I have been asked occasionally by friends why I don’t take more pictures and post them on Facebook. Previously I never had much of an answer beyond “I just don’t” that was until a recent trip to Washington, DC when a far more practical reason became clear to me. With some time to kill my girlfriend and I took a walk through the heart of the Smithsonian and down to the monuments on its west end. The Washington Monument, Lincoln Memorial and the Reflecting Pool that lies between them has always been one of my favorite spots in DC, and it is a visit that I frequently try to make when in town. As we walked past the reflecting pool I saw a number of people taking pictures however they were not standing around and snapping shots of what was going on around them. What we noticed was selfie after selfie after selfie being taken. Everybody standing by the reflecting pool was trying to do their best to capture a shot of themselves and everything that was going on behind them. Some crouched with arms out stretched, and others had their Selfie Sticks deployed to help them do the job. What I realized though as I walked past person after person was that all of these people were experiencing life, and one of the greatest places in this country, with their back to it. I became much more aware of what was going on once we got up the steps to the Lincoln Memorial. The view from there is incredible as you look back across the Reflecting Pool to the Washington Monument and then on to the Capitol Building at the far end of The Mall. We were surrounded by people trying to get their picture with Honest Abe as they seemingly disregarded everything else that was around them. To sum it up, if anybody is ever wondering why they don’t see me taking or posting more pictures it is because I refuse to live life with my back to the world. There is far too much going on right in front of me that I would rather experience with my own two eyes...
The Podcast
We took the week off last weeks or Labor Day and this week the podcast is back with a short interview that I did on Jamie Davis’ The Medicast where we talk about the show and what it is all about. Regular shows will be back next week! Enjoy! To download the show in MP3 format, follow this link! Otherwise check the show out below: ...
Read MoreFor Leadership
Roughly twelve years ago, AMR and AEV’s Safety Concept Vehicle made its way to Springfield for us to take a look at. It included a number of interesting features like an expanded harness setup to allow providers to move a little more freely around the box while still being anchored. There were mounting brackets for cardiac monitors, and video cameras to monitor both the rear of the truck for backing up, and the passenger side to check for traffic before opening the curbside door. The vehicle itself contained a lot of positives that have been adopted over the years. I see more cameras used in emergency vehicles and I’m a a fan of the checkered or striped patterns on the backs of trucks to make them more visible to oncoming traffic. I have also seen a few more monitor brackets. But where is everything else? When is that ambulance of the future going to get here? Year after year at conference after conference, there will undoubtedly be some ambulance parked on the exhibit hall floor touting itself as the “ambulance of...
Read MoreFor the Field
There has been a lot of buzz over the past week about California’s EMS Bill of Rights. Dave Konig has a great take on it over at The Social Medic that I encourage you to read. American Medical Response has even launched a counter campaign to it complete with the hashtag #LivesBeforeLunch. While that makes me cringe a bit, I want to touch on one line of AMR’s response to the bill that stuck with me. “As written, AB 263 is an unprecedented political power grab, and will heavily penalize private – but not public – employers of EMTs and paramedics.” When I look back at my career with AMR that spanned more than twelve years, I had a lot of ups and downs. Had busy shifts and I had slow shifts. I found myself mandated to work despite being sick, or just needing a day off. Through the highlights and the lowlights of working in a busy 9-1-1 system that amassed roughly 40,000 calls per year, the instances where my 12 hour shifts hit double digits were rare when compared...
Read MoreLessons to Learn
Any time I peruse the pages of EMS related articles I will inevitably come across some service that is trying to take over another service’s area. Diving deeper into those articles usually reveals the same usual arguments. Imagine my surprise when I clicked on an article about the East Longmeadow Fire Department’s move to take over EMS response in the town of East Longmeadow. I should first point out that what I am about to write is meant to represent my own personal views on the state of the industry. I have not inquired about anything having to do with the current staffing of ambulances and volume. What I am reflecting on is the article and just the article coupled with my years of experience in the greater Springfield area. Just to give a little bit of background here, I used to have a dog in this fight. As many of you know, I was a 12-year employee of American Medical Response, the last seven of which as a supervisor. I participated in contract bids for the town, and saw service...
Read MoreRecent Posts
Testing Stinks
Years ago, when discussing the precepting program at my division, somebody said, “I don’t know why we are taking so much time to evaluate these people. They were able to pass the paramedic test that right there should tell us that they are ready for the field.” What this person did not understand is that testing that takes place in the written and practical settings have very little to do with. Our testing, which has evolved very little in the fifteen years that I have been a paramedic, has become so disconnected from what our profession actually does, and we need to start reevaluating it. Granted, my frame of reference is about three years old, and I am otherwise going by what I have heard third hand from people, but I can say, without a shadow of a doubt, that the practical stations that I went through in 2012 for my National Registry certification almost matched the stations I participated in back in 2000 when I received my certification in Massachusetts, the exception being the two oral stations that NREMT has added to the testing. I guess most of the credit for my performance in 2012 goes to the staff at Springfield College and the meticulous teaching of Gary Childs who was the head instructor back in 2000 who spent more than a year instilling on me the importance of things like memorizing the critical fail points of each station, ripping the tape before starting an IV, and making sure that I verbalize every single step as I do it in case an evaluator is not watching. I did, however, have to break a number of bad habits to get myself ready for the 2012 test. I found as I walked into each station that a number of steps that I was asked to do had little to do with how I perform as a paramedic. For example, as I freely walked around a patient and worked from all angles to apply the KED to the volunteer who was my patient, I could not help to think about not only how impractical this was, but I also wondered how many items I would have...
Change Through Catastrophe
Your department has a policy that they send two ambulances to reported cardiac arrests. On one particular busy night two of your trucks are dispatched to a person reportedly not breathing. The first truck gets on scene and finds a patient beyond help. Before they can cancel the second ambulance, they are involved in an intersection accident. In response to this incident the next morning your director releases a memo stating that second ambulances will no longer be dispatched to cardiac arrests. In a labor management meeting, an employee suggests development of an “emergency code” for field personnel to report to dispatch that they are in trouble to help activate a large law enforcement response to assist them at their location. Your boss says that this will not happen because they think field crews will abuse it. A week later, a paramedic is seriously assaulted by a psychiatric patient. The dispatcher on the other side of the radio was unable to make out their calls for help. Your boss then revisits the policy. Your division uses a non-disposable laryngoscope blades. A supervisor goes to your boss and suggests following the industry trend and shifting to disposable ones to reduce the risk of infection for patients. Your boss decides against this since your company has never been sued by someone receiving an infection from this means of transmission. You are convinced that the only way this policy will change is through some sort of tragedy. All three of these incidents are loosely based on actual events that I have either been part of or have heard about from friends of mine working in different systems throughout the United States. They are all evidence of the same though, change driven by catastrophe. We have all experienced it at some point in our career. We have all been sitting around in a conversation with our friends and coworkers and had somebody utter the words, “Nothing is going to change until somebody gets hurt.” Some of this attitude from leadership is because of a generalized disconnect from the field. Some of it is because of the kneejerk, reactive nature of EMS that seems to carry on with people...
Valuing the Culture of Safety
Last month I headed down to Baltimore for an afternoon to visit the exhibit hall at Firehouse Expo. While I was there I had the chance to sit in on a class about leadership on the fireground that raised some interesting questions for me about the safety of responders and more specifically our regard for that safety. The instructor took a considerable amount of time out of the class to question the “culture of safety” that we operate with feeling that you need to be willing to sacrifice more to save more, likening his battlefield experience in an extremely admirable and heroic military career to his time on the fireground. To sum up what I, as an attendee in the class saw as his message, you need to be willing to sacrifice more to save more. He was saying that many were too cautious by putting the concept of “at the end of the day, everybody goes home” above the mission of the department which generally is to save as many lives and as much property as possible. He disagreed with the “nothing is worth your life” concept of the culture of safety. Now, let me start off by once again stating, as I have many times before, that I have zero experience in firefighting. My personal participation on a fire scene consists of me standing around, waiting for a patient to be delivered to me, or handing out Gatorade and water in an attempt to keep those on the fireground from not becoming my next patient. What goes on inside that house is something that I have no knowledge about. What I do have, however, is a great respect for those who do put their lives on the line in those situations. The angle of this class that I want to discuss is the bleed over from the fire side to the EMS side of the profession since in many communities the two are so closely tied. Some firefighters might sit in on a class such as this and receive and honor the message that “when you’re on the engine, you need to be willing to risk it all.” Then, the very next...
Welcome Back!
Well the summer of 2015 is now behind me and it is time to get back to writing. I have been doing a lot of traveling as of late both to Austin, TX for the EMS Compass project as well as some traveling for pleasure as well. It was very therapeutic and frankly it was nice to get away from the keyboard for a couple of months. It did, however, remind me of how much I enjoy writing so it is good to get back to that as well. I have a lot of ideas developed that I hope to roll out here over the next couple of months. One of the biggest ones is I plan to include a few posts here and there that have nothing to do with EMS at all. If you follow me on Twitter or are friends with me on Facebook you know that I can be pretty opinionated about some issues. While I plan to touch on those on occasion I also want to talk a bit about life outside of EMS because getting away from the field can be just as important as what we do on the street. After over five years of writing, I feel like a break was exactly what I needed but rest assured, I am back! Now, let’s get back to it. ....
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