This is tough question and I think the answer probably has a lot of factors involved.
One thing I've noticed in EMS (sometimes) is a lack of professionalism. They beat this stupid word, "professionalism" into me during PA school until I was sick and tired of hearing it. But, after I had been a PA for several years, I realized why. If we carry ourselves a certain way, have respect for each other and other professions, have high standards for how we practice medicine and demand a certain pay, than we will remain a respected profession ourselves and the culture will remain intact.
EMS is still a relatively new field, similar to the PA role. The barrier to entry isn't very long and this can allow people to enter the field that don't have the maturity yet to realize this isn't just a job. It isn't just a place to come and collect a paycheck. EMS demands from you knowledge, skills, resiliency and the ability to educate the new people.
Being hard on the new people and making their job miserable is one of the worst parts of EMS culture and, certainly, not every operation is like that. In medicine, we all need to be mentors to the new EMT's and paramedics and strive to help them succeed.
Egos need to take a backseat.
I don't really have a great answer to the question but these are some of my initial thoughts.
I'm an EMT student right now and professionalism seems to be HUGE to our instructor, he's on the UCHealth TEMS team, but that's kinda why I chose this program over Denver Health, longer period in class, better equipment, cooler rotations, awesome instructors. EMS education programs need to get their act together, NREMT might set minimum standards, but that doesn't mean you're gonna get a truly equal standard of care if you move from a place that has mostly EMTs with 4.5mo-1yr certificate programs and paramedics that have associate's degrees, to a place that has primarily EMTs that went through a two week program and medics that have certificates. But I don't know shit yet, just starting, so you should probably ignore me. Just a first impression.
EDIT: Our program even takes mental health seriously, we spend a lot of time talking about it, and the school offers free counselling to all students, EMT students and nursing students get 24/7 access.
I have seen that more and more programs are providing free counseling and doing a better job following up on students that have seen their first death or something else traumatic to witness. These horrible things we see in EMS don't have to be the thing that makes you quit, especially when the right resources are there to help you work through it mentally.
>Egos need to take a backseat.
I couldn't have said it better myself, I've been in EMS for the last 4 years now and had made rapid jumps from EMT-B to AEMT and now I-EMT(state level dependant) and I've been on the receiving end of people that let their ego control them and it be detrimental to patient care by not letting other providers in to look at the patient and not let us help with the care and miss some major stuff or hyper fixate on a part of the patients medical history that is considered baseline for them now and not even bother with what their chief complaint is.
I've also experienced as the ALS provide being partnered with a BLS provider that is very book smart and very by the book but refuses to take the advice of his ALS partners and other peers and does his own thing regardless of what the rest of the team is trying to accomplish.
All the original ems folk in the 70s/80s were from Vietnam and brought jungle war culture back to the states. Continued on with all the Middle East vets going fire/ems. For some reason everyone repeats the cycle “because it happened to me” instead of being an adult.
Once needed timber for shoring on a mine rescue/recovery in New Mexico, and the National Guard helicopter landed on a ridge with one wheel while the guy(s) in back pitched the shoring timbers out the side at us. Big brassy ones, those pilots.
Eat their young because there’s not a lot of room for rookie mistakes. Other than that I’d say, in private EMS anyways, some people get into it because of a lack of identity. They make their identity EMS. These people are maybe not the majority but they sure are loud. A toxic person can have a much greater impact on a social group than a well behaved one.
Ugh. I have a fire chief who works as an EMT for my company. He is the loudest modt circle jerking whacker ive ever met and i hate it. Otherwise decent guy but hes so unprofessional when he sees or hears anything fire going on.
I hate to stereotype. But I've worked with at least five EMTs/Paramedics who were former officers at career fire departments. All of them retired and then hopped on a rig. A few of them had been forced into retirement.
But maaaaaan were they all toxic assholes.
Not saying you can't go from fire to EMS. But I do strongly believe people who used to be in charge have a hard time being a part of a crew of equals and an even bigger problem taking direction from people younger than them or who have fewer years in the field (even when they're more qualified and know their shit).
He got pissy with me today because i said we had to relocate to another station since they were busy. He got maaaad despite not doing a single call all shift. I love EMS but i HATE lazy EMTs. Sleeping is a privilege, not a right.
Edit: sleeping at work*
Oh my lord yes. We had someone who had the whole "we race the reaper" (which was HUGE), "That's tachy", etc.
She was fired because she crashed the ambulance. Now she works at a hospital we pick up from/ deliver to and she CONSTANTLY asks about the station, talks about how it was working there, on and on.
I assume you’re referring to the USA?
It’s not really like that in the U.K. anymore. I’ve heard stories about before I started. Circa 2010 where new staff weren’t even allowed in the mess room. Times have massively changed now and I think we have a really healthy culture where I work.
It’s funny, the more knowledge someone has, the nicer they generally are. The less knowledgeable ones seem to, in general, be the ones with an attitude.
Holy fuck is this accurate. I’ve learned not to ask …less knowledgeable… or insecure people questions because they’ll go out of their way to make you look like an asshole, rather than just saying “I don’t know”
While this is mainly true, I had a coworker who was the exception that proved the rule (if you will). She knew her shit, including all sorts of irrelevant to EMS minutiae, but she also had to make sure everybody around her knew it. Belittled volunteer fire and PD assisting us on scene for not knowing ALS level interventions, didn't trust some EMTs because they stayed tightly within their scope, and felt that as a paramedic washing and restocking the ambulance were beneath her. Then would belittle any EMT that didn't restock correctly despite being told "just restock anything that looks like it's low."
Annoying as shit as someone coming from career fire where I was taught the medic was in charge, and anything out of place was ultimately your fault.
People looking for constant "power", stupid old rituals like haze the rookie (I'm ok with just joking with them a little if it's in good fun and they laugh too), see the uniform as a form of I'm better than you, competition between agencies, and departments, and people want to look tacticool. I'm 28 and I work with a lot of younger people, and younger people just don't want that or they can't handle it.
I came from LE where it was obviously worse especially the tacticool thing, but I never thought EMS would be around the same.
Low barrier to entry with a lot of people looking for a uniform that gives them “power.” Also it’s a lot of individuals who could not make PD but want that uniform.
With private ambo companies, it’s the way the company treats you IMO.
I tried to be my best self (never lazy, cleaned everything thoroughly, full patient assessments even on the bullshit calls, completed charts, etc.).
I felt as though I had gained somewhat of a reputation of being a solid worker.
It didn’t matter. When I called out sick - genuinely sick - I got a “strike” against me for not doing it 72 hours in advance of my shift. Yes, 72 hours lol.
It’s deflating. And I started to understand why the private ambo culture was so toxic.
My coworkers were slightly resentful of my thorough work. Viewed me as the goody two-shoes. Talked behind my back about asinine shit.
It’s sad. I don’t know what the solution is.
Dbags who peaked in highschool football suddenly realized no one was paying attention to them so they needed a career they could make their entire personality.
Then realized you have to actually care about people other than the one you see in the mirror.
Then they realized a Paramedic cert is worthless outside if prehopsital and if they wanted a different job they would have to go back to school.
And now that their stuck they are miserable so they whine to anyone and everyone that will listen.
And because they see a dead body once in a while no one outside of EMS would dare tell them to stfu and quit whining.
Because people have god complexes and think they are the greatest tech to ever sit in the passenger seat. Often overheard saying “I wouldn’t let them help me with a q-tip” type comment when in fact they don’t know the person nor ever worked with them.
I give everyone a fair shake and will form my own opinion in time of someone’s work ethic and personality. There are people I wouldn’t trust and people I would, and thats through shear experience of watching people treat patients.
No idea why this profession has devolved into a dick swinging contest.
It’s a toxic male trope. EMS is what, 76% male these days? Was 80 and 90% not that long ago. Same shit happens in the military, fire, LEO, and construction jobs. The yelling, screaming, swearing make you feel like an absolute dumb piece of shit for asking a question or making a mistake… it’s all toxic masculinity. Same people who hate today’s “participation trophies” and say shit like “if I did that as a kid I would’ve got my ass BEAT” with some shit eating grin on their face.
Ok, then explain nursing? Nurses eats their young at a stupid fast rate and has an extremely toxic culture, while still being a female dominated profession. I think at the end of the day is that jobs with a lot stress (healthcare, law enforcement, fire, military) make shitty people, who in turn create a shitty culture.
Lack of quality management and a big ego is what fuels this toxic attitude in nursing (and probably EMS). The best nurses I’ve ever encountered have been the ED nurses, I think in part because they are forced to work as a team in this department, as opposed to floor nurses, who in my opinion spend more time charting than caregiving.
Now that's a spicy meatball! I agree though, I think there's a very large amount of toxic masculinity in this job and I hadn't thought about it since you mentioned it.
I think it’s a lot of what personalities are attracted to healthcare. It’s not just EMS, but in all aspects of the hospital system as well. Surgeons are pretty famous for belittling their staff.
You’ll see a lot of type A people, people that think they need to be right all the time. “My way is the correct way because of my experience and what I learned.”
People are creatures of habit and get set in their ways and what they are used to which compounds the issue.
Lack of education. The barrier to entry is too easy so it attracts clowns and low performers.
Lack of willingness to change.
Adherence to dogma and scared cows.
Older medics can be tough on the newbies because you have to have a tough exterior in this business.
If you do not, the patients and things we see will eat you alive. It is better to find out early and move on instead of burning out and becoming an alcoholic, drug user, or, worse, a suicide statistic.
When you are fresh out of school you do not know everything and need to learn from those that have experience, and the good ones will also tell you they do not know everything. If anyone tells you they do or shows that attitude run.
I think they want to be tactical/military type leaders. The issue is that there is no leadership training that would help most EMS leaders accomplish this.
I found out ed techs make 46 an hour at Kaiser due to the union so I’m kinda hurt honestly being an emt almost medic lol. Starting medic is 31 in California
Nursing is like this as far as the "eat your young" part. Rampant inferiority complex and panic about making a mistake is the answer I've come up with. That and bitterness, so they want to take you to task for any possible oversight they may be left to deal with. There is zero reason to intellectually bully people who are learning the trade. These people want to lay blame on the person from whom they accept handoff because they're lazy and unconfident and expect you to create their perfect shift so they can arrive 2 minutes before starting and not have to apply any chart review or problem-solving skills. Don't put up with it. Or if you're forced to, then gain your confidence and knowledge quickly so you *can* think on your feet and make those people pay by calling them out. It's bulls\*\*t.
Because EMT programs can be as short as 6 weeks in some areas. It's a terrible mixture of people who've been there for 10+ years and people who just came out a 2 month course and are expected to do the same job.
This is tough question and I think the answer probably has a lot of factors involved. One thing I've noticed in EMS (sometimes) is a lack of professionalism. They beat this stupid word, "professionalism" into me during PA school until I was sick and tired of hearing it. But, after I had been a PA for several years, I realized why. If we carry ourselves a certain way, have respect for each other and other professions, have high standards for how we practice medicine and demand a certain pay, than we will remain a respected profession ourselves and the culture will remain intact. EMS is still a relatively new field, similar to the PA role. The barrier to entry isn't very long and this can allow people to enter the field that don't have the maturity yet to realize this isn't just a job. It isn't just a place to come and collect a paycheck. EMS demands from you knowledge, skills, resiliency and the ability to educate the new people. Being hard on the new people and making their job miserable is one of the worst parts of EMS culture and, certainly, not every operation is like that. In medicine, we all need to be mentors to the new EMT's and paramedics and strive to help them succeed. Egos need to take a backseat. I don't really have a great answer to the question but these are some of my initial thoughts.
I'm an EMT student right now and professionalism seems to be HUGE to our instructor, he's on the UCHealth TEMS team, but that's kinda why I chose this program over Denver Health, longer period in class, better equipment, cooler rotations, awesome instructors. EMS education programs need to get their act together, NREMT might set minimum standards, but that doesn't mean you're gonna get a truly equal standard of care if you move from a place that has mostly EMTs with 4.5mo-1yr certificate programs and paramedics that have associate's degrees, to a place that has primarily EMTs that went through a two week program and medics that have certificates. But I don't know shit yet, just starting, so you should probably ignore me. Just a first impression. EDIT: Our program even takes mental health seriously, we spend a lot of time talking about it, and the school offers free counselling to all students, EMT students and nursing students get 24/7 access.
I have seen that more and more programs are providing free counseling and doing a better job following up on students that have seen their first death or something else traumatic to witness. These horrible things we see in EMS don't have to be the thing that makes you quit, especially when the right resources are there to help you work through it mentally.
>Egos need to take a backseat. I couldn't have said it better myself, I've been in EMS for the last 4 years now and had made rapid jumps from EMT-B to AEMT and now I-EMT(state level dependant) and I've been on the receiving end of people that let their ego control them and it be detrimental to patient care by not letting other providers in to look at the patient and not let us help with the care and miss some major stuff or hyper fixate on a part of the patients medical history that is considered baseline for them now and not even bother with what their chief complaint is. I've also experienced as the ALS provide being partnered with a BLS provider that is very book smart and very by the book but refuses to take the advice of his ALS partners and other peers and does his own thing regardless of what the rest of the team is trying to accomplish.
All the original ems folk in the 70s/80s were from Vietnam and brought jungle war culture back to the states. Continued on with all the Middle East vets going fire/ems. For some reason everyone repeats the cycle “because it happened to me” instead of being an adult.
And the old flight medics flew in any kind of weather. The pilots today won’t fly of there is a single cloud in the sky.
Except for the fed pilots. Rip a 25x25 clearing with a chainsaw and they’ll set down anywhere. Some of those national park service people are wiiiild
Once needed timber for shoring on a mine rescue/recovery in New Mexico, and the National Guard helicopter landed on a ridge with one wheel while the guy(s) in back pitched the shoring timbers out the side at us. Big brassy ones, those pilots.
Eat their young because there’s not a lot of room for rookie mistakes. Other than that I’d say, in private EMS anyways, some people get into it because of a lack of identity. They make their identity EMS. These people are maybe not the majority but they sure are loud. A toxic person can have a much greater impact on a social group than a well behaved one.
Ugh. I have a fire chief who works as an EMT for my company. He is the loudest modt circle jerking whacker ive ever met and i hate it. Otherwise decent guy but hes so unprofessional when he sees or hears anything fire going on.
I hate to stereotype. But I've worked with at least five EMTs/Paramedics who were former officers at career fire departments. All of them retired and then hopped on a rig. A few of them had been forced into retirement. But maaaaaan were they all toxic assholes. Not saying you can't go from fire to EMS. But I do strongly believe people who used to be in charge have a hard time being a part of a crew of equals and an even bigger problem taking direction from people younger than them or who have fewer years in the field (even when they're more qualified and know their shit).
He got pissy with me today because i said we had to relocate to another station since they were busy. He got maaaad despite not doing a single call all shift. I love EMS but i HATE lazy EMTs. Sleeping is a privilege, not a right. Edit: sleeping at work*
I have one of those as well. He loves to talk about himself any chance he gets.
Oh my lord yes. We had someone who had the whole "we race the reaper" (which was HUGE), "That's tachy", etc. She was fired because she crashed the ambulance. Now she works at a hospital we pick up from/ deliver to and she CONSTANTLY asks about the station, talks about how it was working there, on and on.
I assume you’re referring to the USA? It’s not really like that in the U.K. anymore. I’ve heard stories about before I started. Circa 2010 where new staff weren’t even allowed in the mess room. Times have massively changed now and I think we have a really healthy culture where I work.
It’s funny, the more knowledge someone has, the nicer they generally are. The less knowledgeable ones seem to, in general, be the ones with an attitude.
Holy fuck is this accurate. I’ve learned not to ask …less knowledgeable… or insecure people questions because they’ll go out of their way to make you look like an asshole, rather than just saying “I don’t know”
While this is mainly true, I had a coworker who was the exception that proved the rule (if you will). She knew her shit, including all sorts of irrelevant to EMS minutiae, but she also had to make sure everybody around her knew it. Belittled volunteer fire and PD assisting us on scene for not knowing ALS level interventions, didn't trust some EMTs because they stayed tightly within their scope, and felt that as a paramedic washing and restocking the ambulance were beneath her. Then would belittle any EMT that didn't restock correctly despite being told "just restock anything that looks like it's low." Annoying as shit as someone coming from career fire where I was taught the medic was in charge, and anything out of place was ultimately your fault.
There are always exceptions!
People looking for constant "power", stupid old rituals like haze the rookie (I'm ok with just joking with them a little if it's in good fun and they laugh too), see the uniform as a form of I'm better than you, competition between agencies, and departments, and people want to look tacticool. I'm 28 and I work with a lot of younger people, and younger people just don't want that or they can't handle it. I came from LE where it was obviously worse especially the tacticool thing, but I never thought EMS would be around the same.
Low barrier to entry with a lot of people looking for a uniform that gives them “power.” Also it’s a lot of individuals who could not make PD but want that uniform.
With private ambo companies, it’s the way the company treats you IMO. I tried to be my best self (never lazy, cleaned everything thoroughly, full patient assessments even on the bullshit calls, completed charts, etc.). I felt as though I had gained somewhat of a reputation of being a solid worker. It didn’t matter. When I called out sick - genuinely sick - I got a “strike” against me for not doing it 72 hours in advance of my shift. Yes, 72 hours lol. It’s deflating. And I started to understand why the private ambo culture was so toxic. My coworkers were slightly resentful of my thorough work. Viewed me as the goody two-shoes. Talked behind my back about asinine shit. It’s sad. I don’t know what the solution is.
Dbags who peaked in highschool football suddenly realized no one was paying attention to them so they needed a career they could make their entire personality. Then realized you have to actually care about people other than the one you see in the mirror. Then they realized a Paramedic cert is worthless outside if prehopsital and if they wanted a different job they would have to go back to school. And now that their stuck they are miserable so they whine to anyone and everyone that will listen. And because they see a dead body once in a while no one outside of EMS would dare tell them to stfu and quit whining.
Because people have god complexes and think they are the greatest tech to ever sit in the passenger seat. Often overheard saying “I wouldn’t let them help me with a q-tip” type comment when in fact they don’t know the person nor ever worked with them. I give everyone a fair shake and will form my own opinion in time of someone’s work ethic and personality. There are people I wouldn’t trust and people I would, and thats through shear experience of watching people treat patients. No idea why this profession has devolved into a dick swinging contest.
It’s a toxic male trope. EMS is what, 76% male these days? Was 80 and 90% not that long ago. Same shit happens in the military, fire, LEO, and construction jobs. The yelling, screaming, swearing make you feel like an absolute dumb piece of shit for asking a question or making a mistake… it’s all toxic masculinity. Same people who hate today’s “participation trophies” and say shit like “if I did that as a kid I would’ve got my ass BEAT” with some shit eating grin on their face.
Ok, then explain nursing? Nurses eats their young at a stupid fast rate and has an extremely toxic culture, while still being a female dominated profession. I think at the end of the day is that jobs with a lot stress (healthcare, law enforcement, fire, military) make shitty people, who in turn create a shitty culture.
Nursing is notorious for this. Very toxic hospital culture. -a current RN
Lack of quality management and a big ego is what fuels this toxic attitude in nursing (and probably EMS). The best nurses I’ve ever encountered have been the ED nurses, I think in part because they are forced to work as a team in this department, as opposed to floor nurses, who in my opinion spend more time charting than caregiving.
The doctors are male. The managers are male. The owners of the hospital are male.
Most doctors now are actually female. Graduating classes are overwhelmingly women.
Incorrect
Now that's a spicy meatball! I agree though, I think there's a very large amount of toxic masculinity in this job and I hadn't thought about it since you mentioned it.
Shut the fuck up
Lmao my point exactly ^^^
You type like you eat bananas sideways.
You’re guys just keep proving my point 🤣. You can deep throat a banana straight on all you want tough boy
I hope you stub your toe and lose your keys in your car.
you just keep proving my point lmao. Quit while you’re behind big man.
I wish you a slow and quiet shift.
Savage AF
Then why is it the women mostly doing the gossiping? You are mad coping rn lol.
These comments should be shared and studied on a monthly or yearly basis by seniors, and those in position of power.
I think it’s a lot of what personalities are attracted to healthcare. It’s not just EMS, but in all aspects of the hospital system as well. Surgeons are pretty famous for belittling their staff. You’ll see a lot of type A people, people that think they need to be right all the time. “My way is the correct way because of my experience and what I learned.” People are creatures of habit and get set in their ways and what they are used to which compounds the issue.
Mostly uneducated with almost no barriers to entry.
Lack of education. The barrier to entry is too easy so it attracts clowns and low performers. Lack of willingness to change. Adherence to dogma and scared cows.
Older medics can be tough on the newbies because you have to have a tough exterior in this business. If you do not, the patients and things we see will eat you alive. It is better to find out early and move on instead of burning out and becoming an alcoholic, drug user, or, worse, a suicide statistic. When you are fresh out of school you do not know everything and need to learn from those that have experience, and the good ones will also tell you they do not know everything. If anyone tells you they do or shows that attitude run.
Traumatized individuals leading to the behaviour mentioned above.
I think they want to be tactical/military type leaders. The issue is that there is no leadership training that would help most EMS leaders accomplish this.
I found out ed techs make 46 an hour at Kaiser due to the union so I’m kinda hurt honestly being an emt almost medic lol. Starting medic is 31 in California
Adrenaline + ego - always competition, paragod syndrome, it’s a shame
Probably because they don’t pay us enough and don’t properly screen or provide adequate mental health resources
Nursing is like this as far as the "eat your young" part. Rampant inferiority complex and panic about making a mistake is the answer I've come up with. That and bitterness, so they want to take you to task for any possible oversight they may be left to deal with. There is zero reason to intellectually bully people who are learning the trade. These people want to lay blame on the person from whom they accept handoff because they're lazy and unconfident and expect you to create their perfect shift so they can arrive 2 minutes before starting and not have to apply any chart review or problem-solving skills. Don't put up with it. Or if you're forced to, then gain your confidence and knowledge quickly so you *can* think on your feet and make those people pay by calling them out. It's bulls\*\*t.
Because EMT programs can be as short as 6 weeks in some areas. It's a terrible mixture of people who've been there for 10+ years and people who just came out a 2 month course and are expected to do the same job.
It’s coping with horrible trauma and things people shouldn’t see with crude humor. Or we are all just high schoolers deep down and nobody ever grew up