Equality

Some posts are more difficult to write than others.  This is one of them.

Coming from a volunteer background, I have seen a variety of levels of abilities in EMTs.  Some can’t hear a blood pressure.  Others just seem to say the wrong thing at the wrong time.  Some are just plain unreliable, and still others are downright negligent.  Sometimes, people tried to make excuses for these people by shrugging and saying “they’re doing this out of the kindness of their heart.”  That argument never seemed to hold much water to me.

I came to the conclusion early in my career that not all EMTs are paramedics are created equally.  This should not be anything anyone considers earth shattering, some people is better at things than others.  As an industry though we seem to have taken this “all for one and one for all” mentality and it is hurting us.

“A paramedic is a paramedic, and an EMT is an EMT.”  Have you ever heard anyone say that?  Unfortunately, if they don’t say it, many people think it.  There is no differentiation between a good provider and bad one, and there needs to be.  It is time to work with those who might not be cutting it.  It is time for them to get on the bus or move on.

How much of the problem comes down to our reluctance to be educated?  Our view that continuing education is the two or three year grind that we have to do.  I think many providers might get a decent education under their belts right out of the gate, but once the reeducation or discovery of new educational opportunities is put in the hands of the “responsible” provider, we fail.  Miserably.

But I digress. . .

The first step to dealing with someone who is not cutting it is to correct them.  Be blunt about it.  Let them know that they are not getting the job done and show them the right way to do it at the right time: away from the patient.  Let them know what they are doing wrong, and tell them, no, show them how to do it the right way.

When that does not work, more serious steps need to be taken.  Remediate them.  People are capable of learning and fixing their practices if they are willing to swallow their pride and do it.  Sometimes people respond well to being retaught, especially when they have now seen a process in action somewhere other than in a classroom or text book.

If correcting and reteaching do not work, then it may be time to take more drastic steps.  EMS is not for everyone and maybe they are one of those people.  Regardless of whether they are being paid for their time or are “doing it out of the kindness of their heart” that is some pretty precious cargo that we are responsible for.  Once every avenue has been explored it may be it is time to have the “EMS may not be for you” discussion with them.  It is better to move on than to disk having someone get hurt or worse. . .

Not every provider was created equal, like policy makers would like us to believe.  If we can do a better job with quality assurance and policing our own, maybe we can do a better job of convincing those who dictate what we do that we deserve more responsibility.  Let’s stop treading water and start moving forward.