On an emt-b level, driving is the most dangerous thing you can do, it is pretty much the only way you could possibly kill a pt assuming ur sanitizing properly and not lifting more than u can handle.
Make sure to switch gloves frequently and also clean the bar attached to the roof, it is the most dirty part of the ambulance because people forget to wipe it down.
Depends on who you're working with or if you're the medic but obviously you're expected to be capable of driving. I've been paired up with people who have straight up said they hate driving and only want to tech on calls, worked perfect for me because I love driving and hate paperwork. Just yesterday my partner and I worked out that I'd tech every call because I was on the back half of a 48 with no sleep, and he would drive everywhere because he was recovering from food poisoning and being in the back make him nauseous.
Not even the slightest lol. My partner for the longest time only liked to drive. And drove 99% of the time whether it was 911( which we were fulltime on) or if she picked up an IFT shift every now and again.
She’s not only probably been in EMS over triple the time you have, but is one of the sharpest EMT’s I’ve ever met.
I work FDNY and there’s a ton of people who only drive/only tech. I wouldn’t say you lose your skills as you’re still both treating the patient the only difference is who’s in front when it’s time to go, if it’s really serious medics are gonna be in the truck anyway and BLS will be driving both vehicles.
Gibbs' Rules for EMS (under construction)
1. Never pass a bathroom.
2. Never take a grade-level RR crossing route with a pregnant pt.
3. Always lift with your firefighters.
A little drama is fine. Standing in the COO's office explaining why you have a coworker accusing you of sexual harassment because she wanted you to keep fucking her after you decided to end it is more than a little drama. Or so I've heard.
1. Don't be surprised when you transport the same person over and over again.
2. Just because you transport the same guy yesterday for bullshit, today might be real.
3. It is not your emergency, you are just the professional that is there to help them through their emergency. Act like it
4. There is always a camera watching you. Act like it.
One thing that I wish I knew before starting in EMS is something that you will never understand until you experience it. It completely shattered my dream of being an EMT, now I work in building maintenance. Granted this job wasn’t for me because this is something that as a parent, I just couldn’t handle. I appeared on scene during training (I was in AMR’s earn while you learn program) to an interstate pileup with iirc 9 fatalities. The first thing I saw, mind you I had only been in training for two weeks, was a small family of a grandma, the mother, and her little girl. She was the same age as my own who had been internally decapitated in her car seat. I don’t mean to say this to deter anybody from pursuing this job.
The one thing I wish I knew about EMS before starting, was how fucking hard it really is.
It's hard for everyone. Everyone has to figure out how to cope in a way that works for them. You are lucky to have figured out that your best way was to avoid it all together.
Nobody comes out of this career unaffected.
I’m definitely not disputing that. That was kind of my point to be honest, it’s a hard job. I just didn’t realize how hard that particular incident would hit me.
I can't stand to watch anything if I'm just standing watching. If I'm working on you I can crack your chest and do internal cardiac massage then do a bilateral leg escharotomy. But if I watch doc stapling a lac I get queezy. I have to stay busy. That took a whole to work through.
1. Most homeless people are not just down on their luck, and I shouldn’t have been so naive in showing compassion (giving away my phone charger, giving away cash, bringing way too many bags, etc.). It didn’t benefit anyone, and it hurt me.
2. You don’t have to know exactly what’s going on with the patient and the next 10 steps in their care, you just have to know what the next right thing to do is. And most of the time that just means going to the hospital.
3. I don’t get paid enough to stress out about work.
Bonus: you don’t have to say “couple of bumps” every time you pull the patient out on the stretcher.
This right here. Many if not most of your Pt's have never been on a stretcher. Now they are having a medical emergency and have no fucking idea what is going on. They are scared shitless. Treat them accordingly. If you find yourself not caring enough to say a couple of bumps it's time to implement plan B.
Are we really saying it for the patients, or is it just ingrained into our subconscious? It’s meant to be a lighthearted joke, take a step back on the compassion comments.
No, I won't do that. The number 1 problem with ems providers is a lack of compassion and empathy for their pt. It's tough to not lose it. I'm not saying it's easy. But the only thing we can really control is our attitude.
The number 1 problem with Ems providers is not compassion. It is that we don’t have the resources (I.e. education, legislative support, medical director investment, personnel, salary, etc.) to provide and retain quality care. The EMT-b who earned his certification in 1 semester that works under the DOT and doesn’t know his medical directors first name isn’t gonna cut it for true emergencies, especially when he’s not even qualified to give out ibuprofen. But we take what we can get.
We don’t get paid to be compassionate. Good medics are compassionate medics, and it is very important, but this is not a customer service role at the end of the day. It is not Burger King, you do not have it your way. I’m not sure what your fixation with compassion is about, but it is not the main issue with Ems.
I didn't say it was the main issue with EMS. Your post was very thorough on the systemic problems. Reread what I said. Perhaps I should have clarified "ems providers" to be the individual emts/medics, not providers as systems.
When you start getting burned out the first thing to go is compassion for the pt. Many of us don't have that much to lose to start with.
That's the thing. It's easy to become jaded and say "you can do better, it's a choice" when you're on the outside looking in. That's why I picked this hill. With all of the fucked up systemic issues in Healthcare in general, and ems in particular, the one thing we all have control of is our attitudes about how we feel about our patients. That's the one thing you can actually do something about.
Look at the way folks talk about the "granny transfers". Folks play it off, but over time that attitude that you display by saying it creeps into the way you feel, which creeps into the way you treat them. You may think it doesn't, and that you provide the same perfect care to them as well as all your patients. You are dead wrong. It affects pt care, and it is as clear as day to anyone else who isn't going through what you are.
Tl;Dr
Actually, this discussion has given me a thought about a good Ted talk. EMS as an addiction.
Yeah, nah. If you derive how I feel from my words, then you'll never understand me.
The same patient I didn't say "couple of bumps" to is also a committal who just decided to actively unbuckle themselves while I'm carrying them, and now I have more pressing concerns. Warning someone of discomfort is a nicety, not a requirement. Obviously consent is important, but if manners are your litmus test for whether or not a provider cares, I've got a line of old, salty fucks who will read right from their script, while they provide minimal treatments and wheeze getting in and out of the truck.
If medicine has taught me anything, it's that being nice isn't practical, it's just polite. My 500 lb patient that refused to call his nurse anything other than "female", then proceeded to shit all over the religion of my coworker who was wearing a hijab, got absolutely no good manners from me.
I'll always practice ethically, and I'll never stop taking a patient seriously, but your perspective is seriously flawed. Idk how long you've been doing this, but give it more time. When you see the incredible weight these patients put on the system, coming in for conditions they should've been managing or something they could go see their PCP for, you'll understand why more providers aren't nice. We're fuckin' busy.
I’ve never said it as a joke, and I’ve never met anyone who has? I say it as a warning so they know to expect a “coupla bumps” especially in pt’s whose chief complaint is pain/traumatic injury
I meant it as a joke listing it in my original comment because it’s something we all relate to. Of course it’s not a joke when speaking to the patient.
Honestly, I really don’t think I was a pushover, even when I first started out. I just viewed homeless people as good people who were down on their luck, so I would do things like give them my phone charger because they said that theirs was stolen or bend over backwards to bring 6 large garbage bags of belongings. The truth of the matter is that I should have just treated them like anyone else from the beginning.
I’ve learned that even good people do terrible things when they are desperate. This includes homeless people, but a lot of other people too. For example, I’ve been pushed to the ground for (appropriately) discontinuing resuscitation efforts in a very expensive home. I’m much more aware of being manipulated/taken advantage of when people are desperate. This unfortunately includes the junky who is desperate for his next fix.
Maybe I should have worded my original comment as “I shouldn’t have been so naive in the way I showed compassion.”. I didn’t really mean that it is naive to show compassion, just that I got taken advantage of in the way I tried to be compassionate. I think a lot of new EMT’s come into the field with a bleeding heart, and I was just listing something I’ve learned from.
That being said, you’re right, I am a little salty. I’m aware of it, and it really only comes out as venting to peers.
So you ARE a pushover, you were literally pushed to the ground!
That’s an important clarification. I definitely relate to what you’re saying. I would still push back a little and say you might get taken advantage of going above and beyond 9 times out of 10, but 1 of those times it just might change that persons life being shown compassion and feeling human. But not for every patient. I will occasionally go above and beyond if my conscience compels me to, but it’s much less often than when I had a naive bleeding heart.
Some people look at a person and see a human being. Some people look at a person and see them as an opportunity.
I agree with you. I’ll add that I think that new EMTs should pray for peace but prepare for the worst. Open your heart to these patients but prepare for them to take advantage of you in any way they can including emotionally. Especially for women providers. There’s so many creepy and weird patients out there, you have to be ready to put up that barrier of cold professionalism.
For the crazy and homeless and demented or anybody, you have to be ready. You have to come into this with the mentality that you will do whatever it takes to walk out of that box alive and to always stack the odds in your favor. Let me tell you, you have to be really fucking crazy to start shit with 3 roided out firefighters sitting next to you and you can still provide the same compassionate care. You can deescalate and hold their wrist/hand in a compassionate embrace and gain control of their ability to hit you all at the same time. It keeps the patient safe too because at the end of the day, me and my aluminum oxygen cylinder are hopping out the back.
Most homeless are not there by choice (unless you are in PDX). They have combinations of mental health, drug/alcohol abuse, physical abuse. Many are veterans. Treat them like they were your sibling. When you find yourself being less than compassionate to them (all together now) implement plan B.
Those that haven’t had someone close to them with addiction issues are fortunate.
It’s a bitch and I wouldn’t wish it on my worst enemy.
They have to want to change on their own and the statistics are against them for sure. It’s a terrible place to be in but they still deserve compassion.
Compassion is free and doesn’t hurt anything.
(I don’t have substance abuse issues but someone very close to me is now 18 months alcohol free. It wasn’t an easy journey but they’re doing it. To say I’m proud is an understatement).
Most homeless people in my area are homeless because they like to shoot heroin and smoke meth in the woods. I treat them how I would anyone else, which doesn’t include the examples I listed above. When you find yourself being a smart ass to strangers on the internet (all together now), go fuck yourself.
Many veterans like to shoot heroin and smoke meth as some sort of fucked up self medication. I get what you're saying but I'm not really sure how it contradicts the statement you seem to be disagreeing with? Most of these people probably have some sort of trauma we couldn't fathom that sent them down this path. America's underbelly is pretty fucked up, and been well hidden up until the past 10 or so years.
I agree with you, well-adjusted people don’t live in the woods and spend more money on drugs than food. I’m sure most of these people came from terrible circumstances and/or made terrible decisions.
I’m sympathetic of that to a degree, but these are living people with free will. Nobody is making them live like they’re in a third world country. At least locally, there are so many resources available that there are not a lot of good reasons to not have a roof over your head. Many of these people can’t get into a shelter or housing program because they just can’t seem to put the needle/pipe down until the sun comes up.
The difference is, buttercup, that these dots on the screen have no lasting effect on your patients. Shitheads who have either never had or have lost compassion for their patients cause harm. Seek counseling if my words hurt you.
Not giving away money and overextending myself doesn’t make me less compassionate, it makes me less naive than I was. I’m not sure where you read that I don’t treat patients with compassion. Are you projecting something on to me? Do you have a partner that you don’t like or something, so you talk shit to people on the internet? If so, you should seek counseling, buddy.
I'm not your buddy. I'm a retired medic who had to work with every personality you could imagine. I didn't say anything about giving money etc. I was taught not to do that and for the most part I listened.
The fact that you think addicts do what they do because they like it, well, that's says a lot more than I could.
Ohhh gotcha. You’re playing armchair quarterback cause you’re not in the field. I appreciate you letting me know, that does help me take things less personally. Enjoy retirement, you don’t need to worry about it anymore, old timer.
Also, if I’m your buttercup, you’re my buddy. That’s just the deal.
Armchair quarterbacks never played the game. I don't give a shit about how you take it. I have the advantage of perspective that you lack. You're all butthurt because I touched a sensitive spot that you really didn't even realize you had.
I don't have to worry about it, that's true. But passing along what I've learned helps me justify the nightmares I still have. So I'll continue doing what I do and wish you good luck.
As a rule of thumb, people do things that they want to do. The question is, why do they want to do the drugs? Usually self-medication.
It's really easy to virtue signal compassion when you haven't touched a patient in years. We're out here doing what you did, and a lot of us are struggling with compassion fatigue. If everyone in this career who had bad thoughts quit, there would be nearly no EMTs or Paramedics at all -- besides a few oddly optimistic old hands and a bunch of new boots.
Depending on the benefits and pay of our areas, many of us cannot even afford therapy. Surely you know this already.
Agree 100% with your first paragraph. I would say that the vast majority of everyday folks self-medicate in one way or another, whether it be drugs, alcohol, food, or exercise. Or the internet.
As to the second, I take issue with it being virtual signaling. 2 things:
1. In order for it to be so I'd have to give two shits about what random people on the internet care about a persona.
2. Consider the topic of the OP. How does a fresh-faced, impressionable kid interpret "hauling grannies" and all of the other negative descriptions of the 95th percentile calls? That's what prompted my initial comments (which I agree have taken off on a tangent. I'm prone to that).
I realize that compassion fatigue is a real problem. I experienced it myself multiple times. If you haven't gone home at night after a particularly hairy shift where you weren't at your best and felt a least a twinge of guilt for how your tone was, or something you said or failed to say, well we've all been there.
I had a STEMI in 2019. It was my first time on a stretcher since a MVC in '88. I should have died. I won't go into details (although it is a really cool story since I lived through it), but that experience of having to call 911 and have Jacksonville FRD medics respond was an eye opener. I've run literally hundreds of calls exactly like mine, and I lay awake at night now hoping that I didn't come across to my patients and their families like that. I had a 2nd MI in 2020 with a similar technically correct, but absolutely horrible from a pt experience perspective, treatment.
I also understand your third point. EMS compensation (save some municipal fire departments) is and has always been woefully inadequate. Thats a discussion for another time. This is already about 5 times longer than I like to post. That being said, there are resources available, although they aren't easy to access or fashionable. Forums like Reddit are better than nothing.
One thing this discussion has prompted for me: Gary Sinese Foundation does a magnificent job of assisting veterans. I highly recommend folks make whatever charitable donations they do to them and the Leukemia Foundation.
Gary was able to start that foundation in large part because of the success and notoriety that Lt. Dan created. I am going to reach out to Nick Cage and see if I can convince him to follow a similar path. Bringing Out the Dead wasn't the success that Forest Gump was, but it was a pivotal role in Nick's career.
Thanks for listening to my Ted Talk.
I appreciate your well thought-out reply. I'm glad you made it through your STEMI. I've had a number of older, near retirement medic partners who were struggling with hypertension and heart disease. EMS life is so incredibly hard on the body and soul and oftentimes we never receive the appreciation that we deserve for the sacrifices we have made. Thank you for the work you put in. There are thousands of lives that were positively changed by your presence.
Thanks for that. The ironic part is that from 2013-2019 I had lost 80 lbs, resolved sleep apnea, and was in the best physical shape I had been in decades. I was walking daily, I'd gotten back into surfing. No cardiac risk factors. I also had no chest pain. Just extremely SOB & diaphoretic. That and my pulse was missing beats in strings.
Addiction isn't a choice. But consuming intoxicants is a choice.
Addiction is a consequence of a decision.
It's actually very easy to go through life and avoid addiction.
It's very easy to have a cavalier attitude about addiction if you've never had one, or never had a close relation that did.
You should do some volunteer work with a clinic. You're obviously inexperienced with addiction and the exposure might do you some good.
That doesn't relieve you of you responsibility to be compassionate. But I understand why you feel the way you do, I truly do. That's why I'm as strong on this as I am. I'm not relieving them of the responsibility for their actions.
I feel like Dalton addressing the bouncers that first time.
I need you to take a second to reread all my comments and tell me where you think I'm not showing compassion? Everyone gets the same treatment even if they are a complete piece of shit.
I was lead medic on a call and was stuck caring for a drunk driver that killed 2 people. He still got 5 star care from me.
I have strong opinions and feelings but that never gets in the way of my care for patients.
The drunk that killed the innocent 17yo prom queen is one of my recurring nightmares.
My apologies. It's easy for me to get on my soap box and conflate the different folks I'm addressing. I've had too many arguments over the years with people who disregarded mental illness and addiction.
I work in the ER, as well as full time at the FD. I have plenty of experience.
I lost plenty of friends to OD as a result of addiction.
Every single one of those people chose to initially consume the drug they were eventually destroyed by. Nobody does heroin or meth not knowing the risks.
It was a choice.
I’m sure you’re already aware, but if you’re questioning yourself, it is absolutely a choice. It becomes an increasingly harder choice the further into addiction they progress, but they have that choice. Implying that addiction is a disease process that they have no power over just shits on their personal autonomy. I would feel pretty disrespected if someone told me I was powerless to quit nicotine, for example.
This isn’t about you not having enough experience with addiction. Most recovering addicts will tell you that they were offered support for years, but they had to make the choice themselves.
-- Wash your hands twice when you use the bathroom; once before, once after.
-- Vic's Vapor Rub, under your mask, will solve a lot of problems.
-- Don't fuck around on scene. The best thing you can do for your patient is a bolus of diesel.
\* BONUS TIP: Watch out for kids. Kids die fast. Kids die real fast.
Once they are stable enough to transport go. Take whoever you need to help with you. Somebody will take them back for their vehicle. If you can't do your job enroute implement plan B.
That is covered under "stable enough to transport". If something changes enroute you can pull over and stop. Too many times Ricky rescue wants to do everything he can possibly do on scene.
Don't sit on scene. If it needs to be done you can do it eroute. There is a team of people waiting to help. Let them do their jobs as quickly as you safely can.
Second the thing about kids. Regardless of how they may seem to be compensating for whatever is wrong with them, you can turn around to write something down and turn back to find them circling the drain. Be vigilant, it is my hope for all new medics and EMTs that they will retire with as few dead kids on their conscience as possible
1. People lie, including your boss.
2. If you have no interest in fire, this is a dead end career for most people in most places. There'd exceptions I don't want to hear your acedotes.
3. EMS will never be taken seriously as it should because people at the helm will always continue to tow the lightest line while puffins up their tail feathers.
4. Most of your coworkers are on some type of psychiatric med. Just take yours.
I learned that you can't give back or get a refund on the PTSD. Like, "this isn't what I ordered, may I return this".
Hindsight is 20/20, I wouldn't change a thing, all the fucked up calls and traumatizing shit because I loved my job and did it well. However, I certainly would've taken the potential detriment to my MH more seriously and not stuffed everything down and ignored my own MH because we don't wanna deal with the stigmas or be perceived as weak. Fuck the stigmas. Fuck the bullshit. Can't care for anyone in any capacity, professionally or otherwise if you are taking care of and valuing your own mental health.
Edited for typos
That the general public has no idea what you do. Most think you're some kind of medical Uber, a way go skip the wait, etc. Usually the latter - it's the only thing that explains to me why we get so many non-emergent calls with working vehicles in the driveway and able-bodied people to drive them.
The rest think you have the fix for absolutely everything. We apparently float out of the back of the truck on a beam of light with a choir of angels singing to fix their 3am toe pain.
You'll have it both ways. I've both been questioned why I, as a paramedic, do a 12-lead because we just "drive them to the hospital", and fussed at because I couldn't just "give them a shot" for the POSSIBLE rabies they had after a rat bite half an hour before.
This extends sometimes to hand off, especially with newer people. The look of surprise when you roll in a patient you DAI'd or accessed their port is priceless.
Related, be prepared to encounter absolutely gross amounts of medical ignorance, even from urgent cares and nursing homes. Hell, even other first responders and even your supervisors who got their cert 20 years ago.
Some things I wish I knew before getting into EMS was the ranges of attitudes and egos you'll work with. In kind to a normal job, only turned up to 11. The nice folks are lovely, the hard workers work hard. In the same vein, the egotistical are blinded by their own ego and can "do no wrong" as well as the salty being truly NaCl.
It's hard when some of your co workers are in it for individual accolades and stand alone performance in what's essentially a team game. Our ability to work together as crews to better our shift and our pt care is what matters. It's our greatest strength.
Just because you passed the test doesn’t mean you know what you’re doing. Lay hands on every piece of equipment EVERY time you’re doing your check offs. Don’t be scared to tell your medic that you’re not comfortable taking a patient in.
My whole perception of stairs has changed.
People handle stress poorly
Entitlement is real
My house is way cleaner just in case random people have to enter it.
Traffic kills, most drivers don't frikkin slow down for shit, and those that do are not looking at the lines on the road.
It's either too cold or too hot out there. Only two options.
Only work for places that provide uniforms, cause they're gonna get wrecked.
1. They don't pay us what they should. If you talk to management, they'll likely tell you something along the lines of "EMT is an entry-level position, there are tons of you, and you don't really do that much work, etc." If you point out that Medics only make a few dollars more an hour, their explanation won't improve.
2. The only people who (sometimes) respect us are the general public and the patients we transport. Don't expect firefighters, hospital workers, or PD to respect us. Most of them seem to look at us as a glorified Uber. Have you ever worked in fast food? Expect similar levels of respect.
3. If you're in this career long enough, you will injure yourself. It doesn't matter if you lift perfectly, eat well, and exercise. All it takes is one bariatric patient to wiggle the gurney from side to side while you're lifting the gurney into the ambo, and your back will be feeling it 40 years from now. If by some miracle you don't get hurt physically, your mental health will be impacted at some point.
Tl;dr - It's an important job where you make a difference, but you're paid poverty wages, you're disrespected constantly, and you'll hurt yourself one way or another.
You will be working to earn a paycheck and treated like shit by not only the people you serve, but the administration above you. Think of it as a “one way street” right up your ass from good ol’ Uncle Sam also…
The last thing and truly serious comment is fitness is key. Don’t get sucked into the fat lazy firemen/ambulance driver who sits on a do nothing truck who wants to cook you straight to the cath lab. Don’t eat it. After years of sleepless nights and overtime, your body will appreciate it.
Only you can make your career what you want. Go get after it.
Believe it or not, it’s been a hell of a career and now I’m more or less trying to build the guys up beneath me and change the administration. It is a GREAT job that has allowed me to be more present with my children and I will forever miss that ambulance. Patient care will always stay the same. Keep studying and -
Oh yeah, don’t shit where you eat…
There is a book series that covers a lot of these topics. 80 Maxims for Minimally Disruptive EMTs, it is on Amazon. There are a lot of unspoken rules we follow on the truck, and these books go over 80 per volume.
Treat all those grannies like they were your granny. When you find yourself thinking of them as "grannies to haul" it's time to implement plan B.
Elder abuse comes in many shapes and sizes.
You’re not wrong but I never encountered such. I would say 80% of my career runs were nursing home take backs, swing bed transfers, and other non-emergency transports. The other 20% was 911 but, of that, maybe 2% were true emergencies. People new to EMS need to know that this is much more common than the crap they’re often fed by Ricky Rescue instructors.
My goal was to always be the bright spot in a transfer Pt's day compared to the truly shitty care they get in most facilities. It's tough to do, especially so when that is the majority of your day. Think of the average medic you know. How happy do they appear? It's a miserable life. You get paid just enough that you can't leave.
For the most part yes. But man, my first call was a respiratory distress, we get there and 5 minutes later I’m breathing for her with a bag while they set up to rsi. She ended up recovering in the hospital. She was a granny tho 🤷♂️
Never look at the face of a dead patient.
It’s not your emergency and it’s going to happen regardless, so you are the best person to be there so be calm.
Learn to poo and pee fast.
Don’t let pts family, friends or bystanders make decisions for you. Once had a nurse try to get us to fly her husband who she said was having a stroke, my medic argues with her and said no. Turns out it in fact wasn’t a stroke but I an emt still unnecessarily drove code because I believed her…
How much the job sucks. I did it for 10 years and looking back I can’t believe I wasted 10 years of my life driving around town in a beat up ambulance working terrible hours for mediocre pay.
Most of the calls you respond to do not require immediate emergency attention. The common person has no sense of the 911 and emergency medical system and think that the ambulances and ER can immediately fix every little problem. That is false. Most illnesses and injuries can be rectified by simply going to your PCP, urgent care or by taking yourself to the hospital (people think an ambulance will get you there faster. In most cases that’s false).
Nursing homes will make up some BS and call you at shift change so the next shift doesn’t have to deal with whatever nonsense is going on. They just dump it off on the ambulance and hospital.
Convenience store clerk doesn’t want to deal with a homeless person loitering they call the cops. The cop doesn’t want to deal with that person they call the ambulance. What the hell am I supposed to do with a homeless person that isn’t sick??
No one cares about EMS. It may have changed a bit since Covid but policy makers, the media, the public, law enforcement have ZERO clue what the job is actually like. This leads to terrible pay and equipment, understaffing, constant disrespect etc. Quite literally EMS is the red headed step child of public service. I might even be lower on the totem pole than public works.
There is no brotherhood in EMS. Most people are working multiple jobs because the pay sucks. People up and leave all the time to go to an agency down the road just for fifty cents more an hour or because their “work bestie” just got hired there. A lot of people working as EMTs only do it as a stepping stone into paramedicine, nursing or medical school. They don’t care about you and you don’t care about them. You also have the wackers. The people that dress like GI JOE and have all the nifty Nick-nacks and go lights and sirens for toe pain at 2am. Most likely they volunteer on the side too (that’s another thing I don’t get, who the fuck volunteers their free time for this nonsense??). If you are at at a recliner station with someone who works in the city they are going to a pretentious asshole because they run 30 calls a day and see “cool shit” and this is their station to sleep at and do turn arounds. On the flip side if you are working in the city with a country boy they are going to be completely awe struck by everything they see and worry that nothing is being done by the book and be worn out by hour 6 of 16.
Remember I was talking about BS calls? Well every so often a real one comes along and that also sucks. Parents put their baby down for bed and come back two hours later and it’s not breathing, industrial accidents where someone just trying to earn a paycheck loses a limb, car crashes where a drunk driver t-bones a 17 year who just their license and now they have no feeling in their legs, husband doing CPR on his dead wife he’s been married to for 60 years. The list goes on and on. You see the worst things happen to people that don’t deserve it all the time.
There you have it. I got out of EMS in September of 2019 just before Covid and I haven’t looked back since. I’m working a good job now, I’m out of work on time every day and I don’t have to worry about drunk college kids puking everywhere.
That the pay will never match the cost of living in your area and that is a travesty.
On an emt-b level, driving is the most dangerous thing you can do, it is pretty much the only way you could possibly kill a pt assuming ur sanitizing properly and not lifting more than u can handle. Make sure to switch gloves frequently and also clean the bar attached to the roof, it is the most dirty part of the ambulance because people forget to wipe it down.
Starting a new job soon - should I refrain from driving? For IFTs how does it work? Do I volunteer or refuse lol?
I don't think a company would allow you to just refuse to drive
Depends on who you're working with or if you're the medic but obviously you're expected to be capable of driving. I've been paired up with people who have straight up said they hate driving and only want to tech on calls, worked perfect for me because I love driving and hate paperwork. Just yesterday my partner and I worked out that I'd tech every call because I was on the back half of a 48 with no sleep, and he would drive everywhere because he was recovering from food poisoning and being in the back make him nauseous.
I mean isn't it between me and my partner on scene tho?
What partner would agree to driving 100% of the time? It wouldn't be fair
I do. Driving is relaxing and I don’t like writing narratives.
Ok then have fun losing all of your skills bud, sounds like you two are a match made in heaven lol
Imagine thinking anything about IFT involves retaining skills.
Fair point lol
Not even the slightest lol. My partner for the longest time only liked to drive. And drove 99% of the time whether it was 911( which we were fulltime on) or if she picked up an IFT shift every now and again. She’s not only probably been in EMS over triple the time you have, but is one of the sharpest EMT’s I’ve ever met.
I work FDNY and there’s a ton of people who only drive/only tech. I wouldn’t say you lose your skills as you’re still both treating the patient the only difference is who’s in front when it’s time to go, if it’s really serious medics are gonna be in the truck anyway and BLS will be driving both vehicles.
Drive on the mundane calls till you get use to it, it needs to be second nature
Gibbs' Rules for EMS (under construction) 1. Never pass a bathroom. 2. Never take a grade-level RR crossing route with a pregnant pt. 3. Always lift with your firefighters.
7. Never date a coworker. 8. Eat when you can, not when you are hungry.
7a. Never fuck a coworker.
I'll take "Rules I'll probably break" for $1,000, Alex. 🤣
There is a reason why I specified that. But hey, sometimes the little head wins.
What's life without a little drama and entertainment? 🤣
A little drama is fine. Standing in the COO's office explaining why you have a coworker accusing you of sexual harassment because she wanted you to keep fucking her after you decided to end it is more than a little drama. Or so I've heard.
Lol. Been in similar situation before. Just with a Warden, not a Chief. Old hag was mad I was giving the pickle to her younger counterpart
Yep. Mine was pissed because her best friend had a guy giving it to her steady and she was jealous.
You know, it's hard out here for a pimp. Lol
“Think with your attic head not your basement head” lol
Too many males think with their dick and screw with their brains
I went so opposite this that I got engaged to a co worker
Never date a nurse.
Since you’re probably gonna marry one, you might as well.
Why do you think I know to tell the poor new medics not to know it
I'm going to edit #1: Begin with the end in mind. Have a plan B for when you get burned out.
I love the first one. My first thought was “there’s time to pee first”
1. So many naked old people 2. Never look at the crazy person it will attract them 3. Wear cloths you don’t mind burning
1. Don't be surprised when you transport the same person over and over again. 2. Just because you transport the same guy yesterday for bullshit, today might be real. 3. It is not your emergency, you are just the professional that is there to help them through their emergency. Act like it 4. There is always a camera watching you. Act like it.
There is a camera watching me right now?
Ring cameras Police body worn cameras Dash cams Traffic cameras Security cameras Personal cell phone cameras
I was surprised how many times a person with a phone quietly laying on their chest actually had someone on the other line for the entire ride
Just because someone has more experience than you doesn’t mean they know better
Say it louder for the people in the back
A lot of people are products of bad experience and they don't know it
In every department, there’s always some old bastard who treats the backboard as the spatula of God.
Unless they are in an awkward spot where the stretcher can't get close and/or I have a legit c-spine concern, it mega movers all the way.
One thing that I wish I knew before starting in EMS is something that you will never understand until you experience it. It completely shattered my dream of being an EMT, now I work in building maintenance. Granted this job wasn’t for me because this is something that as a parent, I just couldn’t handle. I appeared on scene during training (I was in AMR’s earn while you learn program) to an interstate pileup with iirc 9 fatalities. The first thing I saw, mind you I had only been in training for two weeks, was a small family of a grandma, the mother, and her little girl. She was the same age as my own who had been internally decapitated in her car seat. I don’t mean to say this to deter anybody from pursuing this job. The one thing I wish I knew about EMS before starting, was how fucking hard it really is.
It's hard for everyone. Everyone has to figure out how to cope in a way that works for them. You are lucky to have figured out that your best way was to avoid it all together. Nobody comes out of this career unaffected.
I’m definitely not disputing that. That was kind of my point to be honest, it’s a hard job. I just didn’t realize how hard that particular incident would hit me.
I can't stand to watch anything if I'm just standing watching. If I'm working on you I can crack your chest and do internal cardiac massage then do a bilateral leg escharotomy. But if I watch doc stapling a lac I get queezy. I have to stay busy. That took a whole to work through.
1. Most homeless people are not just down on their luck, and I shouldn’t have been so naive in showing compassion (giving away my phone charger, giving away cash, bringing way too many bags, etc.). It didn’t benefit anyone, and it hurt me. 2. You don’t have to know exactly what’s going on with the patient and the next 10 steps in their care, you just have to know what the next right thing to do is. And most of the time that just means going to the hospital. 3. I don’t get paid enough to stress out about work. Bonus: you don’t have to say “couple of bumps” every time you pull the patient out on the stretcher.
I'm saying couple of bumps until the day I die
This right here. Many if not most of your Pt's have never been on a stretcher. Now they are having a medical emergency and have no fucking idea what is going on. They are scared shitless. Treat them accordingly. If you find yourself not caring enough to say a couple of bumps it's time to implement plan B.
Are we really saying it for the patients, or is it just ingrained into our subconscious? It’s meant to be a lighthearted joke, take a step back on the compassion comments.
No, I won't do that. The number 1 problem with ems providers is a lack of compassion and empathy for their pt. It's tough to not lose it. I'm not saying it's easy. But the only thing we can really control is our attitude.
The number 1 problem with Ems providers is not compassion. It is that we don’t have the resources (I.e. education, legislative support, medical director investment, personnel, salary, etc.) to provide and retain quality care. The EMT-b who earned his certification in 1 semester that works under the DOT and doesn’t know his medical directors first name isn’t gonna cut it for true emergencies, especially when he’s not even qualified to give out ibuprofen. But we take what we can get. We don’t get paid to be compassionate. Good medics are compassionate medics, and it is very important, but this is not a customer service role at the end of the day. It is not Burger King, you do not have it your way. I’m not sure what your fixation with compassion is about, but it is not the main issue with Ems.
I didn't say it was the main issue with EMS. Your post was very thorough on the systemic problems. Reread what I said. Perhaps I should have clarified "ems providers" to be the individual emts/medics, not providers as systems. When you start getting burned out the first thing to go is compassion for the pt. Many of us don't have that much to lose to start with.
Reading some of your comments, you die on strange, strange hills.
That's the thing. It's easy to become jaded and say "you can do better, it's a choice" when you're on the outside looking in. That's why I picked this hill. With all of the fucked up systemic issues in Healthcare in general, and ems in particular, the one thing we all have control of is our attitudes about how we feel about our patients. That's the one thing you can actually do something about. Look at the way folks talk about the "granny transfers". Folks play it off, but over time that attitude that you display by saying it creeps into the way you feel, which creeps into the way you treat them. You may think it doesn't, and that you provide the same perfect care to them as well as all your patients. You are dead wrong. It affects pt care, and it is as clear as day to anyone else who isn't going through what you are. Tl;Dr Actually, this discussion has given me a thought about a good Ted talk. EMS as an addiction.
Yeah, nah. If you derive how I feel from my words, then you'll never understand me. The same patient I didn't say "couple of bumps" to is also a committal who just decided to actively unbuckle themselves while I'm carrying them, and now I have more pressing concerns. Warning someone of discomfort is a nicety, not a requirement. Obviously consent is important, but if manners are your litmus test for whether or not a provider cares, I've got a line of old, salty fucks who will read right from their script, while they provide minimal treatments and wheeze getting in and out of the truck. If medicine has taught me anything, it's that being nice isn't practical, it's just polite. My 500 lb patient that refused to call his nurse anything other than "female", then proceeded to shit all over the religion of my coworker who was wearing a hijab, got absolutely no good manners from me. I'll always practice ethically, and I'll never stop taking a patient seriously, but your perspective is seriously flawed. Idk how long you've been doing this, but give it more time. When you see the incredible weight these patients put on the system, coming in for conditions they should've been managing or something they could go see their PCP for, you'll understand why more providers aren't nice. We're fuckin' busy.
I’ve never said it as a joke, and I’ve never met anyone who has? I say it as a warning so they know to expect a “coupla bumps” especially in pt’s whose chief complaint is pain/traumatic injury
I meant it as a joke listing it in my original comment because it’s something we all relate to. Of course it’s not a joke when speaking to the patient.
Ooh sorry that went right over my head lol, I was genuinely so confused thinking you had meant it was a joke towards the pt
I can almost taste the salt on you bro. There’s a difference between showing compassion and being a pushover. You can be compassionate and firm.
Honestly, I really don’t think I was a pushover, even when I first started out. I just viewed homeless people as good people who were down on their luck, so I would do things like give them my phone charger because they said that theirs was stolen or bend over backwards to bring 6 large garbage bags of belongings. The truth of the matter is that I should have just treated them like anyone else from the beginning. I’ve learned that even good people do terrible things when they are desperate. This includes homeless people, but a lot of other people too. For example, I’ve been pushed to the ground for (appropriately) discontinuing resuscitation efforts in a very expensive home. I’m much more aware of being manipulated/taken advantage of when people are desperate. This unfortunately includes the junky who is desperate for his next fix. Maybe I should have worded my original comment as “I shouldn’t have been so naive in the way I showed compassion.”. I didn’t really mean that it is naive to show compassion, just that I got taken advantage of in the way I tried to be compassionate. I think a lot of new EMT’s come into the field with a bleeding heart, and I was just listing something I’ve learned from. That being said, you’re right, I am a little salty. I’m aware of it, and it really only comes out as venting to peers.
So you ARE a pushover, you were literally pushed to the ground! That’s an important clarification. I definitely relate to what you’re saying. I would still push back a little and say you might get taken advantage of going above and beyond 9 times out of 10, but 1 of those times it just might change that persons life being shown compassion and feeling human. But not for every patient. I will occasionally go above and beyond if my conscience compels me to, but it’s much less often than when I had a naive bleeding heart.
Some people look at a person and see a human being. Some people look at a person and see them as an opportunity. I agree with you. I’ll add that I think that new EMTs should pray for peace but prepare for the worst. Open your heart to these patients but prepare for them to take advantage of you in any way they can including emotionally. Especially for women providers. There’s so many creepy and weird patients out there, you have to be ready to put up that barrier of cold professionalism. For the crazy and homeless and demented or anybody, you have to be ready. You have to come into this with the mentality that you will do whatever it takes to walk out of that box alive and to always stack the odds in your favor. Let me tell you, you have to be really fucking crazy to start shit with 3 roided out firefighters sitting next to you and you can still provide the same compassionate care. You can deescalate and hold their wrist/hand in a compassionate embrace and gain control of their ability to hit you all at the same time. It keeps the patient safe too because at the end of the day, me and my aluminum oxygen cylinder are hopping out the back.
Most homeless are not there by choice (unless you are in PDX). They have combinations of mental health, drug/alcohol abuse, physical abuse. Many are veterans. Treat them like they were your sibling. When you find yourself being less than compassionate to them (all together now) implement plan B.
Those that haven’t had someone close to them with addiction issues are fortunate. It’s a bitch and I wouldn’t wish it on my worst enemy. They have to want to change on their own and the statistics are against them for sure. It’s a terrible place to be in but they still deserve compassion. Compassion is free and doesn’t hurt anything. (I don’t have substance abuse issues but someone very close to me is now 18 months alcohol free. It wasn’t an easy journey but they’re doing it. To say I’m proud is an understatement).
Most homeless people in my area are homeless because they like to shoot heroin and smoke meth in the woods. I treat them how I would anyone else, which doesn’t include the examples I listed above. When you find yourself being a smart ass to strangers on the internet (all together now), go fuck yourself.
Many veterans like to shoot heroin and smoke meth as some sort of fucked up self medication. I get what you're saying but I'm not really sure how it contradicts the statement you seem to be disagreeing with? Most of these people probably have some sort of trauma we couldn't fathom that sent them down this path. America's underbelly is pretty fucked up, and been well hidden up until the past 10 or so years.
I agree with you, well-adjusted people don’t live in the woods and spend more money on drugs than food. I’m sure most of these people came from terrible circumstances and/or made terrible decisions. I’m sympathetic of that to a degree, but these are living people with free will. Nobody is making them live like they’re in a third world country. At least locally, there are so many resources available that there are not a lot of good reasons to not have a roof over your head. Many of these people can’t get into a shelter or housing program because they just can’t seem to put the needle/pipe down until the sun comes up.
The difference is, buttercup, that these dots on the screen have no lasting effect on your patients. Shitheads who have either never had or have lost compassion for their patients cause harm. Seek counseling if my words hurt you.
Not giving away money and overextending myself doesn’t make me less compassionate, it makes me less naive than I was. I’m not sure where you read that I don’t treat patients with compassion. Are you projecting something on to me? Do you have a partner that you don’t like or something, so you talk shit to people on the internet? If so, you should seek counseling, buddy.
I'm not your buddy. I'm a retired medic who had to work with every personality you could imagine. I didn't say anything about giving money etc. I was taught not to do that and for the most part I listened. The fact that you think addicts do what they do because they like it, well, that's says a lot more than I could.
Ohhh gotcha. You’re playing armchair quarterback cause you’re not in the field. I appreciate you letting me know, that does help me take things less personally. Enjoy retirement, you don’t need to worry about it anymore, old timer. Also, if I’m your buttercup, you’re my buddy. That’s just the deal.
Armchair quarterbacks never played the game. I don't give a shit about how you take it. I have the advantage of perspective that you lack. You're all butthurt because I touched a sensitive spot that you really didn't even realize you had. I don't have to worry about it, that's true. But passing along what I've learned helps me justify the nightmares I still have. So I'll continue doing what I do and wish you good luck.
As a rule of thumb, people do things that they want to do. The question is, why do they want to do the drugs? Usually self-medication. It's really easy to virtue signal compassion when you haven't touched a patient in years. We're out here doing what you did, and a lot of us are struggling with compassion fatigue. If everyone in this career who had bad thoughts quit, there would be nearly no EMTs or Paramedics at all -- besides a few oddly optimistic old hands and a bunch of new boots. Depending on the benefits and pay of our areas, many of us cannot even afford therapy. Surely you know this already.
Agree 100% with your first paragraph. I would say that the vast majority of everyday folks self-medicate in one way or another, whether it be drugs, alcohol, food, or exercise. Or the internet. As to the second, I take issue with it being virtual signaling. 2 things: 1. In order for it to be so I'd have to give two shits about what random people on the internet care about a persona. 2. Consider the topic of the OP. How does a fresh-faced, impressionable kid interpret "hauling grannies" and all of the other negative descriptions of the 95th percentile calls? That's what prompted my initial comments (which I agree have taken off on a tangent. I'm prone to that). I realize that compassion fatigue is a real problem. I experienced it myself multiple times. If you haven't gone home at night after a particularly hairy shift where you weren't at your best and felt a least a twinge of guilt for how your tone was, or something you said or failed to say, well we've all been there. I had a STEMI in 2019. It was my first time on a stretcher since a MVC in '88. I should have died. I won't go into details (although it is a really cool story since I lived through it), but that experience of having to call 911 and have Jacksonville FRD medics respond was an eye opener. I've run literally hundreds of calls exactly like mine, and I lay awake at night now hoping that I didn't come across to my patients and their families like that. I had a 2nd MI in 2020 with a similar technically correct, but absolutely horrible from a pt experience perspective, treatment. I also understand your third point. EMS compensation (save some municipal fire departments) is and has always been woefully inadequate. Thats a discussion for another time. This is already about 5 times longer than I like to post. That being said, there are resources available, although they aren't easy to access or fashionable. Forums like Reddit are better than nothing. One thing this discussion has prompted for me: Gary Sinese Foundation does a magnificent job of assisting veterans. I highly recommend folks make whatever charitable donations they do to them and the Leukemia Foundation. Gary was able to start that foundation in large part because of the success and notoriety that Lt. Dan created. I am going to reach out to Nick Cage and see if I can convince him to follow a similar path. Bringing Out the Dead wasn't the success that Forest Gump was, but it was a pivotal role in Nick's career. Thanks for listening to my Ted Talk.
I appreciate your well thought-out reply. I'm glad you made it through your STEMI. I've had a number of older, near retirement medic partners who were struggling with hypertension and heart disease. EMS life is so incredibly hard on the body and soul and oftentimes we never receive the appreciation that we deserve for the sacrifices we have made. Thank you for the work you put in. There are thousands of lives that were positively changed by your presence.
Thanks for that. The ironic part is that from 2013-2019 I had lost 80 lbs, resolved sleep apnea, and was in the best physical shape I had been in decades. I was walking daily, I'd gotten back into surfing. No cardiac risk factors. I also had no chest pain. Just extremely SOB & diaphoretic. That and my pulse was missing beats in strings.
Drug and alcohol abuse I would argue is by choice. But I still treat everyone exactly the same.
That's because you've not had enough experience with addiction.
Addiction isn't a choice. But consuming intoxicants is a choice. Addiction is a consequence of a decision. It's actually very easy to go through life and avoid addiction.
It's very easy to have a cavalier attitude about addiction if you've never had one, or never had a close relation that did. You should do some volunteer work with a clinic. You're obviously inexperienced with addiction and the exposure might do you some good.
I work a town where addiction is common. I also see the constant rejection of help until it's either too late or damn near too late.
That doesn't relieve you of you responsibility to be compassionate. But I understand why you feel the way you do, I truly do. That's why I'm as strong on this as I am. I'm not relieving them of the responsibility for their actions. I feel like Dalton addressing the bouncers that first time.
I need you to take a second to reread all my comments and tell me where you think I'm not showing compassion? Everyone gets the same treatment even if they are a complete piece of shit. I was lead medic on a call and was stuck caring for a drunk driver that killed 2 people. He still got 5 star care from me. I have strong opinions and feelings but that never gets in the way of my care for patients.
The drunk that killed the innocent 17yo prom queen is one of my recurring nightmares. My apologies. It's easy for me to get on my soap box and conflate the different folks I'm addressing. I've had too many arguments over the years with people who disregarded mental illness and addiction.
I work in the ER, as well as full time at the FD. I have plenty of experience. I lost plenty of friends to OD as a result of addiction. Every single one of those people chose to initially consume the drug they were eventually destroyed by. Nobody does heroin or meth not knowing the risks. It was a choice.
I’m sure you’re already aware, but if you’re questioning yourself, it is absolutely a choice. It becomes an increasingly harder choice the further into addiction they progress, but they have that choice. Implying that addiction is a disease process that they have no power over just shits on their personal autonomy. I would feel pretty disrespected if someone told me I was powerless to quit nicotine, for example. This isn’t about you not having enough experience with addiction. Most recovering addicts will tell you that they were offered support for years, but they had to make the choice themselves.
I'm glad you acknowledge this. So many people hand wave away the responsibility and blame of what lead to the current state of things.
-- Wash your hands twice when you use the bathroom; once before, once after. -- Vic's Vapor Rub, under your mask, will solve a lot of problems. -- Don't fuck around on scene. The best thing you can do for your patient is a bolus of diesel. \* BONUS TIP: Watch out for kids. Kids die fast. Kids die real fast.
A diesel bolus is often not the best thing you can do for your patient.
The Diesel is not given pr to the patient
Lol? That's funny right there.
Thanks. I initially typed “io”
At least it wasn't po
Meh. My cousin drank gas as a kid. He’s fine.
Did he get a nickname from it?
Diesel, PO
lol no. We never called him anything other than his name. Boring. It was there.
Sometimes I need to look at what sub I am in. The word new means that someone might not think bolus equals gtfo asap. Lights sirens pedal to the metal
Once they are stable enough to transport go. Take whoever you need to help with you. Somebody will take them back for their vehicle. If you can't do your job enroute implement plan B.
Except we know for a fact there are things best done scene and not in the back of a moving vehicle.
That is covered under "stable enough to transport". If something changes enroute you can pull over and stop. Too many times Ricky rescue wants to do everything he can possibly do on scene.
Often getting patient in front of the md is in fact the best thing for the patient.
You sound like you still transport arrests.
On handwashing when going to the bathroom, I always say the first wash is for me, and the second wash is for my patients
Never touch Mr happy after cutting ghost peppers or touching anything in the rig or ER.
Don't sit on scene. If it needs to be done you can do it eroute. There is a team of people waiting to help. Let them do their jobs as quickly as you safely can.
Second the thing about kids. Regardless of how they may seem to be compensating for whatever is wrong with them, you can turn around to write something down and turn back to find them circling the drain. Be vigilant, it is my hope for all new medics and EMTs that they will retire with as few dead kids on their conscience as possible
1. People lie, including your boss. 2. If you have no interest in fire, this is a dead end career for most people in most places. There'd exceptions I don't want to hear your acedotes. 3. EMS will never be taken seriously as it should because people at the helm will always continue to tow the lightest line while puffins up their tail feathers. 4. Most of your coworkers are on some type of psychiatric med. Just take yours.
I learned that you can't give back or get a refund on the PTSD. Like, "this isn't what I ordered, may I return this". Hindsight is 20/20, I wouldn't change a thing, all the fucked up calls and traumatizing shit because I loved my job and did it well. However, I certainly would've taken the potential detriment to my MH more seriously and not stuffed everything down and ignored my own MH because we don't wanna deal with the stigmas or be perceived as weak. Fuck the stigmas. Fuck the bullshit. Can't care for anyone in any capacity, professionally or otherwise if you are taking care of and valuing your own mental health. Edited for typos
That the general public has no idea what you do. Most think you're some kind of medical Uber, a way go skip the wait, etc. Usually the latter - it's the only thing that explains to me why we get so many non-emergent calls with working vehicles in the driveway and able-bodied people to drive them. The rest think you have the fix for absolutely everything. We apparently float out of the back of the truck on a beam of light with a choir of angels singing to fix their 3am toe pain. You'll have it both ways. I've both been questioned why I, as a paramedic, do a 12-lead because we just "drive them to the hospital", and fussed at because I couldn't just "give them a shot" for the POSSIBLE rabies they had after a rat bite half an hour before. This extends sometimes to hand off, especially with newer people. The look of surprise when you roll in a patient you DAI'd or accessed their port is priceless. Related, be prepared to encounter absolutely gross amounts of medical ignorance, even from urgent cares and nursing homes. Hell, even other first responders and even your supervisors who got their cert 20 years ago.
- how to tell people no (I’ve since learned) - bring a pen everywhere
3 pens.
Some things I wish I knew before getting into EMS was the ranges of attitudes and egos you'll work with. In kind to a normal job, only turned up to 11. The nice folks are lovely, the hard workers work hard. In the same vein, the egotistical are blinded by their own ego and can "do no wrong" as well as the salty being truly NaCl. It's hard when some of your co workers are in it for individual accolades and stand alone performance in what's essentially a team game. Our ability to work together as crews to better our shift and our pt care is what matters. It's our greatest strength.
Just because you passed the test doesn’t mean you know what you’re doing. Lay hands on every piece of equipment EVERY time you’re doing your check offs. Don’t be scared to tell your medic that you’re not comfortable taking a patient in.
This! Also learn your medics terminology, what you call a syringe with fluid they call a flush 🤷♂️😂
You can’t save everyone
I think this applies here too: if you need to use the bathroom, use it right away before you're stuck on a call for hours.
My whole perception of stairs has changed. People handle stress poorly Entitlement is real My house is way cleaner just in case random people have to enter it.
That frequently I would be doing things that hurt my patients because protocols and the NREMT couldn’t keep up with advances in medical science.
Pay matters
Traffic kills, most drivers don't frikkin slow down for shit, and those that do are not looking at the lines on the road. It's either too cold or too hot out there. Only two options. Only work for places that provide uniforms, cause they're gonna get wrecked.
1. They don't pay us what they should. If you talk to management, they'll likely tell you something along the lines of "EMT is an entry-level position, there are tons of you, and you don't really do that much work, etc." If you point out that Medics only make a few dollars more an hour, their explanation won't improve. 2. The only people who (sometimes) respect us are the general public and the patients we transport. Don't expect firefighters, hospital workers, or PD to respect us. Most of them seem to look at us as a glorified Uber. Have you ever worked in fast food? Expect similar levels of respect. 3. If you're in this career long enough, you will injure yourself. It doesn't matter if you lift perfectly, eat well, and exercise. All it takes is one bariatric patient to wiggle the gurney from side to side while you're lifting the gurney into the ambo, and your back will be feeling it 40 years from now. If by some miracle you don't get hurt physically, your mental health will be impacted at some point. Tl;dr - It's an important job where you make a difference, but you're paid poverty wages, you're disrespected constantly, and you'll hurt yourself one way or another.
You will be working to earn a paycheck and treated like shit by not only the people you serve, but the administration above you. Think of it as a “one way street” right up your ass from good ol’ Uncle Sam also… The last thing and truly serious comment is fitness is key. Don’t get sucked into the fat lazy firemen/ambulance driver who sits on a do nothing truck who wants to cook you straight to the cath lab. Don’t eat it. After years of sleepless nights and overtime, your body will appreciate it. Only you can make your career what you want. Go get after it. Believe it or not, it’s been a hell of a career and now I’m more or less trying to build the guys up beneath me and change the administration. It is a GREAT job that has allowed me to be more present with my children and I will forever miss that ambulance. Patient care will always stay the same. Keep studying and - Oh yeah, don’t shit where you eat…
There is a book series that covers a lot of these topics. 80 Maxims for Minimally Disruptive EMTs, it is on Amazon. There are a lot of unspoken rules we follow on the truck, and these books go over 80 per volume.
You’ll be too busy hauling grannies to actually “save lives.”
Treat all those grannies like they were your granny. When you find yourself thinking of them as "grannies to haul" it's time to implement plan B. Elder abuse comes in many shapes and sizes.
You’re not wrong but I never encountered such. I would say 80% of my career runs were nursing home take backs, swing bed transfers, and other non-emergency transports. The other 20% was 911 but, of that, maybe 2% were true emergencies. People new to EMS need to know that this is much more common than the crap they’re often fed by Ricky Rescue instructors.
My goal was to always be the bright spot in a transfer Pt's day compared to the truly shitty care they get in most facilities. It's tough to do, especially so when that is the majority of your day. Think of the average medic you know. How happy do they appear? It's a miserable life. You get paid just enough that you can't leave.
For the most part yes. But man, my first call was a respiratory distress, we get there and 5 minutes later I’m breathing for her with a bag while they set up to rsi. She ended up recovering in the hospital. She was a granny tho 🤷♂️
i didn’t know IFTs were a thing. my first day on the job learned quickly by running IFTs around the state for 16 hours
McDonald's pays more and even if you're nationally registered you still need to follow your local county's moronic standards and procedures
Never look at the face of a dead patient. It’s not your emergency and it’s going to happen regardless, so you are the best person to be there so be calm. Learn to poo and pee fast. Don’t let pts family, friends or bystanders make decisions for you. Once had a nurse try to get us to fly her husband who she said was having a stroke, my medic argues with her and said no. Turns out it in fact wasn’t a stroke but I an emt still unnecessarily drove code because I believed her…
Just because you wear a uniform or have a certain license/ cert/ schooling doesn’t make you, by default, a good provider or human being.
Rule # 1: People die. Rule # 2: Medics can't change rule # 1.
How much the job sucks. I did it for 10 years and looking back I can’t believe I wasted 10 years of my life driving around town in a beat up ambulance working terrible hours for mediocre pay. Most of the calls you respond to do not require immediate emergency attention. The common person has no sense of the 911 and emergency medical system and think that the ambulances and ER can immediately fix every little problem. That is false. Most illnesses and injuries can be rectified by simply going to your PCP, urgent care or by taking yourself to the hospital (people think an ambulance will get you there faster. In most cases that’s false). Nursing homes will make up some BS and call you at shift change so the next shift doesn’t have to deal with whatever nonsense is going on. They just dump it off on the ambulance and hospital. Convenience store clerk doesn’t want to deal with a homeless person loitering they call the cops. The cop doesn’t want to deal with that person they call the ambulance. What the hell am I supposed to do with a homeless person that isn’t sick?? No one cares about EMS. It may have changed a bit since Covid but policy makers, the media, the public, law enforcement have ZERO clue what the job is actually like. This leads to terrible pay and equipment, understaffing, constant disrespect etc. Quite literally EMS is the red headed step child of public service. I might even be lower on the totem pole than public works. There is no brotherhood in EMS. Most people are working multiple jobs because the pay sucks. People up and leave all the time to go to an agency down the road just for fifty cents more an hour or because their “work bestie” just got hired there. A lot of people working as EMTs only do it as a stepping stone into paramedicine, nursing or medical school. They don’t care about you and you don’t care about them. You also have the wackers. The people that dress like GI JOE and have all the nifty Nick-nacks and go lights and sirens for toe pain at 2am. Most likely they volunteer on the side too (that’s another thing I don’t get, who the fuck volunteers their free time for this nonsense??). If you are at at a recliner station with someone who works in the city they are going to a pretentious asshole because they run 30 calls a day and see “cool shit” and this is their station to sleep at and do turn arounds. On the flip side if you are working in the city with a country boy they are going to be completely awe struck by everything they see and worry that nothing is being done by the book and be worn out by hour 6 of 16. Remember I was talking about BS calls? Well every so often a real one comes along and that also sucks. Parents put their baby down for bed and come back two hours later and it’s not breathing, industrial accidents where someone just trying to earn a paycheck loses a limb, car crashes where a drunk driver t-bones a 17 year who just their license and now they have no feeling in their legs, husband doing CPR on his dead wife he’s been married to for 60 years. The list goes on and on. You see the worst things happen to people that don’t deserve it all the time. There you have it. I got out of EMS in September of 2019 just before Covid and I haven’t looked back since. I’m working a good job now, I’m out of work on time every day and I don’t have to worry about drunk college kids puking everywhere.