The Inspiration Of True Compassion

Yesterday I was inspired. I got to work with someone that I knew by name and reputation only. I listened intently as he spoke with one of the many vulnerable people within our city. There was something in his voice that went beyond the words that were being spoken. They came from a place that on occasion, we as Paramedics and EMT's forget about. I was in awe as he spoke quite directly, and plainly with our patient about their situation. This place that we sometimes close up and protect, so that we can protect ourselves, is called compassion, real, genuine compassion.

It goes beyond empathy, it goes deeper than just helping. Compassion is and was the driving factor that brought most of us into this business. Many of us, myself included, let that compassion slip away and it takes something special to remind us that helping people and compassion are the fundamental values of medicine. It is true that because of problems within the system and the tragedy we see we allow ourselves to become hard. We often let the people that abuse the system cause bitterness and then our compassion gets left out when we go to people that just need our help. This career changes us, and not always for the better.

I felt privileged to work with Dan yesterday and as I got to know him I learned another fact that increased my respect for him even greater. Many of you know this, but I had not put it together at this point. Dan is one of the founding members of The Sheepdog Lodge. The Sheepdog lodge is a not for profit organization that allows military veterans, as well as emergency first responders to come and stay there for free with their families. They offer a peer supported weekend away from everything that allows these people, suffering from PTSD, or other Occupational Stress Injuries, to focus on themselves, their family, and their recovery. This has been a tremendous undertaking. Dan and the other members of their steering committee have a true passion to help veterans and first responders recover from occupational stress and PTSD, and their role is an important one. A place that is safe, disconnected from the world. The lodge is heated by wood burning stove, there is no wifi, no television, and is your home for the 3 days you are there. Visit the website to learn more, and to offer help if you are able, http://www.sheepdoglodge.com.

Military veterans and emergency first responders choose to protect the public by offering their services, and in doing so are forced to see things that no person was ever meant to see. These events build up and take a toll on people mentally and physically. The Sheepdog Lodge is completely volunteer based, and the people are paired with a volunteer of the same discipline, someone that speaks the same language and can offer real support and understands their situation. Dan shared with me that The Lodge could use many more volunteers, his colleagues and himself offer up a short training program to help volunteers host families in the cabin for a weekend. The host is there to help, listen, cook and clean, while the person that is there focuses on why they are there. If you have a desire to help you can contact them through their website and they can help you from there.

The Sheepdog Lodge envisions a time when there is a nationwide community of veterans and first responders that are available to mentor and support other veterans and first responders. This statement copied directly from their website states it quite plainly. The vision for The Sheepdog Lodge is simple. Help each other to remain strong, healthy, compassionate and recover from the stresses that we face every day in our careers helping others. We help others because it is what we were built to do. The Sheepdog Lodge is finally a place that we can go when we are the ones that need help.

I would personally like to thank all of the staff and volunteers at the Sheepdog Lodge for their strong dedication to helping others. Please visit their site at The Sheepdog Lodge, read more about what they do there, and watch their story that appeared on CTV news  earlier this year. Please share this post with your friends and families to spread the word about the Lodge.

I Always Have Your Back, Except When.....

I know it's been a long time since I have written, so without adieu, here is today's post. An anecdote if you will. It was a warm shift that day, and my partner and I had been having a fun shift. No different than any other day. We had been doing some calls, and had had some down time. The day was a fairly typical shift and we didn't expect anything out of the ordinary.

The tones go off for a call to an older home in an older neighborhood for a lady in distress. The details were non specific and as we responded to the call it seemed like a normal type of call with no unusual expectations. As we arrived on scene the house was quite dark, and there was no light on on the outside. We approached the home and knocked on the door, a faint voice inside said to come in. As we opened the door we were greeted with no one. No one was in the foyer, but there was some piles of papers, and random junk. The house itself was not unkempt, just the entry way.

We called into the home to see where our patient was, and she stated she was upstairs, so I had asked if we needed to come up there or if she would come down to us. Immediately we got an uneasy feeling in the home when she insisted we stay down stairs. As we looked around the home was definitely older and had some unusual statues in it. There was nothing specifically odd about the home, but we had that uneasy feeling. As we patiently waited for our patient, she appeared after some time, crawling from one room across the floor towards another room... Now if you have ever seen the movie The Ring and remember the way the girl crawls out of the well...... Well that's what the patient looked like, crawling across the floor in a choppy almost animated state. The uneasy feeling intensified at this point, but we continued to wait at her request.

When she did finally allow us to come upstairs, we learned that she had an ankle injury and this is why she had been crawling. So we assisted her down the stairs and onto our stretcher, and made our way out to the ambulance. This is where things got weird. As we are assessing the patient and determining her history she looks me dead in the eye, and with the most serious voice I have heard, she says to me, "My sister is a satanist and I think she is trying to kill me!" To which my partner responded by slamming shut our tough book, and literally bolting straight out of the side of the ambulance, leaving me alone with this patient in the back. Now the humor to this story is of course my partners reaction to the patient's words. There was of course nothing to fear, it was just something that the patient needed help with.

When we got to the hospital and had dropped off our patient I had asked my partner, "what was with that reaction?" I was laughing when I asked him, and we both had a good laugh over his reaction. I know some people might read this, and not see the humor the same way I did,  but in our career it's little things like this that keep us going. The patient was cared for appropriately and brought to the hospital for the help she needed. I just had to laugh at my partners reaction to her words, and to this day it sticks in my mind as one of the more memorable calls in my career as a Paramedic.

EMS Credibility A Fragile Commodity

When paramedics arrive at the hospital with their patients and report to triage it's important to have our ducks lined up. The credibility of a paramedic is fragile when dealing with triage nurses and physicians in hospital. They often don't understand the conditions in which we work so it is vital that we are ready to give a solid triage report. When things go wrong on a call that's OK, that happens. This can sometimes look bad when we roll into the ED, which is why our credibility and out report is so important.

If things go wrong on a call, it's not a time to panic, it's just important to be organized in your report to triage. If we are running bush league and don't have that solid report, then we are presumed to be bush league. Don't forget our world is usually quick and dirty, they call us ditch doctors for a reason. To our nursing colleagues, it is important to remember that as practitioners we do our utmost best for our patients, just as you do. When you aren't there it is important to hear the story before you pass judgment.

In someone's home, or the back of an ambulance we potentially deal with poor lighting conditions, cramped spaces, and  limited help. These are not excuses, because this is also where we are specialists.  I once heard it said, 

"There will always be someone better at intubation than you, there always be someone better at IV's than you, there will always be some one better at assessments and differentials than you, BUT nobody can do it like you can with the wheels moving." 

This quote had always stuck with me, because it's true. We specialize in these environments and that is what sets our world apart from the world of the ER. To that end though, not every call goes perfectly. That in and of itself is not the end of the world. To maintain our credibility it is important to be honest when things go wrong, not make excuses, just be honest. Communication of what has went well and what has not gone well will go a long way to maintain the respect of your colleagues. Some might say our colleagues shouldn't judge our performance, and for the most part they don't. They do, however, know when we aren't honest with them. 

At the end of the day as paramedics and EMT's you work very hard for your patients, and the vast majority of the time you provide excellent care. That is why when a call goes sideways and your bringing them into the ER it's OK to tell them that call went poorly, these things happen  for various reasons. Your credibility will remain much higher with your colleagues if your straight up about what happened, and then as a larger team of professionals everything still gets taken care of! 

Let's continue to progress the profession and build relationships within our professional medical community. Doctors, Nurses, paramedics, RT'S, and the list goes on, all work hard to provide excellent care for our patients. Remember we are all a team and cohesiveness translates into effectiveness. 

Please like and share this post with your friends and loved ones!! Join the discussion and leave your comments below!! 

Through My Eyes

When I began my journey to become a paramedic in 1998 and stepped into a world much larger than myself, I had some misguided conceptions of what this job would be. As time has gone on I have seen the world through different eyes. When we come into this career we are all fresh and eager and feel like we are bullet proof ready to take on the world, save lives and run on water! The reality of this job hits pretty hard, and pretty fast. Not to say that the career is not worth it, because it is. There are just things that no amount of training can prepare you for.

When I was in school they told me I would see things. They told me I would see things that would stick with me, forever. During training they prepare you for the dead, they try to desensitize you to the ugly things you might see. The smells you might face. The horrible things that people will do to themselves or to others. They try to get us ready to handle the things that no one else should see. Through my eyes though, I was never prepared for the hurt, the pain, the turmoil or the agony I would see in the faces of families and loved ones of the people we were trying to help.






Those are the images that have stuck with me, and have burned themselves into my soul. Arriving at a home for a person who has just gone into cardiac arrest. The only words I hear as I approach the daughter doing CPR are the words of his wife, "He can't die, He is my life!" Uttered with such desperation that a lump forms in my throat as I kneel beside him to start treatment. The questions from a gentleman in a car accident asking about his young daughter whom I know is passed away, but now is not the time to tell him. The friends of a young girl asking about her condition. She was the one doing things right, wearing her seat belt, had a designated driver. Her life lost as a drunk driver smashed into their vehicle right where she was sitting. Their faces burned into my memory with the tears, and the pain they feel. The agonizing cry of a father who has just witnessed his daughter go into cardiac arrest. The sound rings in my ear even now as I write this. The training we receive is exceptional, the care we provide is second to none, and the people we help are truly the reward that make this career worth getting in the truck every day. These memories are the thing that I was unprepared for and I believe that sentiment is shared with many of my colleagues.

I don't tell you these things to discourage your career path, or even to invoke sympathy. I tell you these things so that you can prepare. Psychological safety and well being is a big deal in emergency services, and if you are not prepared for the things you will see, or the families of the people you are helping, it can take a toll on you. This glimpse into the world through my eyes is my way of trying to help you understand what we go through and also to prepare you as you enter this field. This is the most rewarding career I could have ever found for myself, and I truly love what I do. I encourage others that feel drawn to this career to pursue it. This career takes a little extra something as does any emergency service. Those people that find a passion for this career will be the people that continue to move it forward in a positive direction. They will continue to make pre hospital care a dynamic and ever evolving industry.

When you are doing your schooling take time to learn about work life balance. Find things to do that you love outside of this career. If this career becomes your whole focus you will lose appreciation for the beautiful things that are out there. My career went full circle and I am hoping that these anecdotes and stories can help prepare you for your journey. I hope you enjoyed the read, and encourage you to share it and like it so others can see it too.

Lights And Sirens. Riding The Line Between Safety And Patient Care.

What is the priority for Emergency Medical Services? Is it patient care, or is it rapid transport? This has become a hot button topic of late, and I want to try to address it, carefully. For many years Paramedics and EMT's have driven as they drive, with the only generalized label put on it was to be safe, and to drive as you feel comfortable. This was always considered to be quite vague. According to the highway traffic act an ambulance can contravene the act in a safe manner not exceeding 25 percent of the posted speed limit. No specific policies had been in place with many agencies, and unfortunately due to some unsafe driving practices, limited training and also due to other people not yielding to emergency vehicles, collisions happened, and people got hurt.






That last line is what is important.. People. GOT. HURT! This, in my opinion, is unacceptable. THIS flies directly in the face of what we do as a profession. I am not laying blame, that is not what this is about. This is about what exactly it is that we do. We are health care professionals. We conduct health care in a moving box, usually on bad roads, with unpredictable situations, and drivers. These are all things that need to be considered before we start to wonder how fast we can drive. It's not a matter of how fast CAN we drive, it boils down to how fast SHOULD we drive.

I'm not going to put numbers on things, we are professionals and at the end of the day we should make professional decisions. The reality is that there are now policies in place. Whether we agree or not is kind of irrelevant. I don't say that to be harsh, it is just the reality. As health care professionals it is important to refocus on what it is we do. We take care of the sick and injured, and we transport them to health care facilities. In these facilities there are many people who can start IV's better than you, many people who can read 12 leads better than you, and a few people who can intubate better than you, BUT NO ONE can do it like you can with the wheels moving. None of those skills,however, can be performed in the back of an over sized, over weight box at mach 1 on bad roads.

There needs to be a change in our mind set. We used to, many years ago, show up, throw people on a stretcher, and drive like hell to the hospital. That is not how we do things anymore. With the advancements of treatments that can be conducted in the field we have the opportunity to initiate many therapies and effect positive change in our patients prior to arriving at the ER. Does this mean that it's OK to drive slow? Of course not! We should still be diligent and ensure that scene times are minimized while treatments are maximized. When we are responding to a scene, it is important that we arrive as quickly and as safely as possible. Bare in mind that our role as Paramedics and EMT's is constantly evolving, and we need to evolve with that role. At the end of the day focus on what is important. What is it that's important? Your patient, and YOUR safety.

Reflections. How Leadership Affects The Streets

Poor morale and the degradation of paramedical services are a double edged sword that every individual should pay special attention to. It is a fact that paramedics and EMT's are good at adapting and overcoming a lot of adversity to ensure that patients receive excellent care. There comes, in time though, a negative feedback loop if the leadership of an industry becomes complacent and appears unsupportive of its staff. This is true in any industry but today we will focus on paramedicine. When leaders become disconnected from the street they can sometimes start to make decisions that in their eyes appear beneficial. This is not always the case, and if there is poor communication from the leadership it leaves the people on the street confused, and angry. This then causes a decrease in the general morale of the people on the floor. The people on the floor are the reason an EMS system works and degrading morale can directly affect their ability to do their job. It's the street staff that are going into people's homes to help them. The leadership team has a part to play in taking care of the business side of things, but if there is no back and forth communication and no acceptance of input from the people on the street the problems become worse.


The problem though is that the leadership are not the only people at fault. Sometimes street level staff are not the best at finding ways to communicate ideas to the upper management teams. I spoke the other day about how it is important to let ideas surface and find practical ways to implement them. That being said, it is evident sometimes that there is a complete disconnect from upper leadership and the street. When a leadership team has issues with implementing good ideas, and spend a lot of time arguing about things, and on occasion fail to get along themselves it will reflect directly to the street. The street level is a direct reflection of their leadership. We have all heard the phrase lead by example, and if the example being portrayed is disconnected, confrontational, and apathetic these attributes will show up at the street level as well. This is a known and studied fact. There is good news though!

There is room for improvement and fortunately it only takes one or two good leaders to at least affect positive change for morale. When a leader steps up and listens to the street level staff there can be a drastic increase in morale. When that happens there is a good chance that the staff will be able to let their good ideas surface. The people at the street level are the people that are going to give you the best ideas for improvement. Necessity is the mother of invention, and when someone sees something that can improve patient outcomes, or safety or any number of other things that person should be able to send that idea up the chain of command. When leadership teams can't even accept ideas from one another though, the staff becomes complacent, and reflects the actions of their leaders.

This double edged sword can freeze an industry in apathy, and complacency. When this happens, morale crumbles, leadership fails, and the industry can fall apart. Good communication is one of the biggest factors that can drive change within an industry. It is known that not all ideas can be implemented, but if ideas are at least heard, and discussed openly, that alone can boost morale. It can show that ideas are being considered. This will make a huge impact at the street level. Leadership is important, there is a vast difference between running an organization and leading one. At the street level it is important to remain positive and let good ideas surface and find the right channels of communication to implement or at least have good ideas looked at!

Positivism, Professionalism, Pride, Progress

How do we make change? The world of EMS can be a fast and progressive system as is being demonstrated in countries like Australia, and the UK. These advancements have provided for fewer ER visits, as well as progressive and improved patient care at home. Patient's are given different options, and care plans are made that can improve patient quality of life as well.

These advancements don't just happen. They happen because someone or a group of someones made a choice to advocate for patient's and advocate for improvements in the system. I'm not saying that a revolution is needed, but a resolution does need to be sought. The health care system needs help. We have overloaded ER's, full patient units, increasing EMS call volumes, and no money to increase resources at any level. So how do we make change?

The first thing that needs to change is our attitude. That's a hard thing to hear, but being negative about everything is not the way to change anything. A positive attitude goes a long way to at least improve your day to day mental health, and helps to keep your mind open to seeing ideas for improvement. When you start to see the ideas that could improve patient experience, or lower hospital overload it's important to write them down. New ideas don't get implemented if they never get suggested. That being said you can't just throw ideas at people and see change. Proper presentation is also vital. So how do we make change? In the picture above it's said in fairly plain English. A long time ago I recall hearing a phrase that said, be the change you want to see in others.

Taking pride in our profession and being positive at work and letting the ideas that could make real change come to the surface is a good first step. The next step is to find ways to show that these ideas will work. One of the best ways I have found to do that is to use On Line Medical Control. When you want to step out of the box, involving a doctor is a great way to do it. They will usually agree with a good idea and help you make it happen. These ideas are then documented, recorded and can be studied to ensure the outcomes are positive and beneficial, both to the patient, and to the system.

It is a fact that our system is going to continue to get busier, it is also a fact that we are not going to get a bigger budget. The other fact that some people might not agree with is that we don't need a bigger budget. What we need is YOU, your ideas, your thoughts, presented in a positive fashion. Thinking outside the box is OK, it just has to be done in the right way. We are the front line, we are the ones that have the opportunity to see potential changes that could be positive and beneficial. Let's think outside the box and involve our OLMC doctors and direct supervisors. Be diligent, be professional, and let's work together to bring progress to the paramedic profession.

The Importance Of Putting Ego Aside

It was a shift like any other shift. We were steady, calls were kind of run of the mill, the hospitals were backed up, and healthcare plodded on in it's broken state. I had brought a patient into the ED who was moderately injured and would need some diagnostic imaging to confirm or deny a possible head injury and other injuries. The patient was uncooperative and didn't want anything to do with EMS but agreed to accept a ride. The details are of less importance than what transpired in the emergency department. Upon giving my bed side report I was ostracized because I hadn't started an IV. This is something that occurs in our world far too often.

The constant ego battle between paramedics and nurses has been an ongoing concern and problem for years. It is something that has baffled me, and angered me for just as long as I have been in this industry. I have the utmost respect for every one of my healthcare colleagues and when I am ostracized for not getting one thing done, or criticized for varying reasons it affects me deeply. I know by far that I am not perfect at this career, as none of us are, but that is why we have a health care system that PRACTICES medicine. Medicine has never been perfect and we learn new things every day, and make advancements and change things based on evidence and common practice. This battle of ego's between nurses and medics is something that is archaic, out dated, and the evidence shows that it only causes tension, complaints and general bad feelings between the two groups. This is a detriment to patient care.

If we look at both professions and match up our similarities and our differences, together we are a mighty awesome team that can provide excellent care to any patient. Don't misread what I am saying, this is a small problem and definitely not the majority of the time. Although it happens enough to my self and many colleagues, both nurses and medics, as medics are guilty of doing it to nurses as well, that I felt it was something worth mentioning. Health care has to be a team approach, utilizing the skills of every person involved from the nursing aid to the neurosurgeon. Nurses, ED physicians, respiratory techs, Paramedics, lab techs, cardio techs, and every other discipline that works together to provide every patient with excellent care. Imagine if you will an ideal world where the medics have done everything they can in the short time, limited space and chaotic conditions. They arrive at the emergency department, and hand off care to the ED team and instead of focusing on the one or two things the medics didn't get a chance to finish before they got there the team acknowledges the work they completed, and continues the care from that point, all the way to the end of the patient's time in the hospital. This is how health care should be. Patient focused, let me say that again, patient focused.... Your ego is irrelevant, your skills, and your knowledge and your patient advocacy are vital, and are important. Communication about what is done and what isn't done is vital, and transferring care calmly, and efficiently is what is important.

Egos are dangerous friends, and it's time that nurses, and medics recognize that when we argue, or focus on the little imperfections of each other and act better than the other we are only hurting ourselves. As a team we are amazing together, we are a force to be reckoned with that make a huge impact on any situation. How do I know this? I know this because I have seen it, and the evidence shows that when we focus on the patient, the out come is always better.

As I said earlier, this is not the norm, but I believe that relationships between medics and nurses can and should be improved. Gentle ribbing of course is acceptable, but at the end of the day we have to recognize that our strength lies in the fact that our similarities give us synergy to enhance patient care, and our differences broaden the scope of care that we can provide. How is this ever a bad thing? It looks like a win win to me. The next time you are faced with a medic or a nurse that hasn't done everything that YOU deem is necessary think of this. You weren't with that patient five minutes ago, and their condition could be changing, also you have no idea what the situation was like before you arrived or before they arrived. Sometimes if things aren't done there is a reason, it may not seem like a good reason to you at the time, but instead of ostracizing them, focus on the patient and work together to enhance the patient's care. Put your ego aside, it only gets in the way. Ego gets in the way of intelligence and professionalism, and those are the two things the patient needs from you, be a team, work together, be part of the solution.

Public Relations, The Importance Of Shameless Self Promotion

Today I had the privilege of being involved in a public relations event for the Police department and for EMS. This was such an amazing event and every time I get to do one of these I remember the importance of shameless self promotion. When it comes to emergency services many people do not understand who we are or what we do. This is OK for the most part, but if we don't promote who we are, no one else will. We as Paramedics, and EMT's need to plug in to public relation events. I find these events also remind me why I got into this career in the first place.

Today I got to partner up with our City Police department as well as with the city public library. My self and one of my best friends and co workers went to a school today to meet with several grade 3 classes. This is not a new program and has been going on for several years. I have only participated a couple of times now, but it is becoming a regular thing when our schedules allow. Kids truly are our future. If we don't demonstrate and talk about what we do we won't have as many people in the future wanting to pursue this career. This would be tragic because, to me, this is one of the best careers that a person can do. Especially a person that has a burning desire to help people. Yes, as I have said in past posts, this job can take a toll on you emotionally and even physically, but it is still a noble and important profession. Public relation events are actually very good for the emotional aspect of what we do. I never laugh more than when I am with a group of kids, answering their questions, and hearing their stories of when they have had dealings with Paramedics and Police.

OK, so a little more about what we did today, because the day was a great time. We were involved in a program today called "It's A Crime, Not To Read." This program promotes reading, and at the same time promotes emergency services. It originally started with Police only but over the last several years EMS has been getting more involved. The fun starts the moment we arrive! The kids are always so excited to meet us, and talk to us, and ask us questions. We are in a stream of endless high fives, fist bumps, and smiling faces.

As we took our seats, and the Public Library representative introduced us the kids sat and were attentive and welcomed us to their classroom. We then listened as the two police officers read a story to the kids. The story was hilarious, and brought to life by these two amazing officers who had a great time reading it. Once their story was done, it was our turn. We were a little nervous following up such a great performance, but we gave it our all. The story we had was also very funny, and the kids received our antics just as warmly as they had received the police officers. Once everything was all said and done the kids were encouraged to ask us a few questions, and then they were allowed to come and speak to us. We spent several minutes at the end of it all signing autographs for the kids, and more high fives, fist bumps and genuine thank yous for coming to read to them! We laughed a lot with the kids, and had an overall amazing day! I encourage my fellow emergency services workers to embrace a few public relation events a year. They are usually easy to find, and help to rekindle that excitement that brought you into this industry in the first place. Who knows, one day, you might be the inspiration for someone to join us in this awesome career!

Unplugging In Our Digital Age, A Necessary Break

Unplugging  can be hard in this world where everything seems to be connected to everything else. I see a lot of posts on line that ask about unplugging. The only problem is that to be unplugged means you are disconnected from everything. Wait though, isn't that the point? In emergency services we are surrounded by media, radios, MDT's, cell phones and we are constantly being bombarded. We spend four days glued to these devices and then when we are on days off we are surrounded by tablets, TV's, super phones, GPS and more! This is not healthy. Unplugging is one of the most freeing and necessary things you should do. Unplugging is easy, though many people are too afraid to try it.

I think that some people in emergency services have recently started to learn that getting away from everything is healthy. It is exciting to be in this time in EMS, although there is a lot of darkness and storms still to weather. As the story goes though it is always darkest before the dawn. The media attention and public admissions of people under duress in our industry is ushering in changes that have been necessary for decades. This change will still take a long time as old ways of thinking take a long time to die, but the most unwise thoughts we can have is "we have always done it this way." In the meantime I encourage people every where to unplug.

Before my last post, I needed some time to reflect on my problem, and on the solution. The steps I will take to ensure I break this habit. The two days before I wrote my last post I decided it was time to unplug. I literally shut my phone off, and took time for me. I spent time with a good friend and went on a long hike. I also spent some time cooking and avoided television, especially the news. This time was for me and was important. It is also something I plan to embrace often. When we are surrounded by digital media and constantly bombarded our psyche takes a beating. We may not notice it as it is now just what we are used to. We are surrounded by it in every aspect of our lives.

I encourage you to take the time to shut off your computer, shut off your phone, and even shut off your television. Take time to be outside, enjoy nature, look at wildlife. It is one of the most therapeutic things you can do for yourself. When your mind is full of stressful situations, and some of the awful things we see in our career, clean air, blue skies, trees and nature are an almost certified treatment. Of course it is not always just that easy, but when things are getting you down it is a good stop gap that can cleanse your mind and help you regain perspective.

Perspective of our place in the world is vital to ensuring we continue to provide our best work in our career. We are not machines, and we are far from perfect. We strive to be, but at times we are not going to get there. It's important to take that pride in what we do, as our career can literally be life and death, but we can not let it define us. Those decisions that we make, right or wrong, will carry with us always. It's how it works. Gaining perspective will help us to realize that we don't have to be perfect. We strive to always be as perfect as we can, but dwelling on things that may or may not have made a difference will take a much deeper toll on your psyche than you think. It is time to unplug, and refocus your perspective on things. This allows for recovery, and for healing, which in turn makes us better practitioners.

Reining In Demons

It is no secret that this job will take a toll on you personally. There will be demons that you will carry, in the form of bad calls, disappointment in yourself and expecting more of your self than is realistic. These demons sometimes can and often do take the form of addictions of some sort. Facing these demons is something that we should do, and need to do. Take it from someone who has tried going this road alone, it doesn't work. I never wanted to admit I had an addiction to something, until I realized that by not facing it I was at risk of far worse consequences. Fortunately my addiction is not any form of drug, but it can be just as damaging. I recently realized this and reached out to a friend for help. Reining in ones demons can and will be a difficult task, but with help demons can be beaten.

When you expect much of yourself you sometimes find it difficult to reach out and show that you need help with something. You forget that just like you are there for your friends, that they will also be there for you, and if people won't be then they are not friends worth having. Recently Emergency services has been in the spotlight for occupational stress injury which manifests itself in many ways. Over the last 10 weeks 13 first responders have committed suicide due to PTSD and other occupational stress injuries. This is a big deal, and I am deeply saddened by this unnecessary loss of life. When my demons surfaced recently and I looked them in the eye and realized I had a problem I was in disbelief. I couldn't believe that I had a problem, I couldn't comprehend that I was carrying so much. I have been in this industry a long time and I didn't want to believe that the reason I was addicted to gambling was possibly career related. I have been lucky, as I have realized it before things got too desperate for me.

Making a decision to face, and defeat our demons comes at a price. There is fear, there is apprehension, even as I write this I don't know if I will publish it, as this puts it out there for everyone to see. That might be a good thing though, being transparent, and accountable for my own actions. Actions that could have cost me everything. Biggest lesson I learned this week is to never try and go it alone. We have an awesome support system and though times are tough with work being busier and lives also remaining busy it's important to stay connected to your peers. Our camaraderie is what helps us, and keeps us whole. For anyone suffering alone or going through things that they think people won't understand, reach out to someone you trust. You will be surprised at their understanding and their support.

Reining in our personal demons takes effort, it takes time, and it takes honesty. Honesty with your loved ones, and honesty with yourself. Admitting there is a problem is sometimes the hardest part. Once you have passed that step, the road ahead is long, but the road is passable. Taking things one day at a time and finding your joy on the journey is the best part. I share this for two reasons. One I don't want to go it alone anymore, and two, I want anyone that may be keeping things in to know that it's ok to reach out. Reaching out doesn't make you weak, reaching out shows that you have the strength to face what your going through. Strength takes many forms and sometimes when we feel at our weakest it's the next step that demonstrates how strong we are.

Pride, Professionalism, Duty

Three words. These three words bring the driving force that draws people into the career of emergency services. Long before we ever understand those words, the moral fiber is built into us. The emergency services of any kind, police, fire, ems, search and rescue and others, is truly a calling. Most people that begin this career will tell you that they got into it because they wanted to help people. People are our business. People that get hurt, that get sick, that have mental health issues, or in general can't cope with their current situation. These people need someone, these people need us. We are there to answer the call, and if there wasn't people like us, what could people do? 

Over my years as a paramedic I have met many other medics, EMT's, Fire fighters, and Police officers and there is something that I have noticed that binds these three groups. Regardless of how much ribbing or joking we might torture each other with. There is a high level of professionalism in every service. It may look different in each case, as each of our jobs is different in each situation. This professionalism goes beyond a clean uniform, polished boots and proper radio etiquette. This professionalism is how we treat the people we meet in our day to day lives, and in our day to day calls. Professionalism goes beyond the job and extends into our personal lives. When we interact with someone at a grocery store one evening, the next day we could be in their home treating them for any number of ailments. If we are not professional off duty, those people we meet may remember us, and their confidence in us could be shaken. This would be a tragedy of epic proportion. It is important to remember that out of uniform we are still a member of emergency services, and the way we act in public matters. I learned this lesson where I grew up and started my career in EMS. Every day I saw people that I knew, and more importantly knew me. As I grew in this industry I learned that my actions outside of work mattered just as much as they did at work. 

Taking pride in who we are is vital to help us to remain professional. Even when we are over worked, short staffed, and have any number of extra stresses imposed on us from outside or internal sources, what we do matters. That is what pride is. Remembering, when it feels like no one else notices, that we make a difference in people's lives. The people that we meet, they know, and they appreciate what we do. Many people are ignorant to the world of emergency services, and that's ok, they don't have to know or understand, or even care. The truth is that one day they may need us, and when that day comes we will treat them with the same dignity and professionalism that we treat every person with. Public education about emergency services could go a long way to help people understand, but in reality, for many people ignorance is bliss. Until that day comes that they are dialing 911 they won't understand what we do and that is actually ok. 

When a person makes the choice to serve in emergency services it is because of those three words. Pride, Professionalism and Duty. We are drawn by a duty to act on the behalf of people who are unable to act on their own, due to injury, illness, or a bad situation. We treat every person with dignity, respect, kindness, and honesty, even when those people may not treat us the same. We take pride in the fact that we are educated, motivated and dedicated, and we will be there, every time. There is nothing on earth that will stop us from responding to someone in need as that is what our calling is. Emergency Services World Wide Live The Words, Pride, Professionalism, Duty. 

Found this video on You Tube. It's self serving but It was made by someone that appreciates YOU as an Emergency services provider for what you do. 

When Professionalism Meets Silliness, Tongue Bleeding Moments

In the world of EMS not every call is tragic, many calls are routine, and some are almost too funny for words. I want to give you a look at some of the funny things we get to see. I have to point out that details will be limited due to privacy laws, but hopefully you will see the humor in these little anecdotes. For the most part the people were good people and were literally just having a bad moment or a bad day. On occasion we are presented with a call that has us biting our tongue, and at times to the point of bleeding because what we are seeing is absolutely hilarious, but for the person in that moment is a very real concern. This level of professionalism that we maintain is necessary because we are in a place of trust. We are not there to judge people, and we are definitely not there to belittle people. We are there to help people and if the situation has gotten to the point that EMS needed to be called then we will show up and we will treat you with the utmost in dignity and professionalism.

To start off the anecdotes I must tell you about one winter evening where we were dispatched to a person laying in a bus shelter. It was quite cold out, and the buses had stopped running for the night. When we arrived at the scene we met a very pleasantly intoxicated homeless gentleman who was waiting for the bus to get back to the homeless shelter. Two problems with this though, it was well past the times for the buses to be running and he was at a South Bound bus stop and the shelter was north. So after a thorough assessment it was determined the individual was ok and he wanted to be taken to the homeless shelter. On the way to the shelter my partner had our gentleman singing a very pleasant tune to pass the time. It was great to have a patient that was pleasant and not trying to assault us because he was drinking. It was also nice to hear something different emanating from the back of the ambulance than the usual hustle and bustle involved in caring for seriously injured people.

In the world of EMS we discover people who find all kinds of new and inventive ways to hurt themselves. I can't share details about this as most are graphic. I have one story from several years ago though, this was more a hospital story than an EMS story. An individual had driven him self to the hospital as he was too embarrassed to call 911. The individual had lodged a paper towel holder into his rectum. The circumstances of how it got there are unimportant. The relevant data is that it was there, and it was protruding approximately 4 inches outside of his rectum. My question has always been... How did he drive? Anyway, at the end of the day surgery was required to remove said paper towel holder. Surprisingly the end of it had a condom on it, again the circumstances of how that got there are also unimportant! Let me be clear; you as an individual have the right to put things where ever you like. You also have the right to wrap things with what ever you like. Keep in mind though, when things go wrong and you get hurt, you will have to explain the entire situation to the paramedics and then again to the doctors and nurses in the emergency department.

This career is not always going from tragedy to tragedy, a lot of the time we get to meet really nice people that are having a bad day. I have found many people are just having trouble coping with their situations and it feels good to be called upon to help them through it. At times we get to see humor in our calls and in the right context that humor helps the calls flow well. In some cases we are surprised by the incredibly creative ways people hurt themselves but as long as people keep doing it we will have jobs and stories to tell. I encourage you to remember a small piece of philosophy I heard recently, "Don't do anything you wouldn't want to explain to a paramedic". Solid advice, but honestly you have the right to do what you like, and when it goes wrong, we will be there to help you.

Camaraderie In EMS, Why It Is Important

If you are not a Paramedic or an EMT and you have ever been out with a group of us, our behavior may shock you. We have a penchant for the inappropriate, and a flair for twisted humor with a dash of darkness. We are generally a handsy bunch with a lot of hugging and we share openly about many parts of our lives with each other. This flies against the mainstream ways many people behave, but it is important and necessary for us to behave this way. It's no secret that the work that we do can take a toll on us and as that toll builds it is necessary to find ways to cope with that stress.

At first glance inappropriate behavior and twisted humor might not seem like much of a coping mechanism, but it is very important for us. This camaraderie is a relationship that grows quickly and it becomes strong. It is not something that needs to be feared. It may seem strange to you as a non medical professional but I assure you it keeps us sane. The things that we are forced to see on a day to day basis create a bond. We work closely with our partners for 12 hours or more per shift. We live in the cab of our ambulance and in busy centers rarely see halls or have any time apart. When faced with things that no one else should see it is important for us to be able to get those thoughts and feelings out of us. Enter the camaraderie of EMS. When we get together we may not talk about that difficult call right away, but we will often get as many hugs as we can.

Overall it's a small thing that gives us an outlet for our feelings that we may not voice in the moment. A lot of those feelings don't necessarily need to be voiced, they just need to be hugged out. Our dark humor on the other hand can come across as offensive. In today's "Let's be offended by everything" mentality I worry for the future generations of Emergency Services Personnel. For the most part we try to keep our dark humor out of the public eye, but if you are at an event with Emergency Services there is a chance you will hear it. I urge you to not judge, and I assure you this does not mean that we don't care about people. We do this job because we care about people. When we let those bits of dark humor out with each other, and usually we are unaware if it happens in front of people that might not understand, it's again just a way of letting out the feelings that take a toll on us.

Overall our camaraderie is what keeps us gong in this career. If we are unable to joke, and be inappropriate and spend time with each other the toll on our psyche could be devastating. If you are dating or the spouse of an emergency services member I encourage you to promote them spending time with other emergency services people and having that good time unhindered and free from judgment. In the long run this will give us longevity in our career and have us bringing less of our "stuff" home, "stuff" that no one should be subject to or burdened with.

Please share this post with your loved ones and friends so that our camaraderie can continue to thrive and keep us serving the public good.

Essential Emergency Service, Or Partner In Health Care, An EMS Identity Crisis.

Over the past several years a lot of talk and study has gone into whether or not EMS is an essential service, or not. It was always interesting to watch the debates and changes made based on the need of the day. It has got me thinking about what EMS actually is in the eyes of the public and in the eyes of Emergency Medical Service workers. The name implies that we are an emergency service, but our actions define us in a much broader role. With that in mind I ponder the idea that maybe, like the fire department of old, we are in an identity crisis and it might be time to embrace our full range of diversity.  This in turn makes us a far more essential service than some people are ready to admit.

The diversity in EMS reminds me of the days when fire departments first started up. Every time something happened that people didn't know how to handle, they called the fire department. Through that commitment to doing what was asked of them, the fire department has evolved into an entity that is highly diversified with many facets. In EMS many practitioners get upset when they are asked to do things outside of the norm. I think that it is time, as a profession, to embrace those things so that in time we also have a highly diverse practice. Having many specialities would allow practitioners to change their career field without changing their career.

More often than nought we are heading into situations that require many different techniques and plans to effect positive change for patients. These include putting patients in touch with external resources for help. We also can provide many treatments and therapies right in people's homes removing the need for an ER visit. We also partner with the hospitals in providing care to patients in hallways when hospitals are over capacity. We perform facility transports to home, or other Healthcare service providers. The list goes on and each of those facets can be and in some cases already exist within EMS.

I believe it will be many years before the powers that be and EMS nail down a conclusive version of what Emergency Medical Services is as a full entity. I also think that as practitioners it is our responsibility and our duty to own the diversity that is EMS in all of its facets. In time I foresee a highly diverse system that allows it's practitioners to participate in the parts they truly enjoy. I also firmly believe at some point as allied health care professionals we will also be seen as an essential emergency service without debate. 

Wear your uniforms with pride my friends. Others may not see it yet, but the health care system and general public safety does need us. We are an essential emergency service with a bright and growing future full of diversity and opportunity.