“In Germany they first came for the communists, and I didn’t speak up because I wasn’t a communist. Then they came for the Jews, and I didn’t speak up because I wasn’t a Jew. Then they came for the trade unionists, and I didn’t speak up because I wasn’t a trade unionist. Then they came for the Catholics, and I didn’t speak up because I was a Protestant. Then they came for me – and by that time no one was left to speak up.”

- Rev. Martin Niemoller

Yesterday an Action Care ambulance covered my station while I was at a training. Action Care is the local private ambulance service. I know, the name always seemed a little silly to me. If a super hero ever created an ambulance service, he would most certainly call it Action Care. I joke about the name, but they’re the real deal.

I’m glad we have Action Care. They help cover our district when we are low on resources. They are always professional and polite on scene. They give good care.

Sometimes, working with a private ambulance service on scene can be challenging. There are conflicts. There always are. Occasionally a private ambulance service medic will assume that I’m an idiot because I’m wearing fire gear. Sometimes, that can be amusing and sometimes it can be frustrating. Sometimes a fire medic will assume that the private ambulance medic needs her hand held because, well, she works for a private company after all. I’m sure that’s frustrating for them as well.

I know that most of these biases are made up. When I was in the private ambulance service, I advocated for the advantages of private ambulance service and denounced the fire service as bad for EMS. When I became a fire fighter I suddenly saw things differently and the flaws of private, for profit medicine became more evident.

I’ve certainly seen both sides of the equation. Which, recently made me consider an interesting question. While driving back to my station, thinking about how much I appreciated having our local private service available for our district, an interesting thought occurred to me.

What would happen if we advocated for each other?

I know, it’s a crazy thought. The very idea of a fire fighter / paramedic extolling the virtues of private ambulance service medicine and a private service medic understanding and advocating for the benefits of fire based EMS seems insane. But consider it. Go crazy with me and ask yourself, “What if..?”

What if firefighters saw private EMS as good for our industry and supported the efforts of their private ambulance brothers and sisters?

What if private services recognized the important contributions of fire based EMS systems?

What if, instead of being threatened by each other, our service were public advocates for the others needs?

What if I told members of the community that our local private service was an essential part of our response plan and an excellent example of everything private services can be?

What if my private ambulance counterparts explained why my fire based service was the right design for the community and a good model of what fire based EMS can be?

What if we spoke up for each other?

What would happen next?

You tell me.

I asked on twitter. I asked on Facebook. I even asked right here at the blog. And the answers poured in. Your responses represented the full spectrum of personalities that inhabit our workplace. There were poignant responses, cynical responses and a bunch of funny ones. The responses made me smile and frown and think.

Within this list of answers you’ll find feedback from 30+ year EMS veterans and newbies just getting their EMS feet wet. Everyone is represented. And the responses are telling.

I’m rather proud of how this little experiment turned out. I hope you find these responses as enjoyable and thought provoking as I did. Thanks for all your contributions. Aside from categorizing these contributions, I’ve made no further editorial additions. This post will become part of the guest posts category, because it was written by you.

Complete the sentence, “Behind every great EMT…”

The Humorous:

Behind every great EMT are 5 firefighters. – @isuhawkeye via Twitter

Behind every great EMT is a stack of empty pint glasses. – @MedicSBK via Twitter

Behind every great EMT is an Englishman in a green jumpsuit watching over them from a distance. – @MedicSBK via Twitter

Behind every great EMT is an ambulance. – Mark Daube via Facebook

Behind every great EMT is an adrenaline junkie. – Anonymous via the blog

The Cynical / Funny:

Behind every great EMT there’s a pissed off lawyer that can’t sue you. – @texaschef via Twitter

Behind every great EMT there’s a chief with a boot headed for your ass. – @texaschef via Twitter

Behind every great EMT is a partner who can’t drive. – @seanhfitz via Twitter

Behind every great EMT is a supervisor with a write-up for him. – @seanhfitz via Twitter

Behind every great EMT is an ambulance with a flat tire. – @seanhfitz via Twitter

Behind every great EMT is a line of bill collectors. – @Ckemtp via Twitter

The Egotistical / Funny:

Behind every EMT is chaos, brought under control, left in their wake. – @MedicSBK via Twitter

Behind every great EMT there’s a paramedic telling him to move so he can treat the patient. – @paramedicintern via Twitter

The Thoughtful:

Behind every great EMT is a role model, an excellent instructor, and sound judgement. – @hoplessromantic via Twitter

Behind every great EMT is a solid foundation of the basics. – @un_ojo via Twitter

Behind every great EMT is a conscience that whispers, “Is this in my best interests, or the patient’s? – @AmboDriver via Twitter

Behind every great EMT is a never-ending willingness to always learn more & strive to always put the patient first. @JustMyBlog via Twitter

Behind every great EMT is a very understanding & supportive family. – @EMTwicks via Twitter

Behind every great EMT there’s professionalism, patience, empathy, gentleness, and faith. – @dont39350 via Twitter

Behind every great EMT there’s an excellent instructor (or instructors). – @Bitzes via Twitter

Behind every great EMT there’s an ongoing thirst for knowledge. – @NJDiveMEdic via Twitter

Behind every great Paramedic is a damn good EMT. – @EMTDani via Twitter

Behind every great EMT is education. – @EMTDani via Twitter

Behind every great EMT is a mentor, supporter, and educator. – @Gfriese via Twitter

Behind every great EMT is a solid education and an extra dose of common sense. – @UKMedic999 via Twitter

Behind every great EMT there is a spectacular instructor. . .and a good team. – April DeGesualdo via Facebook

Behind every great EMT is a great mentor. – Anonymous via the blog

Behind every great EMT is a great mentor, a great education, and a great passion to keep learning. – Anonymous via the blog

Behind every great EMT are compassion and humility. - Captain Tom via the blog

Behind every great EMT are friends, family, a good head, the drive to keep going, and keep learning, and a love of what we do. – Jen D. via the blog

Behind every great EMT is the passion to always be improving through education, run reviews, and being a sponge with mentors and other EMTs. To learn to be humble, compassionate and remembering that every, I mean every call is important to the patient and we treat every call as such. If you don’t really enjoy what you do, it may be time to seek another career. – Randy via the blog

Behind every great EMT is the knowledge that it is all about the patients, not us. – Sean Fontaine via the blog

The Personal:

Behind every great EMT there’s a heart that cares and an inner drive that pushes you to always go above and beyond for your patients. – @PrRescue via Twitter

Behind every great EMT is a family that misses him. – seanhfitz via Twitter

Behind every great EMT is a great support network. – @NavyStingerDoc via Twitter

Behind every great EMT there’s a family and some friends that understand. – @Ckemtp via Twitter (With a bunch of accompanying retweets and affirmations.)

Behind every great EMT is a caring, and determined individual. The status of “E.M.T” is a means of developing skills and knowledge, paired with the legal ability to use those skills and knowledge, in a way that is true to the intrinsic nature of that individual. – Jeremiah Bush via Facebook

Behind every great EMT are their brothers and sisters in service. – Pamela Moore-Eaton via Facebook

Behind every great EMT are equal parts passion and compassion. – Steve via the blog

Behind every great married EMT is a great wife. – Anonymous via the blog

The Optimistic:

Behind every great EMT, there’s a long row of mediocre EMTs who need a little enthusiasm shared with them. – @FloBach via Twitter

The Hard to Classify:

Behind every great EMT is a confused but very lucky citizen to have encountered them. – @MedicSBK via Twitter

Behind every great EMT is an open door to escape through. – @CrazyMedic via Twitter

Behind every great EMT is a sandwich with one bite taken out of it. – Mike Taigman via Facebook

Behind every great EMT is someone just one hour of sleep short of being incapable of screwing up. – Joseph Schmoe via the blog

Behind every great EMT is The EMT Spot. – Anonymous via the blog (Thanks anonymous.)

And thank you to everyone who contributed. Don’t worry if you missed your chance to add your two cents. that’s what the comments section is for. See you next time.

You may be able to guess the results. If there were no pieces of litter on the ground, or only one piece, the subjects were unlikely to throw the unwanted piece of paper on the ground. After that, the likelihood of the person discarding the paper on the ground was exactly proportional to the number of pieces of paper already on the ground. The more litter already present on the ground, the more likely that the next person would also throw their piece of paper on the ground. It’s the law of social conformity.

Litter begets litter.

This isn’t new news. The 1990 research (Cialdini, Reno and Kalgren) was a repeat of similar research done in 1973 (Finnie), 1977 (Geller, Witmer and Tuso) and 1978 (Krause, Freedmen and Whitcup.)

How does this apply to you?

The law of social conformity affects everything. If you leave trash in the bottom of the trash can in the back of your rig, the next guy is likely to leave trash in it at the end of his shift too. If the floor is dirty it’s likely to get dirtier. If there’s blood splatter on the ceiling, the next medic is more likely to not wipe the compartment down either.

It’s not just a cleanliness issue. If you attend a C.E. class and twelve of your coworkers are there, you’re more likely to attend the next one than if there are only four. If two-hundred of your coworkers forge their C.E. documentation, you’re more likely to do it than you would be if only five committed the offense. If you don’t call the patient by their name it’s more likely that the next caregiver won’t either.

Of course, the inverse is also true. Your personal patient greeting, clean ambulance and impeccable C.E. record are just as likely to influence the culture for the better as your negative behavior is to influence it for the worst. Sometimes we talk about the culture as if we are only visiting. We are the culture. What did you beget today?

Now it’s your turn: What else have you noticed that begets more of itself? The possibilities are endless.

Read More Posts:

Ten Reasons I Work In EMS

Passion Counts

6 Reasons Why You Should Be A Better EMT

4 Sloppy IV mistakes You Should Avoid

EMT Burn Management

Perhaps you’ve already heard, starting July 1st, 207 EMT’s in the city of Boston will begin serving suspensions ranging from 45 days to 9 months for falsifying their training records and claiming that they had attended continuing education classes that they had not.

Now, to add a little bitterness to the whole thing, a few Massachusetts EMT’s have come forward to say that the suspensions are unfair. Instead of taking the suspensions with grace, serving the punishment and feeling fortunate to still have a certification, they are coming forward with some comments about the usefulness of continuing education.

Terry Urekew, an uninvolved bystander in the whole debacle, chimed in with this quote, “Give everyone a $100 fine and community service. Don’t take someone’s livelihood away from something that has no impact on whether or not we are better EMTs,” You can probably guess that a guy who writes a website with the subtitle, “Medicine moves fast…keep up.” is going to probably take issue with Terry’s assessment of the usefulness of keeping up on medical education. You’d be right.

Then there’s Kim, the state EMT suspended for nine months who protested, “The refresher course just repeats everything. We didn’t put you at harm.”  Uh, well, yes Kim, good point. But you didn’t not…not, put us at…safe? Bad grammar aside, Terry and Kim are glossing over a few important points about what they did.

If any of the Massachusetts EMT’s are still reeling in confusion over the unfairness of all this, let me offer up a few points of clarification for you.

1) You lied and cheated

There were two significant wrong-doings here folks. First there was the continuing education that you didn’t receive; The updates on protocols and changes to procedures like tourniquet use and CPR that you decided weren’t really critical to your understanding of your job. But then, there’s also the fact that you lied.

You work in a job where the community places great trust in you. They invite you into their homes when they are weak and helpless and they need to trust that you are morally sound. That means, when you say something, it’s true and when you do something, it’s proper. This was your greatest failure. Not your lack of knowledge but your lack of an appropriate moral compass.

2) You disrespected the EMT’s who work hard and follow the rules.

24,000 EMTs in your state managed to complete the requirements of continued certification without fabricating their training records. They followed the rues and respected the process. When you unilaterally decided to forgo your troublesome C.E. requirements you disrespected all of them.

This idea that, since you got caught cheating the system, you should be slapped with a small fine and allowed to continue is insulting to the EMT’s who could have also payed a little money to not go to classes but opted to follow the rules instead. Your punishment needs to be stiff enough that the EMT’s who worked hard can feel rightfully vindicated for following the rules.

3) You disrespected our profession.

This one burns me the most. I’m just astounded at the hubris in your statements. It’s as if you feel like everything you needed to know about medicine was covered in the 140 some-odd hours of your EMT class and now you shouldn’t be troubled with additional knowledge and skills.

What harm could possibly come from allowing you to continue in your work unhindered by advancing knowledge and skills? Well, quite a bit actually. The knowledge you were given barely scratched the surface of emergency medicine. You’re an EMT. You should be hungry for more knowledge. You should be eager to learn more about the medical challenges you’re bound to face in the future.

Perhaps you think your punishment was unfairly harsh. I disagree. I think the system that you continue to openly disrespect was unusually kind to you. The next time a news reporter calls asking for your your opinion, you may want to try, “No comment.” as a response.

What do you think?: Were the Massachusetts punishments unfair?

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

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

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

1) The Cynic “They just do this to screw with us.”

The cynical hero doesn’t trust that anyone is really looking out for the greater good or trying to make the workplace better. They view the world through an exceedingly distrustful eye. To the cynic, every new policy, procedure or memo is either useless or seeded with some ulterior motive to try to make the work environment more difficult.

The way cynic’s tend to draw other into their drama is the allure of knowing the real deal. The cynic will tell you that you’re being deluded and promise you a glimpse into the way things really are, but their fictional world of paranoia never quite lives up to the promise.

2) The Know-It-All “Well, clearly it’s a fascicular hemi-block but which fascicle?”

Not only will the know-it-all hero offer up their insight or opinion as if it were gospel, but they’ll also pepper it with a bit of “Everyone should know this stuff.” just to make you feel a little bit inferior. They base a large part of their self worth on the ability to know just a little bit more than the next guy and they wield that knowledge like a conversational weapon.

Don’t mistake the local smart dude as a know-it-all. There are some real difference between smart people and know-it-all’s. One key difference is humility. Smart people are humble about their knowledge. Know-it-all’s often don’t really know it all but they’ll never let on. Smart people also use their knowledge to build others up while know-it-all’s tend to use it to make others feel smaller.

3) The Mule “I still think he was having a stroke.”

Of all our tragic hero flaws, the mules flaw may be the one most rooted in insecurity. There folks get this idea in their head that they have to be right all the time. They believe that their worth and value is somehow sewn in a persona of stubborn infallibility. This works just fine, until they need to listen to performance feedback, or they make a mistake. Then the mule shows up and all the excuses start flowing.

“I would have recognized that if the firefighter had given me an accurate blood pressure.” “This is the way we always did it where I used to work.” “That doctor doesn’t know what he’s talking about.” And on and on. The sad part is that, as long as the mule stays in their stubborn delusion, they never get any better at anything. How can you improve when you always do it right the first time?

4) The Critic “Their all so stupid.”

This is perhaps the easiest of all the hero flaws to slip into and the toughest to shake. The critic is convinced that the world desperately needs his or her opinions on the way things ought to be.  They figure out that offering opinions is so much more fun and rewarding than working to solve a problem and then it becomes like a drug. Soon they’re framing everything they see with the question, “How should this be done better?” and then offering their sage analysis. Usually with a poor understanding of why the thing is the way it is in the first place.

The problem with the critic is that they genuinely believe that the world wants to hear their endless assessments and when an army of engineers doesn’t show up to start doing the hard work of implementing all their great ideas, they get frustrated. The second problem is that they jump to analysis without seeking to ever understand the nature of the problem. Research and implementation are hard, but critical evaluation is fun and easy. As long as they don’t build anything real, they never have to worry about the next critic showing up, spending a few minutes looking at what they built and offering up their sage criticism.

5) The Spaz “I need it stat.”

It’s hard to pick out the spaz hero in a crowd, they can be anyone. The spaz flaw usually remains hidden beneath a cool exterior. The spaz, well aware of their own flaw, will often hide their spazziness under another persona like the burnout or the know-it-all. You won’t see this flaw until they are under pressure and then their own personal insecurities will come bubbling forward in a string of urgency, frustration and barked commands.

“You! Get over here.” “Get me a backboard now!” “Set up my intubation kit.” The word stat was invented by a spaz. They confuse activity with effectiveness and hope that, as long as they look like they’re the one in charge, nobody will notice that they’re terrified.

There are two big problems with the spaz flaw. The first is that they’re ineffective. Nobody operates at peak effectiveness with this kind of demeanor. They invite mistakes and sloppiness. The second problem is that they wind everyone else up with them. Instead of promoting team effectiveness, they shatter it by pushing everyone into their, “Don’t think, just do.” mindset.

6) The Burnout “So what?”

The Burnout probably used to care at one point, but they didn’t get the reward or accolades that they were anticipating so they gave up. Being burned out is alluring because it’s so effortless. It really takes no effort to decide to not care about anything anymore.

Once they stop caring, burnouts look at everyone else who does care as deluded and sad. they pity those who still put in effort to learn, grow and do a great job. They wonder why others would put so much effort into being good at what they do when there really is no big pot of gold at the end of the rainbow. Burnouts never figure out that being good at what you do is its own reward.

7) The Egotist “You called me for this?”

You’ll know the egotist as soon as the radio calls their unit number. Every emergency is a waste of time. Unless it is a terror inducing, massive pile of mayhem that they’re being dispatched to, it’s a waste of time. The egotist believes that, unless the patient is having a critical, life threatening emergency, they aren’t worthy of the services of EMS.

The big get it that the egotist never quite figures out is that EMS is a service industry. In their heart they believe that their skills are far too important to be wasted on minor complaints or injuries. They see themselves as true heroes who should be kept in reserve until someone needs to be snatched from the clutches of death. When that call happens, they’ll be woefully unprepared because they weren’t putting enough time and energy into their skills when the minor medical complains showed up.

8 ) The Subversive “Rumor has it…”

Working with the subversive can be fun, for a little while. You always get to hear all the inside dirt on what might be happening to whom. The National Enquirer and The Star were created by subversives; people hoping to spread rumors with just enough validity and credibility that they make everyone question what’s really going on.

The problem with subversives is that they’re not sorting information based on what’s true and what’s false, they’re sorting it based on what’s known and verified and what’s secret. Because of this, they’re frequently just wrong. They also waste everyone’s time. That’s the subversive part. Organizations waste a tremendous amount of time trying to track down and replace rumors with good, accurate information. The quest is never-ending, because it’s always easier to create fiction than it is to disprove it. By the time one rumor has been proven false in the light of day, the whisperers have already moved on to new prey.

Now it’s your turn to sound off: Do you have a particular tragic flaw that you struggle with? Do you think I missed one? Leave a comment and let me know.

Read More Posts:

What Is An EMS Non-Conformist?

Where do You Put The Fear?

Stop Whining

One EMT Can Make A Difference

6 Reasons Why You Should Be A Better EMT

“In June, as many as a dozen species may burst their buds on a single day. No man can heed all of these anniversaries; no man can ignore all of them.”

-Aldo Leopold

So many anniversaries. So many happenings in the EMS world. Regardless of how many of them you attempted to heed, you were bound to miss a few. Here’s to the stuff you may have inadvertently ignored.

I started the month with a webinar on how to pass the national registry cognitive exam and quickly moved on to the name the chronicles contest and part three of the very popular ultimate guide to EMT vital signs. I asked you two telling questions with “Where do you put the fear?” and “Are you an EMS nonconformist?” before asking you to consider what will happen on the day that your career clock strikes midnight. Then we talked about what really motivates us and wrapped up with ten reasons why I work in EMS.

Elsewhere around our EMS online neighborhood, one happening that deserves its own paragraph is the sad departure of UK medic Mark Glencorse from the blogging world. Mark made a huge impact on EMS blogging with the Medic999 blog and his influence will continue to be felt for years to come. I’ll deeply miss his musings on the EMS around the world. Fair thee well Mark. Thanks for all the fish.

In the other rings of the perpetual EMS blogging circus, David Konig showed a few creative billboards aimed at getting people to call 911 only for appropriate emergencies. Greg Friese posted a fathers day memory. Peter Canning discussed the use of a magical question, “Would you like more pain medicine?” Jeramedic launched a post series reviewing shock. (Psst: It’s off to a great start.) EpiJunki gave a heartwarming hallelujah for second chances that made me want to send her a silent amen from the choir. Chris Kaiser went all Jeff Foxworthy with “You know you work rural EMS when.” (Chris, I’m still waiting for my deer meat.) Never one to shy away from a fight, Rogue Medic sunk his teeth into a recent podcast and Justin “Happy Medic” Schorr threw down with some hilarious EMS based motivational posters.

And what about EMS news? Plenty of EMTs behaving badly. The Massachusetts dispatcher who canceled critical 911 resources on a medical alert has been fired. The NYC EMS Lieutenant who took a picture of his MDT screen with patient information visible and posted it on facebook will also likely lose his job. Some of the 207 Massachusetts EMTs who falsely claimed they took re-certification courses feel that their suspensions are unfair. A couple of UK medics are in hot water for walking a man having a full blown MI to the ambulance. A lawsuit is claiming that Dallas Fire-Rescue incorrectly billed every call at the ALS rate and may owe the government somewhere around 40 million dollars. Police apparently aren’t done filing charges against the Port-Orange Firefighter Paramedic who was sneaking back into patient’s homes to steal their medications.

Then there were the podcasts. The Medicast interviewed Natalie Quibodeaux. The EMS Educast talked about training EMTs in high school. The GenMedShow discussed the new film Firestorm and The EMS Garage round-tabled over EMS system abuse in the episode Fava Beans. All well worth a listen.

So there you have it. The month in a nut shell. What do you think will happen next?

Read More Roundups:

The May EMS Roundup

The April EMS Roundup

The March EMS Roundup

The February EMS Roundup

The January EMS Roundup

It’s strange. In a line of work as interesting, diverse and unique as ours, you’d think our blogs would read like a fan page for a band called EMS, but that’s just not the case. How to survive in EMS, how to scrape by and how to “fix” EMS seem to be the relevant topics of the day. I thought this readers question was a great opportunity to go on the record and say that there are a lot of good reasons to work in EMS. Here are ten.

It’s different.

I’ve learned that I don’t do well with routine. I couldn’t spend my work life in a cubicle. I’d rather chew tinfoil than show up each day and do the same thing. EMS is infinitely variable. Just when you think you’ve seen it all someone will pick up the phone, dial 911 and prove you wrong.

It’s human.

Unlike so many jobs and careers, medicine is profoundly human. We interact with people and see the full spectrum of the human condition. Few people clean the house or put on their Sunday best before they dial 911. We see a very real slice of humanity in EMS. Being a patient is a, “come as you are.” experience.

It’s huge.

I mean, it’s everywhere. You can go anywhere on the planet and practice medicine. The opportunities are truly endless. I practice EMS in a major urban center but I’ve also practiced it in the middle of the Mojave Desert. Early next year I’ll go out into the jungles of northern Panama and practice EMS there too. I mean really, it’s huge.

It’s challenging.

You will never master emergency medicine. The vast well of knowledge that is medicine grows far faster than you can learn and absorb it. You can dedicate a lifetime to the understanding of this one small facet of medicine and you’ll still only scratch the surface.

It’s fun.

The people are fun and the work is fun. This can actually take some folks a long time to learn. We get so caught up in the seriousness of EMS that we don’t really enjoy the process of running calls together. One of the benefits to sticking with the job long enough to achieve a level of comfortable competence is that you can really start to relax and have fun.

It’s variable.

Two weeks ago, I spent two full days riding a bike around a senior PGA tour event. I was on the medical response team. Last week I was backstage at the Iron Maiden concert. I was on fire watch duty. After 20 years in EMS the job is still filled with first time experiences. I’ve lost count of the seemingly endless parade of lifetime firsts that I’ve logged on the job.

It’s timeless.

People always had medical emergencies and people will always have medical emergencies. When they do, they’re going to want someone like you around. That’s kinda nice when you think about it.

It’s fulfilling.

I don’t get people who don’t feel fulfilled in this line of work. Well, OK, maybe I do get them. So let me clarify. If you do your job to gratify yourself and your ego, EMS isn’t very fulfilling. If you do your job to be of service to others, EMS is very fulfilling.

It matters.

Sure most everyone’s job matters. But some folks have to reach farther than others to explain how their job matters to others and to their community. In EMS it reaches out and smacks you in the face. To every single person who calls for your service you matter. The job you do, the service you provide and how well you provide it all matter.

It enlightens.

This job gives us a unique and privileged perspective on the human condition. One that is hard for people in other lines of work to understand. You just can’t do CPR on someone’s husband and then go home and be angry about the coffee stain on your rug. You can’t take someone’s child to the emergency room for a rare respiratory condition and then go home and yell at your kid for not cleaning his room.

EMS gives us an amazing perspective on what’s really important in life. It’s a perspective that few people have. It’s a perspective that’s reserved for those who experience great tragedy and those who help. We get the perspective without the grief. It’s a gift. It’s a gift than many EMS caregivers leave unopened. That’s a shame.

If you need any evidence of the unopened gifts, just take a look around the EMS blogsphere.

Now it’s your turn: Why do you work in EMS? Leave us a comment and let everyone know.

Or Just Read More Stuff:

Where Do You Put The Fear?

Six Reasons Why You Should Be A Better EMT

The Ultimate EMS Protocol

You Can’t Give Away What You Don’t Have

EMT Basic Skills Are Not Basic

]]> http://theemtspot.com/2010/06/26/ten-reasons-i-work-in-ems/feed/ 10 http://theemtspot.com/2010/06/23/what-motivates-us-really/ http://theemtspot.com/2010/06/23/what-motivates-us-really/#comments Wed, 23 Jun 2010 17:36:14 +0000 administrator http://theemtspot.com/?p=3327 The Surprising Truth About Personal Motivation

For years as an EMS supervisor I sat in operations meetings discussing the timeless business question, “How do we motivate people to be high performers?” Since most everyone in the room was a current or former field paramedic, you’d think we’d have an edge in answering the question. We didn’t.

It’s worth considering while your sitting around with your partner, hashing out the latest management blunders and explaining how you’d fix everything. If it was you sitting in the agonizingly long staff meeting throwing around ideas, chances are, you wouldn’t do much better.

I do know that the one opportunity I had to work on a true high-performance EMS team, these were the basic ingredients.

• We were a relatively small group
• We weren’t highly paid
• We were on a mission
• We respected our leader
• We had a lot of freedom
• We all felt accountable to the team
• We all felt like our role was important

It was fun while it lasted. And then we were successful. And we got big and corporate. And the team got bigger and the rule book got thicker and the memos got longer (I wrote many of them.) and the motivation dropped.

One interesting dynamic I noticed. When I was being paid the highest by the organization, my motivation was the lowest. No amount of money could make up for the sense of loss I felt. The loss of freedom, autonomy and contribution. Getting paid well to be a cog just sucked the life out of me and every other high performer in the group. So I left.

Based on that experience, this video made a lot of sense. I wish I had seen it 10 years ago. I don’t know if it would have helped, but at least I would have understood what was happening better.

Now it’s your turn: Do you still feel like more money would help motivate you to be better at what you do? Leave a comment and let me know.

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

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

Consider Elizabeth Ann Mitchell.

Elizabeth was 24 years old and a newly minted EMT when she ran her last call on April 3rd 2010. She helped supervise a controlled burn, talked with co-workers about her young son’s upcoming birthday and returned home. Five days later, an inattentive driver crossed the center line and struck Elizabeth’s vehicle. She died at the scene.

Elizabeth’s last call came far too soon. In the tragedy of her death and the short life of her EMS career, there is a lesson for all of us. Until that last day, when we decide to hang it up and walk away for good, none of us can say with any certainty which call will be our last.

For those of us who love this job, those of us who feel it in our bones, we become like Cinderella. We dance and we dance and before we know it, the clock strikes midnight.

When your career is over, what will we say about you and your contribution to this art?

The allure of conformity is powerful for all it offers. On the other side of the conformity dance floor is security, approval, and all the benefits of eventual success. Why wouldn’t we waltz? Doesn’t everybody?

Perhaps that desire within us to do something that matters can be fulfilled after we’ve gained the promotions, the love and admiration of our peers, and the power of authority.Then we can start being an advocate for the patient. Then we can start taking good care of the folks who call 911.

We can bone up on our skills, attend the conference, and develop the competencies we were putting off until we got the official nod. We’ll work hard to improve basic proficiencies, overhaul the broken training and orientation systems, and advocate for safer work conditions.

This is all a broken promise the minute we make it. Once we’ve achieved some degree of success by walking the path of conformity the expectations will only continue to grow.

Your leaders, whoever they are, have even less power to step outside the boundaries than you. If there is pressure on you to conform, you can bet there’s twice as much pressure on the poor guy or gal above you. Poor saps.

Non-conformity is stepping back from the speed and thoughtlessness that we tend to operate under. We manage emergencies. Most of our leaders have grown out of this industry that specializes in the fast fix approach. In our business, speed is king, and time is the devil. This creates an environment that doesn’t value thoughtfulness or introspection.

Asking larger questions about the greater purpose of our industry is frowned upon. Those who follow this path get labeled as pie-in-the-sky dreamers.

Non-conformity means being willing to take the time and effort to evaluate ourselves, our performance, and our purpose. It means being willing to stand for something and being willing to stand against something, especially when we stand against the mediocre status quo that pervades our industry.

Are you getting a vision of what I’m talking about here? Let me be even more specific.

EMS Non-conformists:

• Think for themselves. They know their protocols and rules but are guided primarily by their own sense of what is right. Non-conformists speak with their own voice and hold on to their own values and judgment. They do not choose to be defined by what they do (as our culture would prefer) but choose what they do as an expression of their identity.

• Expect to have their values expressed in their work. They don’t check their values and guiding principles at the door when they show up for their shift. On the contrary, they have an expectation that their greatest self can be expressed through their chosen work.

• Believe that their lives and work should stand for something. In this regard, they refuse to be bartered like a commodity. The idea of punching the clock for a day’s pay is taboo to non-conformists. They work because the work is meaningful to them. In doing so, they maintain their power and are accountable for their actions.

• Desire to be a part of a community and a team and seek meaningful connections with others. Our industry is a human industry and non-conformists seek to humanize and personalize their work. They pay attention to the details of their lives and the lives of those with whom they interact each day. In refusing to conform to the sterile, impersonal world of clinical medicine, they dive deep into the tragedy and triumph of medical care and fight to humanize their connections with their patients.

• Hold themselves to a higher standard than the status quo and rally against mediocrity and incompetence. Non-conformists see that their work is worth doing well and refuse to be swayed by the tide of mediocrity that constantly pulls at us to accept what is just good enough as our standard. They always seek to raise the bar.

• Don’t expect their leaders to have the solutions to their problems, embody their values, provide their motivation or direct their career path. They don’t look for parental nurturing and constant direction from their leaders, and they don’t whine and complain about operational minutia like memos and policy changes. Non-conformists seek grown-up partnerships with authority figures and seek common ground and mutually acceptable goals.

• Fearlessly seek performance feedback and relish intelligent coaching and criticism. Non-conformists know who to hear and who to ignore. They consider themselves in a constant state of growth and don’t fear failure or mistakes. They look for opportunities to push their boundaries and acknowledge their own imperfections and mistakes without shame or anxiety. Non-conformists know that if they are not making errors, they are not living at the edge of their potential.

If you would like the full 48 page manifesto, The Non-Conformists Guide To EMS Success, type your name and e-mail address in the sidebar box to your left. I’ll mail you copy.

Now it’s your turn: Have you read the manifesto? What do you think?

Read More EMT Spotage:

The Ultimate Guide To EMT Vital Signs

Patients Define Their Emergencies

The EMT Code of Ethics

Are You The Opening Act or Are You The Rock Star?

Unconventional Thoughts on Emergency Services