You are currently browsing the The Big Get It category.
All that stuff that drunk aggressive patient says.
Or the stressed out soccer mom, or the angry husband, or the grumpy old scared guy.
It can’t be personal. For it to be personal, they would have to know you. Not just know you, but know you personally. Unless they know you personally, know your thoughts, know your motives know your dreams, goal, desires, strengths, weaknesses and all that other stuff that comes along with being you, they don’t know you personally.
Yeah, It’s
been a ride…
I guess I had to go to that place to get to this one
Now some of you might still be in that place
If you’re trying to get out, just follow me
I’ll get you there- Rapper Eminem, I’m Not Afraid, Recovery
I’ve been there.
Sure, I’d like to say that I was always a positive, proactive and optimistic EMS employee but that isn’t the case. I’ve been through periods of burnout. More than once to tell you the truth.
I know what it’s like to dread getting up in the morning and going to work. I also know what it’s like to feel like you aren’t valued by your employer. I’ve been through phases where I just didn’t care about the service that I worked for or the quality of the care that I provided. If they don’t care, why should I…right? I know what it feels like to be a cog in the machine, replaceable and unimportant.
I’ve been to those places and I’ve come back. I’ve come back stronger than I was before.
If you’re in that place right now, first let me say a heartfelt, “I’m sorry.” I know where you’re at. I’ve felt the disillusionment and frustration. Hang in there. EMS still needs you. You still have something meaningful to contribute.
Now let me give you a few ideas for how you might get back to where you need to me.
Change is a part of EMS. Our profession changes faster than most. Many of the treatments you learned in EMT 
class will be changed or refined before you reach your second year of EMS service. Advances in technology and research will place an ever-increasing demand on the field EMS provider to learn new skills and treatment modalities. EMS is not a job for folks who don’t like change.
But what about your organization? Will they keep up?
How tolerant is your organization to change? If you want to find out if the people you work for are resistant to change, listen for how often you hear people say these three key phrases. These are my top three “anti-change” catch phrases. The more frequently you hear people say these three things, the more likely that change will occur slowly…or not at all.
Anti-change phrase #1 – “That’s not the way we do things around here.”
What would you bet your life on?
In 1996 I took a job about 40 minutes south of San Jose, California with a small mom-and-pop ambulance company. The service was named after the owner and had been serving a mostly rural area of northern California for a couple of decades before I arrived in town. They were, without a doubt, the worst ambulance company I ever served under.
The owner ran the place like a dictator. I started work the day after my interview on a dirty ambulance wearing an old uniform that was two sizes too large. My partner was the grumpy silent type. The station conditions were deplorable and the policies and procedures were down-right unethical. (As an example, the owner would frequently order crews to respond to scenes, after they had been canceled enroute, so that they could gather billing information from the caller.)
I worked at the service for about three weeks, then I left. I knew that nothing about that service matched with who I was as a paramedic and nothing I could do would ever change the two decades of tradition and old guard thinking that had brought them to where they were. Unlike my uniforms previous owner, I washed my threadbare shirt before I handed it back in. Then I hit the road and I didn’t look back.
I could have wasted years in that joint.
A recent student of mine is talking about looking for his first EMT job. He tells me how he’s thinking about an ER tech job but he explains how much competition there is for 
the limited number of jobs. Then we talk about some of the local ambulance services and he explains that they’re mostly looking for folks with previous experience. Finally and I stop him and I say, “John, why don’t you let them decide why they don’t want to hire you?”
Sometimes we’re so quick to say no to ourselves to avoid ever encountering the possibility of someone else saying no to us. Showing up and saying you want the job, the promotion, the raise or anything else in life feels a lot like failure. And we all know how scary failure is. Let’s face it, it’s easier to just say no to ourselves…in private
Then we can move on to something else that’s less fulfilling.
Or here’s another idea.
During a recent presentation at EMS Expo I spent quite a bit of time talking about incongruity. I think it’s an important concept to understand before you launch into learning tips and tricks for building patient rapport.
Incongruity is the act of being inharmonious in character or inconsistent. We identify it almost immediately in social interactions. For instance, say you’re on an airplane and you’re approaching the gate and the flight attendant quickly reads you a well prepared announcement thanking you for flying with their airline.
You know the one:
“We at UnitedContiAramriWest Airline know you have a choice of carriers and we sincerely…”
How do you feel? Do you feel like the flight attendant reading the message deeply cares about your business? How about when a sales person calls you at home to tell you you’ve just won a cruise? Do you yell for joy, “I won the grand prize!” or are you skeptical? “Where did I sign up for this contest?”
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?”
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.
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.
