Too Much Information

It’s the week before the final exam and my EMT class is feeling the pressure. The two-hundred question final looms large on the horizon and, in less than a week, the students will need to perform five randomly selected skills stations perfectly. This is the task that has most of the students really feeling the heat.

So we do what we do every class. We practice and practice and practice. So there we were, gathered around in groups, practicing our National Registry skills sheets. That’s when Joey asked me the question that absolutely floored me. It floored me and annoyed me, but really didn’t surprise me. I’ve heard the question asked before in many different ways.

Joey finished up his medical scenario and I was giving him some feedback on his performance. He looked down at the fictional patient’s medication list that I had provided him and he shrugged his shoulders. “We don’t really have to know what all these mean right?”

I told him I didn’t understand. He mulled the thought over in his head and took another stab at it. “I mean…we need to write these down and report them to the doctor, but it isn’t important for us to know what they all do. (Pause.) As EMT’s. (Pause.) Right?”

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Patients Define Their Emergencies (Part 2)

True Story…

The dispatch information was updated before we had even rolled our rig out onto the pad. Eye injury, no serious symptoms. Jodie shut down the lights and I informed dispatch that we’d be responding non-emergent.

Up stairs and inside the small two bedroom apartment, Samantha, our patient, was waiting on the couch, holding a hot compress to her swollen right eyelid. Mom worked calmly in the kitchen finishing diner for her other two children. Alan, Samantha’s father sat on the edge of his seat next to his daughter in a state of barely containable anxiety.

He had recently arrived home from work and his wife had informed him of the apparent infection in Samantha’s right eye. One look and he was on the phone to us. Now he breathed rapidly as he fumbled through a list of questions. What caused it? Could it damage her vision? Could she lose her eye? Could she go blind?

I cleared the engine to go back in service and sat down next to him. Over the next ten minutes we both explained what pink-eye was and how to take care of it. We talked about hot-compresses and how contagious the bacteria was going to be. We reviewed the typical course for such and infection. How to prevent it in the other kids. How likely it was that one of them already had it. And we discussed his plan for morning. (It involved asking a neighbor to drive them to a near-by clinic.)

Alan called 911 for pink-eye. And…(This part is bound to be controversial, depending on what kind of system you work in.) I never offered to take him to the emergency room. And he never asked.

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8 Tragic EMS Behavior Flaws to Avoid

In Greek tragedies, the hero typically displays some form of hamarita, also known as a “tragic flaw.” Hamlet was brooding, Othello was jealous, Macbeth was ambitious. For the most part, it is their tragic flaw that is usually the key to their undoing. When the hero ultimately falls, they tend to sow the seeds of their own demise with their respective tragic flaws.

People often use the word hero when they refer to EMS caregivers. EMT’s, paramedics, firefighters, we all get the hero moniker pinned on us from time to time. I cringe at the term. Most of us are uncomfortable with it to different degrees. And, if there is any truth to our hero title, it is certainly closer to the heroes of Greek tragedy that the comic book heroes we grew up with.

In other words, we all have our tragic flaws. Yes, all of us.

Here are eight of the most common tragic flaws of the EMS hero persona. I have, at one time or another in my career, embodied each and every one of these flaws to one degree or another. I’ve lived each one of them. I would guess that most of us do.

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Midnight

Our department recently offered an early retirement buy-out option.  I understand a half-dozen or so people took it. So next month, 6 or so of my colleagues will run their last call and close the door on their career. Six people will write the final chapter and be done.

It makes me wonder. I wonder what that’s like, to hear the tones go off and say, “Yup, this is probably it, the last call of my career.”

What will people say about your EMS career when you’re all done? For many of the readers here at the spot, retirement is a long way away. It’s hard to imagine what is will one day be like to not be in EMS anymore. Yet, it’s worth considering, because you never really know when your last call will be.

Consider Elizabeth Ann Mitchell.

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Where Do You Put The Fear?

I once thought that part of the goal of being a competent paramedic was getting to the point where I no longer felt any fear or anxiety about running calls. After all, most of the folks I worked with appeared to be absolutely fearless. At least the competent ones did. They never go flustered or rushed. They smiled. They remained calm in the face of very real emergencies. I needed to be like that.

Eventually I figured out how to act like they acted, but I never really mastered the whole not-feeling-any-fear thing. It nagged at me for a long time. It took me almost a decade to figure out the secret.

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The May 2010 Handover Blog Carnival

“And That’s When It All Came Together”

There are moments in life when everything clicks. Synchronicity. Poetry in motion. Bliss. Those moments on our journey when the map suddenly seems so clear and our destination so much closer. It can be a moment of insight or learning, a realignment of our priorities or perhaps just a stunning instant of clarity. Regardless, they are sacred moments in our human experience.

This month, in true EMT Spot fashion, I asked EMS bloggers from around the world to share with you their sacred moments of clarity when everything came together. I hope you enjoy the stories of these fellow travelers. All of us share the experience of stumbling down life’s road looking for a signpost to point the way. One of the most amazing things about breakthroughs is that they help us to point the way for others who follow.

Each of these stories is a sign post in-and-of itself. It’s impossible to tell the story of your own breakthrough without becoming a teacher to the weary traveler who chooses to listen. Perhaps that’s what makes these moments sacred.

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“I’m Only An EMT Basic”

I’m so sick of hearing this phrase. If I could banish any phrase from the EMS lexicon this would most certainly be the one. I heard it today when I posted a question on Twitter, “How much do you really know about ACE inhibitors?” I asked.  The first reader reply, “Not much since I’m only an EMT Basic.” Ouch. I get stomach pains when I hear that.

I want to make a bonfire out of all the worthless phrases in our vocabulary and throw, “I’m only a …” right on top.

Since when was an understanding of out patients medications an advanced skill? Since when is medical knowledge of any kind an advanced skill?

Somewhere along the way we started giving EMT Basics the idea that anything that isn’t contained in their EMT textbook is somehow beyond them. It’s patronizing. “Here you go little EMT dude, here’s the basics. Don’t move on to anything more complicated, you could hurt yourself.” That’s just ridiculous.

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A Deep And Abiding Respect

In the debate over how to make our EMS systems and ourselves better at what we do, there is an underlying danger that’s worth mentioning.

After we’ve examined the research, explored the systems and best practices, fought to advance our scope of practice, supported competence, raised minimum standards and advanced ourselves as a profession, there is an underlying danger that we should mention.

There’s a pitfall that we should take care to avoid.

The danger is that we may begin to do our work for the sake of the work itself, instead of for a deep and abiding respect for life. Life in general and the lives we specifically serve.

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Passion Counts

If you’re going to design a ski resort I imagine that you don’t need to really like skiing, but I bet it helps. I imagine the same is true for most jobs. I would guess that a movie buff would run a better movie theater, a salesman would perform better if he was a true believer in his product, a car detailer would be more successful is she loved cars and a fitness trainer would be far better is he had a burning desire to improve people’s health.

For jobs that require skill, insight and good judgment (Like our job does.) passion counts. Passion is important.

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Credibility and Redundancy

I’m going to make an important point and I need you to pay attention. That sentence, the one I just wrote. The one about saying something important. That was a redundant statement. And it undermined your sense of my credibility as a blogger and an EMS educator. No really, it did.

Not in a huge way. Not like if I had said something that you knew to be completely false, or got all wishy-washy, namby-pamby about some critical issue regarding your patient care. But it made you doubt my sincerity just a little. Somewhere in your subconscious you thought, “If it’s important, why not just say it?” You questioned why I felt the need to preface my important thought with a statement declaring my own thought important.

It’s as if I doubted my own credibility.

So why shouldn’t you doubt it too.

Right?

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