One of the most important skills a person can possess whether they’re working in the streets as an EMT or a paramedic, or they’re sitting behind the desk as a supervisor or manager is the ability to actively listen.  It’s not a very easy skill to perfect. Too many people confuse active listening with actively hearing what is going on around you.  There’s a distinct difference between the two. When a person hears something, they are acknowledging that there is noise.  Have you ever said to someone, “did you hear that?”  If the person’s response is confusion, or a lack of recognition, it’s almost instinctive to follow that up with a one word answer: “Listen!”  Listening involves the actual processing and recognition of what a person hears.  Hearing is instinctive.  People do it, animals do it.  Listening though takes focus and higher brain function. Now, let’s apply this to a situation in the field.  It’s our job to listen to our patients, and it is really one of the biggest pieces of our assessment.  It is what gives us a story, and a history of the events leading up to what led them to call 9-1-1 in the first place.  While it’s important to hear the story that you are being told, it is much more beneficial to the patient if you listen to what they are saying.  There might be more to what is going on, and by not paying attention (not listening) you could miss that little piece of the story that puts everything together. As a supervisor or manager, the act (art?) or listening to something that one of your employees has to say is a great way to make them feel involved, and lets them know that you truly care about the input they have to share with you.  It’s a great way to show an employee that they are valued.  Not every idea is achievable, I think most people realize that, but that doesn’t mean that an idea can’t be explored or even entertained. Body language says a lot about whether or not a person is listening.  Are you facing me or staring at your computer screen?  If it’s...

Almost a year ago, I wrote a post about NJ State Bill S-818 which was set to change the landscape of EMS in New Jersey.  In the year since that article was written, the bill and a second one also making its way through the New Jersey legislature have been revised, but the opposition has remained. I got my start in EMS at the Jersey Shore on a small volunteer first aid squad.  We ran, on average, around 400 calls a year, pretty busy for a town of our size.  Often times, it was not uncommon to have two or three, or sometimes even four EMTs standing in your living room in my town ready to render you emergency care.  The communities around us were no different than we were.  We all took pride in what we did, and knew that we could deliver better service than any paid provider who came into the area because we held ourselves to a very high, very professional standard. To this day, I am still proud of my accomplishments as a volunteer.  I was an active member of two excellent services, and the staff of those services taught me to be the caring, compassionate, knowledgeable provider that I am today.  My roots in New Jersey run deep, and I have been very troubled by what I have been reading lately. As time has progressed, and the political and economic climate in this country has changed, volunteer EMS has taken a turn, and is not as prominent as it was even ten years ago.  Families are working harder to support themselves, and the call volume and expectations of care have grown and evolved.  Some might say that these factors spell the end of volunteer EMS, and I hope every day that it isn’t the case.  It’s not the time to expect less from our volunteers; it’s time to expect more for our patients. Sadly though, the New Jersey State First Aid Council seems content with the past.  Their staunch opposition to Bill S-818 has taken the focus off of where it needs to be: the patient and put their stress on what EMS is about on the provider. ...

This post can also be found on the First Few Moments website. When working on a scene, especially one with a larger patient count, one must be conscious of developing tunnel vision.  Its very easy to get centered in on one patient for one reason or another.  In my experience, there seem to be a few reasons for this: 1. Â The patient is another provider — When one of our own gets hurt, we tend to want to do everything we can for them, right then and there.  Most Incident Command structures account for this: Get them off the scene.  When they are out of the picture, it’s easier to move on and work on whomever else is injured. 2. Â Kids — Everyone’s pulse goes a little faster when there are children involved.  Bystanders will bring them to you, and lesser trained individuals will not be able to leave their side.  We need to work with those around us to make sure the lesser injured children are taken care of while we care for and triage those who could be more seriously injured. 3. Â Cardiac Arrest — When someone is pulseless, there is a desire to do whatever we can for them.  One of the hardest things you’ll ever be faced with in your career will be to look at a patient at the scene of a major incident and say “no, stop.  There are other people here who need us.”  Keep a cool head, stay calm, and remember, you need to do the best you can for everyone at the scene. 4. Â Distracting Injuries — Finally, the one we are going to talk about more in depth this week is those patients who have Distracting Injuries.  You know what I am talking about; those angulated fractures, those more grotesque injuries that make you stop in your tracks and stare.  Just because it doesn’t look pretty though doesn’t mean it needs to be off the scene immediately. As we move through a scene and triage patients, tag or not, think about what you need to look at.  Think, for example, about the scene of a 2 car MVA with three or more patients.  Sitting on one side of...

In the past, I have written posts about the worst jobs in America.  I tackled both the 2009 and 2010 lists of the worst jobs in America, where EMS and being an EMT was way down at the bottom (or right at the top) and that is a huge issue.  It’s time to get out of that rut, and as Skip Kirkwood, Scott Brown, and a few other posters pointed out on JEMS Connect and LinkedIn, it all starts with leadership. It’s time to acknowledge what our greatest asset is.  It’s not the trucks that we drive around, it’s not those $20,000 cardiac monitors in the back of those trucks, and it’s not our stretchers, our buildings or our contracts.  It’s our people.  We send them our everyday expecting them to do “do their jobs.”  We ask them to respond to calls of all sorts of types, transport patients, put their lives on the line, and take the lives of others into their hands, and then when they are ready to go home, we look at their body of work for that day, whether its large or small, shrug our shoulders and say “it’s their job.” The first step towards this is improving our leadership, and improving how we handle people, or how we “engage” them.  Employee engagement is extremely important, and how well it is done depends largely on what your motivation is for doing it. First of all, what is engagement?  I did some searching, and found my favorite definition written by Ken Scarlett, President and CEO of Scarlett Surveys International.  He defines employee engagement as “a measureable degree of an employee’s positive or negative emotional attachment to their job, colleagues and organization which profoundly influences their willingness to learn & perform at work.”  To put it more simply, an employee who is engaged is one who has invested in the ideas and ideals of the organization, and the investment an employee puts into their organization is directly connected to the investment the organization makes in them. Some view employee engagement as a way of interacting with an employee, sort of an ice breaker.  A way of saying, “Hey, Bob.  How are...

Eleven years ago this month, I finished up my hospital clinical time and was getting ready to head out into my field internship.  Prior to that, I completed my 12 month classroom time, and a grueling hospital schedule that was close to 450 hours in length.  Not only did I spend time in the emergency room, but I was also in the ICU, the CCU, the psych unit (not as a patient), the operating room, pediatrics, and the adolescents unit.  While skill requirements were not broken down by department, I was required to get numerous IV starts, establish a number of IV drips, successfully intubate 10 patients, and document a number of patient assessments broken down into different categories. Finishing up my clinical time was like a breath of fresh air.  For four months, I was spending over 40 hours a week in different hospital departments, surviving on coffee and little sleep.  Now that I was done, I’d start my Field Rotation off with 24 hours in Manhattan and 16 hours in Brooklyn assigned to different FDNY EMS Units. My experience in New York was like none I’ve ever had before or since.  While it wasn’t this battle zone where you were constantly dropping patients and moving on to the next call, it was definitely exciting.  The sheer size of the system was staggering.  I was able to meet many of my skill requirements down in New York, which allowed me to come back to Massachusetts and spend a good amount of time concentrating on becoming a good paramedic, and not sweating it out for an apneic patient for 200 extra hours, as one of my colleagues had to do. My sixteen month journey to become a paramedic was worth it, to put it lightly.  When I got that card in my pocket a few months after I finished my ride time, I knew I still had more to learn, but the education I’d obtained so far made me ready to step onto the streets. Then, in 2004, the State of Massachusetts changed the standard, and it seems recently, in the last couple of years, Paramedic programs are starting to adopt the changes in...