Head Honcho

Recently I filled out a survey at work (non-EMS) where one of the questions was if I was satisfied (or not) about the possibilities of advancement. That same question pops up year after year. I worked in other places at EMS jobs or EMS related jobs and the same question popped up those places as well. Do I think my chances are good to advance? Could I advance my career?

And then I started asking questions of my own.

Do I want to advance? What benefit could I give my company by advancing? What's the job scope? How much more responsibility will I have to take on? What are the headaches and pitfalls? Do I have the qualifications? Will I gain or lose respect from colleagues by taking this advancement? What would I hope to achieve? What kind of goals would I need to set for myself or the company? And as always, what's in it for me?

The old adage of "not being able to please everyone all of the time" is SO true. There's seemingly more people to deal with in EMS and the fire service because of our schedules than a normal 9 - 5 job. We have a lot of people because of different shifts. We deal with the public, with our staff, with vendors, and with healthcare facilities. Some even deal with government entities. Some services are paid, some are volunteer. The problems are similar on both sides of the playing field.

Saw someone ask today on Twitter about why he wanted to get back in to management. I replied, "because I got sick of the inadequacies, the inefficiency, the bull%&, and KNOW I can change all of that." Just my thoughts that have been seconded by lots of others all over the world.

Probably one of the biggest problems I faced was respect when I was named the head cheese. Respect doesn't come easily. It has to be earned from peers, colleagues, superiors, and subordinates. If it's not there, the road could be long, uphill, and potentially very, very rocky. It matters not how long you're been in the job, how much experience you have, or how many hours you pull each week. It's about respect. I have 23 years in EMS and by no stretch do I hold the seniority belt at our service. I've gotten to see and do a lot all over the world but I pale next to others.

We are lucky, luckier than most, in that we have a huge array of experiences, experience, and knowledge from which to pull from. The amount of sheer knowledge and experience I have to lean on is tremendous. I try to use whatever I can to help make the best decision I can in the best interest of who we are while trying to fulfill our service's needs. I poll some for advice and others for experience. I get a lot of unsolicited advice and suggestions that are always taken in to account. Some I tear apart on the spot and play devil's advocate, others have a lot of validity and they're used when the situation merits.

When I began my reign I wanted to change the world. I was met with a lot of resistance for a variety of reasons. One probably was that I failed to talk to others first. I wanted things one way without consulting those who were doing the work. While my intentions were what's best for the service I lost sight of the need to accommodate for those who did the work, including myself. Just because I do things one way doesn't mean everyone does, nor do I do things for the same reasons as others. Everyone's situation is different.

Being in charge IS a lot more headaches. It IS a lot more responsibility. But if nothing else, I too have learned from my mistakes. I've learned by watching others make mistakes so that I know which avenues to take and which pitfalls to avoid. I don't have all the answers but I do know that EMS is a fickle animal and it takes a lot to keep things running smoothly. There are the daily rigors that must be dealt with but they can be managed. It's the super duper debacles that come across every once in a while that make the job very challenging. Our service runs itself. I honestly view myself as just another cog in the wheel. I don't need to micro manage everything and never have had to. Maybe I'm lucky in that respect where others aren't.

I'm sure that there are people who want to be in my shoes making the decisions, doing the same tasks, dealing with issues and problems with their version of justice and punishment. Not all view things the way I do and I accept that. But for now I'm here making those choices,... with assistance. I've learned to ask, not something I used to willingly do. If I need help I get it. If I can handle it myself, I do. Sometimes it's just easier that way. When my desire to see our service continue to succeed wanes, I'll gladly step aside. I understand that some of my decisions and choices could greatly impact the public we service and who depend on us 24/7/365.

I love my job. I love EMS. I love the challenges it serves up. I don't like the problems and headaches but I signed up for it and know that they too must be dealt with. I do what I do in hopes of keeping our great service alive. People long before me got our service running and it's my goal to keep it that way while trying to improve things as I can. I take questions, listen to suggestions, welcome feedback from everyone. If I didn't love what I do, I wouldn't be doing it today, 23 years later.

Being A Paramedic

What does it all mean? What is the meaning of life? What do we do, or can we do, to help keep it?

Eh, just questions bound for nothing.

I was thinking the other day about EMS and what part in it I play. Why did I begin? What role do I play? Have I accomplished my goals in the pre-hospital world? Have I achieved what I wanted to? What is it that keeps me here and has for so long?

We're fortunate in our community to have a high school explorer program. We take a select group of high school seniors and train them to be first responders and stick them on a crew. They carry pagers during their school day and if we get a call they simply get up out of their class, head to the station and go on the run. When they're done they go back to class. It's their responsibility to catch up on work they missed. We've had this program for over 25 years and it's amazing how much it's done for people.

Our high school program has allowed us to show high school students part of the medical profession. Lots of our kids have gone on to be EMTs, Paramedics, nurses, RRTs, Rad Techs, you name it. We have a whole host of professions that have arisen out of our program. I'm no different in that I started in 1988 as a high school rookie. Now I'm the ALS Director and thrilled to be able to continue to give back to my community.

But I look at my 20 + years of EMS and ask these questions. Next year I'll be starting my 20th year as a Paramedic. Holy shit, has it been that long? I can remember giving narcotics to people even before I could legally drink alcohol. I always thought that was pretty ironic.

Part of the reason I've hung around for so long is the service, our service. Who we are, what we are, what we've accomplished, are just some of the things that make our service and EMS great. We, like most other volunteer services, take great pride in those things. I'm proud to be a member. I'm proud to see what we've become. I'm proud to see all the changes we've been through and how we've persevered. I love being a part of something like that.

I see the EMS profession as it is and all the changes it's been through just since I've been in it. It's amazing how technology has changed, thoughts have changed, patient care has changed just in that short time period. yet through everything our industry has evolved drastically to embrace most everything in the mindset of "whatever's best for the patient we'll do."

For example, intubation was one of those "cool" tasks we'd get to do once in a while. Now with the advent of Glidescopes and other visual tools, intubation is now becoming a lost art form. Remember the old Datascopes and LP5s? Now we have the LP12s and LP15s that allow a lot of the guesswork to be taken out of patient care and treatment. We can see what's going on in 3D fashion and treat better than ever. Hell, just take the mass push and introduction of AEDs and how they've increased the survival rates of sudden cardiac death.

Probably one of the things I'll never be able to answer is the question if I've achieved my goals or accomplished what I wanted to get out of EMS. I'll say that those are ever-evolving and constantly changing answers. They're being added to daily or shift-by-shift. My goal is to provide the best possible patient care to each and every one of my patients. I want them to feel safe, comfortable, and to have trust in me that I'm doing everything in my power to help them.

I want to empower others. I want to pass on my knowledge and wisdom to those just getting a start. Hopefully they'll learn from my mistakes so they don't have to do things the hard way. Understand why I do what I do in the best interests of the patient, the crew, the service, and themselves.

I've accomplished my goals of helping others and seeing them live longer and healthier lives. But on the days that my patients don't get better I have to readjust that goal, critique what I did, and improve upon those problems to make sure they don't happen again. If not, I try to find out what else I could have done to make things better. My knowledge base is limited as I've not gone to medical school. I learn something every shift. Therein lies another part to that of needing to continue my education. The smarter I am in patient care, the more tools I have to help my patients get better and get back to some sense of normalcy.

I hope that in the next 25 years people will come up and take my place, become the educators and administrators of the EMS world and continue to evolve in to what the public wants and needs. I'm curious just what types of new technology will be available then and how much more efficient we will be with those new tools and skill sets.

Keep saving lives, keep working hard, and provide the best possible care we can as providers. Improve ourselves so that these kids will grow up healthier and safer than we have.