no warning of what I was about to encounter – not to surprise me, but because it was so normal – at least to the medics who worked downtown.

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Don´t shoot me in the face.I think one of my biggest frustrations is when people fail to see the bigger picture.  When a system plays out, just the way it is designed to operate, why do we blame the people who are merely actors in the process?  Why do we shoot the messengers?

For example, there are 30-40 million people in this country without health insurance.  Many of those people are good, respectable individuals who find themselves in a difficult, and possibly temporary, situation.  Others have been raised within a culture of poverty – social, spiritual, cultural, and financial poverty – they don’t know any other way.  It isn’t their fault they are in the situations they find themselves, and they don’t know any other way out.  Why do we blame these victimized people for the using the only system they know?

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