Five Rules For One Shift

   

Try this next shift.

 

Go in service and repeat these rules to yourself:

 

1.) Whatever call I get is the right call.

2.) Whenever the call drops is the right time.

3.) Whoever calls is the right person.

4.) Whatever happens is exactly what was supposed to happen.

5.) When the call is over … it’s over.

 

Try to live by these rules for one shift. Then come back and tell me how it felt.

Comments

  1. Why I was called was for the right and good reason.

    Great perspective thanks.

  2. What if a verbally abusive person calls you at 4am to open the window for her because she is hot? What if a veteran calls you at 2am because he does not have a car and he simply “wants a ride” to the local detox center and he is telling you this while he is loading his suitcase with beer for the ride? I do not want to be a wet blanket but some people just abuse the system and abuse themselves and we need to stop saying, “that’s okay.” Its not okay. It is a horrible drain on tax money and resources and causes burnout. Just saying…

  3. Steve Whitehead says:

    Thanks for this comment Buckman. You’re thinking something that most folks who experiment with this are going to struggle with. The moment you give up wanting a certain patient or a certain type of call you’re brain screams in protest. But what if … (insert situation that can’t possibly have any value to it here.)

    First, let me say, I agree with you. There are people who abuse our system. There will always be. The five rules aren’t about giving people permission to abuse us. It isn’t about being polyanna about our EMS experiences or accepting everything with joy. It isn’t an exercise in positive thinking. It also isn’t about giving up and not caring.

    This is an exercise in reframing how we look at the challenges that are presented to us each day. It is a willingness to accept those problems as ours and own them and work on them and struggle with them. They belong to us. Nobody else. Rise to meet the challenge and know that you are equal to it.

    So look at the situations you’ve presented here and ask, “What is this patient here to teach me?” It may be a lesson about tolerance or patience or forgiveness. Or it may be a lesson about not responding to every request the patient makes. It may be a lesson about creating a system that allows to say, “This is not OK.” It may be a lesson on how we can be better stewards of the tax money we are supposed to utilize responsibly.

    Some patients teach us about our systems strengths, some teach us about our weaknesses. Both are vital if we are to improve our system.

    Once you get your brain over this hurdle the next hurdle is the belief that the solution to the problem is somehow external to you. But I can’t change this because …. blah blah blah … so I’ll just be pissed off instead. It’s another version of the same argument. “This shouldn’t be my problem, it should belong to someone else.” That’s a whole other post.

    Thanks for the great response brau,
    Steve

  4. Amber Anaya says:

    Let us also not forget that the only time it is appropriate to say “it’s not my job” is in the case of judgement. I can guarantee with a degree of certainty that if you were to read your job description, this would not be part of it. Many times however, you will find the words patient advocate. It doesn’t state “advocate for certain patients.”

    If, for whatever reason, you don’t like the reasons people call for EMT’s, advocate for change. Join a professional organization at the state or national level. Become active in these organizations and active in your community. Many people call us because they don’t know of other options. Education is key here. Get involved. I’d like to remind you that passive acceptance and agressive bitching are the same thing. Neither one elicit much change.

    I have now incorporated these rules into my curriculum, not because I want to create a bunch of passive EMT’s but because I want to create ones that are happy in their chosen profession. I want to create EMT’s that treat others as they would have themselves or their family members treated, even if they became confused and called EMS instead of the water department.

    I challenge you, just as Steve did, to live by these rules for one shift but truly live by them. Remain open minded. You may find that you go home happier with your shift, happier with your patients, and happier with your profession in general.

  5. Okay, I now whole heartedly agree with the sentiment and attitude here. And please don’t think I am a passive whiner. I am an active educator and administrator. But the resources for EMS are rare and precious in my neck of the woods. Don’t worry about burnout. I have passed through burnout and emerged on the otherside. I am a stranger person for it, no doubt, but stronger as well. Most administrators throw up their hands when these calls happen and try to do nothing about them. That is where my frustration comes from. I have seen active dispatch triage systems that attempt to allocate the right resource to calls for help. This system interests me greatly. Some systems here have attempted to charge patients for responses that do not lead to transport if that patient calls 911 more than three times in a given period. This has had varying success, but is an interesting idea. I am part of a program here that is attempting to educate the public on the correct documentation and application of DNR’s. Hopefully this will lead to an increase in a more useful and productive interaction in the public during these times as well.

    The original 5 rules just seemed like some sort of daily affirmation or mantra. The response you wrote sounded like something completely different.

    If you call 911 in this area you will receive an engine company with a truck worth over $500,000 to $1,000,000 and a 3-4 person crew. You will receive a BLS ambulance totaling about $200,000 to $250,000 worth of equipment and two crew members. You will also get a chase car that has one paramedic and about $80,000 to $100,000 worth of equipment. Response times for the engine are usually good. The transporting ambulance can often be delayed by 15 minutes or more. And often times the paramedic is completely unavailable. Probably less than half the people who access this system are utilizing the proper resource to solve their problem.

    Many systems in this area have no money and are running on a deficit. Many have gone on hiring freezes or sent employees home on furlo days due to the emergency. Our country is completely broke and was running at a $10.5 trillion deficit before anyone started talking about bailouts. Other taxpayers are losing their homes and living in tent cities.

    This needs to be resolved. Quickly. Period. We can no longer afford to provide this level of service if the system continues to become abused. It is utterly painful, but America is just going to have to lower its sites and be more realistic in the care that is provided, and who this care is provided to.

  6. Christine says:

    I love this & will remember it on my next shift !

  7. Steve Whitehead says:

    Thanks Christine, come back and tell me how it goes.

  8. Charles Butler says:

    The wheel just keeps going round and round doesn’t it Steve. I have been doing this longer than some of you have been alive and EMS providers around the world continue to be dragged down by the same things. God knows that I have felt like Buckman so many times in the past. But, we have been complaining about these same issues as long as there have been people providing prehospital care. Yet, we still line up and compete for the few jobs in EMS. What does that say about us as people?
    Everyone out there needs to hear Thom Hillsons talk on “People Care” to gain a better insight and understanding on how to care for our fellow man.

  9. Dispatcher Chris says:

    Steve these are great rules to live by….I would like to add that after 24 years in EMS the only thing I know for sure is that it isn’t like it is on TV. All of these are good points, but remember we are always Teaching, and forming the next generation of EMT’s and Medics. We need to not be like the old “Burned out” 20 plus years Grumpy old fart’s and remember what an old Medic told me once. Every one no matter how Drunk, Sick, or out of their minds they are is someones Mom, Dad, Son, Daughter, Husband, Wife, Grandmother, Grandfather ect, Treat them as such.

  10. Steve Whitehead says:

    @Charles I second the recommendation on reading “People Care”. Nobody explains the concept quite as well as Thom Dick.

    @Chris Nice perspective. And perhaps we should care for them as if they are our own.

  11. Another fantastic read. There’s a lot to be learned from the 5 rules as well as from the comments following them.

    The EMT spot is my new homepage, for sure.

  12. My mantra is “I get paid by the hour.”

  13. this is great and i will definitely keep this to heart when i get my first shift!

  14. I love it. Its about how you handle the calls, not how they handle you.

  15. Steve, great article and great responses. When I was doing my EMT-B third rides, we were dispatched for a transfer of a pt with an infected fingernail. This was on a Sunday afternoon. I made a comment like “oh, I’m sure this is an emergency”, and was quickly reminded by my preceptor that it’s not up to us to decide what is or isn’t an emergency. It’s up to us to make the call, no matter what we think, and to be professional about it. It really put me in the correct mindset that even if we think the call is ridiculous, we still have the duty to respond and treat that patient with respect, because in their mind, it’s important.

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