I was looking through some old files and articles that I bookmarked, and I found last year’s Career Cast Worst Jobs of 2009. Emergency Medical Technician was ranked as the 6th worst job in the United States using Physical Demands, Stress and Income as criteria. That’s right, everyone, this job that we all love to do, some of us as volunteers, others as our careers, is ranked as one of the worst jobs in the United States. In case you’re curious, Sailor, Taxi Driver (does anyone else find humor here?), Diary Farmer, and Lumberjack were the only jobs that were considered worse then EMT. So, how in the eyes of the folks at Career Cast, can we improve the Emergency Medical Technician position as a job? Let’s take a look at their criteria: 1. Physical Demands — We are already moving in the right direction here. The physical aspect of EMS is greatly diminished thanks to innovations such as tracked stair chairs, hydraulic stretchers, and AutoPulses. Although there is still some wear and tear, and the necessity to lift will always be there, as an industry, we are doing the best that we can for our people. 2. Stress — Stress will be the hardest piece of this puzzle to improve on. Let’s face it, we see things every day that some couldn’t imagine seeing in a lifetime. The best thing that we can do is afford as many outlets for stress relief for our employees. That could come in the form of increasing the availability of Critical Incident Stress Debriefing, or something as simple as giving our people other outlets for their stress by giving them something as simple as gym membership. 3. Income — With the progression of our field, the expansion of our scope of practice, and better understanding of what we do, Income will improve as well. EMS is still a very young field when compared to the other two branches of public safety. We have come a long way in a very short time, but we still have a long way to go. Interestingly enough though, in 2009, USA Today ranked Fire Fighting as one of the best most...

I have totally immersed myself into the Twitter world, and for the last couple of days I have engaged in some great conversations with some great people. Today, I got into a discussion about a few different topics, but my favorite was professionalism, and our image in the public eye with TheRoadDoctor, Rescue_Monkey, CKEMTP, and In_The_City. I was working at the time, and it was really hard for me to put my phone down. Many great points were made, about how many parts of the industry reward mediocrity, and how there is a “just good enough” attitude, rather than people being driven and motivated to go above and beyond. Was this how people really are, or as In_The_City put it, is our perceived apathy a “learned behavior” taught to us by poor role models? I have a feeling that throughout this discussion, I shared a lot of “head nods” with my colleagues as the great points summed up in 140 characters or less flew across the Internet from Twitter to Twitter. It got me thinking though, what steps can we take to be more professional? Professionalism starts before you punch in. One of the things that TheRoadDoctor and I agree on is that like it or not, the public is watching us, and our appearance definitely shapes the opinion that colleagues and the general public has of us. The first thing that every provider in the industry can do to take a step towards being more professional is simply stopping in front of that mirror before walking out the door. How does that uniform shirt you’re wearing look? How are your boots and shoelaces doing? Is it time for a relacing or a polish? Guys, are you up to your department’s grooming standards? Girls, how’s that hair look? Next, grab a quick breakfast. Don’t rely on that early morning *Insert greasy breakfast sandwich of your choice.* Go in on a full stomach. Its rather refreshing. Finally, be on time. Walk up to that time clock when you’re supposed to, or even better, early. Tardiness is a huge pet peeve of mine. I’m ready to go when I’m supposed to be, and lets face it,...

There is no higher liability situation for a Paramedic or EMT than a patient who does not want your treatment. Nationally, on average, approximately 20-25% of all 911 Ambulance calls result in a non-transport, so refusal scenarios are encountered frequently. Determining orientation to person, place, and time is one thing, but feeling confident that leaving a patient is in their best interest is something completely different. My old Medical Director used to tell us, “I would rather have you take someone to the hospital, even if they disagree with your decision and find nothing wrong, than to let them stay home, and get worse, or even die.” Some cases are pretty cut and dry. The patient understands the potential consequences of their actions, which may or may not include death or permanent disability. Others, like the incidents listed below, aren’t quite to black and white. Take a look at these three unique cases in which a patient was refusing treatment and tell me what you would have done. . . Case #1 — The Overdose We are called for the 30 year old possibly not breathing, with CPR instructions being given. Upon arrival, we find a 30 year old male, with a pulse and a respiratory rate of 4. Family was doing CPR upon arrival. Upon further assessment of the patient, we find his pupils to be pinpoint. Family is stating that they found him like this in the presence of a needle and heroin. The Medics on scene go down the usual treatment route: assisted ventilation, and the establishment of an IV. They decide at this point that they want to get their patient conscious, so they give him an initial dose of 0.8 mg of Narcan. After about two minutes, there is a minimal response from the patient. He is still unconscious, and his respiratory rate is not significantly improved. The lead medic makes the decision to give the patient another 1.2 mg of Narcan, bringing our total dose of Narcan administered to a whopping 2 mg. The patient then regains consciousness. While grateful for the treatment the patient has received, the patient and his family who was previously doing CPR on...