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The Shine Factor

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 This is part 2 of a 3 part series on “The Shine Factor”

Part 1 of this series can be found here – The Shine Factor

Part 2 of this series can be found here – What Makes a Great Ambulance Service

Part 3 of this series can be found here – The Shine Factor – Grunts

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You know what I’m talking about here. The distinctly subtle, but powerful mix of sights, smells, and sensory input you find when walking into the apparatus bay of your station. The faint smell of diesel exhaust mixing with rubber tires, the musty smell of damp hose drying on the rack, the smells of not-so-clean turnout gear (best right after a good fire), and all of the various cleaning products used to keep the trucks looking their best. My favorite is when I’m just walking in the station for start-of-shift. It’s about 6am and the guys before haven’t gotten up yet to turn on the lights in the bay or make noise. One of my favorite things to do is to walk around the bay with the lights off, with the sun just starting to glint in from the windows onto the dark floors. It’s quiet. I love the first sunlight making deep reflections off of the shiny paint and gleaming chrome. The trucks just seem to be anticipating the day, yearning for the next call to come in. The atmosphere is electric, and quite palpable. You could blindfold me and take me into any fire station in the country and I could identify it just by smell alone. It’s intoxicating. I think that I like it more than my fiance’s perfume. It’s ok, she’s a firefighter too. She gets it.

So, what I’m about to suggest here plays off of that knowledge that we’ve all got… It’s basically an EKG hooked right up to the morale of your organization. I call it the “Shine Factor”.

Fancy name, huh? Yea, I liked it too. I’d recommend that every person who works in any fire station or ambulance base walks into the apparatus bay every time they start their shift. Don’t go in through any other door. Walk right into the apparatus bay with the memory of the favorite time you’ve ever been there. Take a big whiff of the natural aroma and look to see how much your trucks shine. Check the corners for cobwebs too. Then, simply file the information away in your brain and know exactly how the morale of the troops is doing.

Why is this so simple, yet so powerful, and a lot of the time, so unnoticeable? It’s because every organization has grunts, and the grunts carry out the day-to-day operations of your organization. No matter how many policies are written, budgets are adhered to, or strategic plans are championed by administration, the grunts are out there actually performing the duties that make your organization do what it does. If your department is like every department in the country, the grunts have more tasks than just providing service to the public; they’re responsible for cleaning, maintenance, and upkeep of your equipment. The lower and more “gruntish” they are within the organization, the more responsible for the upkeep they are. This is where the Shine Factor comes into play. Every group has assigned or assumed maintenance and cleaning tasks. Administration can formalize it with all of the written plans, paperwork, and task sheets that they want to, but all those pieces of paper ever do is ensure that the tasks are done to the minimally acceptable level. They cannot and will not make the grunts put in the elbow grease required to get that extra shine out of the equipment. My theory is that only happiness and pride in the organization entice the grunts to go above and beyond, to put the extra few swipes with the rag onto the chrome to really bring the shine out. Think about it, when you complete a task and get it looking good enough to pass muster, you could stop… but if you really have the pride and desire to make the equipment look it’s best, you’re going to go get the magic cleaner in the storeroom and clean out the crust around the lug nuts to make it look perfect, to reflect the personal pride you have in the organization and your fellow grunts.

Do you think that the grunts will spend those extra few seconds, minutes (or in my case, hours.. but I’m obsessive) to make that floor it’s cleanest, or that chrome it’s shiniest if they’re ticked off about management’s latest asinine policy or off the cuff directive? I don’t. It’s human nature. It works on a subconscious level across all of the grunts you have who polish your stuff. If the morale of your department is in the tank, your stuff may be cleaned regularly because the grunts will be sanctioned if they don’t clean off the first layer of crud… but that’s usually where it stops. When morale goes down, the shine factor goes down. When morale goes up and people are uplifted, pride goes up and the grunts put forth the extra effort. It affects more than their performance at the station too, it affects how polite they are to the public, how clean and pressed their uniforms and presentation are reflecting your public image, it affects how much personal effort they put into training, and it may very well affect patient and emergency scene outcomes too. You can regulate all that you want, but the beatings never improve morale. The only things that can do that is respecting your grunts and treating them like adults.

I haven’t formally named it, but I think that new officers and/or managers in the EMS and Fire industry who were promoted from the troops arrive to their new posts with a predetermined agenda. I don’t think that they can help it. Usually, it’s from the mistakes they’ve seen their coworkers make on the streets around them and builds especially upon their own pet peeves. They arrive to their managerial desk wanting to “fix” things and usually the result is a lot of new policy objectives and memos. They know who, at least subconsciously, they want to get back at for the aggravation that they’ve caused them over the years and think that the rest of the organization will share their personal pet peeve. Unfortunately, these attempts to “fix” things usually do just the opposite. The new managers with their personal objectives take things to the extreme. They fail to respect that the people who committed the offenses against the manager’s pet peeves are concerned adults that may have very different pet peeves, and they fail to recognize that every single employee’s pet peeve is micromanagement.

To some managers, paper seems to solve everything. If your ambulance turn-around times are too long in your opinion, you create a paper system to fix it complete with a memo and/or a new policy. The crews fill it out, and it’s supposed to make the management and crews aware of the time it takes them and it’s supposed to fix the problem. Got dirty floors in the trucks? Make a “clean floor” policy with a tracking sheet. Got a crew who uses too much gauze? Make a “Gauze Utilization” flowchart with a tracking sheet. Does your station go through too much toilet paper? You see what I mean. While all management wants to create measurable objectives, all employees hate being micromanaged.

Shortly after I got my first management position my boss, the COO, related to me a story about what he did one day when he found a truck that had been left absolutely filthy by a crew after their shift. Apparently this crew hadn’t been running more than usual that day, and had just left the ambulance filthy. Now, what he could have done, being the COO and all, is write an edict to be handed down through the chain-of-command to have the crew reprimanded from on high about the clean truck policy and the proper utilization of cleaning materials. He could have written a memorandum, or even a shiny new “Clean Truck” policy to enforce the rules. There could have been reams of paper and managerial-type fire power brought down on these guys. But that’s not what he did.

When the crew who had left the truck that dirty came back in for their day shift the next morning the COO met them at the door and lead them to their ambulance. At their ambulance they found a whole host of cleaning supplies… and two chairs. The COO then proceeded to have the medics sit in the chairs while he cleaned their entire ambulance, inside and out, from top to bottom.

Unorthodox? Sure.. Effective? Yes. The problem had been attended to, the desire for a clean
truck was reinforced, and the crews saw just how badly the COO wanted the trucks to be cleaned. Now maybe that’s not something that would work at your department, but it sure seemed to at this ambulance service. Maybe your shine factor would be increased if the grunts got the chance to work with the brass on solving problems like this. Maybe myriad policies aren’t the answer, and teamwork and mutual respect are the answer. Maybe communication increases it. Maybe the full realization by everyone within the organization that everyone has their roles and everyone has to be given the tools to take responsibility for what they own increases it.

Until now, this piece has focused on management, but us grunts can benefit from increased shine factor as well. Right now, you need to decide that you’re going to put in the effort to increase the shine factor in your department. Remember, it’s a subconscious thing. Everyone just feels better when it looks like people are taking pride in the department. Everyone from your partner, the guys, the brass, the public… even you. If the grunts make the effort, it can benefit the shine factor too and maybe the other stuff will come along with it. Positive attitudes breed positive results. It sounds corny, but someone’s gotta make the decision to be the positive change in the organization. Even in a perfect situation, if there even is one, someone’s gotta keep making the decision to keep it that way. Let that be you and others will follow suit.

Now get out there and polish some chrome.

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 This is part 2 of a 3 part series on “The Shine Factor”

Part 1 of this series can be found here – The Shine Factor

Part 2 of this series can be found here – What Makes a Great Ambulance Service

Part 3 of this series can be found here – The Shine Factor – Grunts

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Posted by Ckemtp on February 28, 2010 • Filed under: Administration & Leadership, Ambulance, Ambulance maintenance, Command & Leadership, EMS, EMS Health & Safety, EMS Management, EMS Motivation, EMS Topics, EMS pep talk, EMT, Emergency Medical Services, Fire Rescue Topics, Fire department, Firefighter, Firefighter Safety & Health, Management, PR, Paramedic, Public relations, ems 2.0, pride, profession, professionalism

Two Cases, One letter – From one Paramedic’s struggles, change can come

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A letter I received from a reader recently has gotten me just as mad as he is, even more so maybe. This letter came in from someone who identifies himself as a paramedic but asks that I protect his identity and location completely. I will do so, only identifying that the letter comes from someone who works out west, somewhere between the Mississippi and Montana but not east as Maine or as far south as Amarillo.

So He comes from somewhere in the US, not the east coast, and not Hawaii. He’s a paramedic and he’s male. That’s all I’ll say. I’m going to work the things he wrote me in his letter with my thoughts and feelings on what he wrote and the situation he wrote about. I’ll rewrite the letter keeping the point of it intact. I’m fairly sure that you’ll be just as angered as I. (Note – This is LONG but it’s good. It will probably tick you off too, enjoy)

(more…)

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Posted by Ckemtp on February 25, 2010 • Filed under: Administration & Leadership, DNR, Do Not Resuscitate Order, EMS, EMS Health & Safety, EMS Management, EMS Topics, EMS ethics, EMS paramedics, EMS system, Emergency Medical Services, Ethics, Line of Duty, PR, Paramedic, Patient Handovers, Patient Management, Public relations, change, ckemtp rants, edemse, ems 2.0, ems education, everyday ems ethics, medical ethics, paramedic education, patient care, politics, potential, pride, profession, professionalism, rant, stories

Why I am Passionate about the Chronicles of EMS

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If you’re an EMS professional, you should be paying attention to the Chronicles of EMS.

I think every person involved in EMS on any level needs to pay attention to the work of three of the profession’s upcoming giants, Mark Glencourse, Justin Schorr, and Thaddeus Setla. Their collective project is a warp-leap forward for how our profession is presented to, judged by, and thought about by our internal and external observers, customers, and colleagues. With their efforts come Hope… Hope that one day soon EMS will take its rightful place as a true profession; Hope that our profession will get the paid the attention that it deserves; Hope that our educational standards, resource needs, and compensation will finally be improved; and Hope that we will be able to improve our total service to our patients and our community through shedding a new light on our profession.

If this works… everything could change. Everything could change quickly, incredibly, and wonderfully. Imagine if EMS became “cool” and the public finally thought about who we are, what we are, and what it is that we do for them. Imagine if people demanded that their community leaders pay as much attention to EMS as we need them too… Just Imagine.

EMS needs a strong, unified message. The Chronicles of EMS can be that message. It is a professional, smart, and uber-cool message aimed straight at where we want to be going. It is not lip service, it is not Hollywood glamour, and it is certainly not dramatized for profit. It is being prepared by industry-experts who are still working the same streets that we are everyday. Everyone involved is one of us. Everyone involved is passionate. Everyone involved wants this, and they want it as bad as you do.

The reason I write about EMS is because I want to improve our profession and our service to others. I want to make this better so bad that I can taste it and I’m willing to work as hard as I have to. Our patients and our communities deserve the best we can give them and I believe that key to fixing EMS is communication and the spreading of our message. This blog exists for that reason and so do the other blogs in this genre. The other bloggers, authors, speakers, and writers I’ve met have all spoken to me of the same goals. Our profession exists to save lives and alleviate suffering and improving our profession help us save more lives and alleviate more suffering in our communities. EMS does indeed make a difference out there in the world and we’re the ones doing it. The Chronicles of EMS is a great beacon of hope in our collective quest.

EMS Deserves More. Our Patients deserve more; Our Families deserve more; and yes… We deserve more. Mark, Justin, Ted, and everyone involved in the Chronicles of EMS are working hard to give us just that. They deserve our support and our attention.

I’ll be in San Francisco on March 11th for the premier of their pilot episode. I wouldn’t miss it for anything. Look out world, EMS is moving forward.

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Posted by Ckemtp on February 8, 2010 • Filed under: Administration & Leadership, Command & Leadership, EMS, EMS Blog, EMS Health & Safety, EMS Management, EMS Topics, EMS blogosphere, EMS training, EMT, Emergency Medical Services, Fire Rescue Topics, Firefighter Safety & Health, Happy Medic, Line of Duty, News, Paramedic, Patient Management, Public relations, change, ems 2.0, ems education, humor, medicblog999, paramedic education, pride, profession, professionalism

A Motivational EMS Article Geared towards Newer EMTs

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The following article is what I submitted to my Fire/Rescue/EMS department’s monthly newsletter for this month’s EMS column. It has a readership of every one of the the 110 or so members of the department, their families, and a good percentage of the 30k or so people in our district. They know me personally as someone who (Imagine this) likes EMS.

If you like this article, feel free to steal it and use it for your purposes. All I ask is that you keep the links intact and give byline credit. Shoot a comment to me too so I can see if it indeed does go anywhere.

Oh, and here’s a thought. If you would like a short EMS related piece to put into your department’s newsletter, shoot me an e-mail at proems1@yahoo.com I’ll be happy to come up with something.

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It’s well known around the department that I like the ambulances and EMS in general. I do, and I’ve always been proud to be a part of (My Department’s) EMS program. I think that the level of dedication and professionalism in our department is second to none and that our program is certainly one of the best in the region and in the state.

With that said, in EMS there is never a time to slow down and rest on our laurels. The science that drives our brand of medicine is constantly evolving and the only constant is change. In my EMS career, I’ve seen “The Right Thing to Do” for my patients change more times than I thought possible. Continuing education, reinforcing the basics, and studying the latest research is key in keeping oneself in step with how best to care for our patients. As with any community based Emergency Medical Services provider, our citizens are our families, neighbors, and friends. We have the responsibility of being the first line of defense against the very worst times in peoples’ lives and it is our duty to be at our best when we are called to make a difference. The people we care about most are depending on us.

Just as in firefighting, in EMS, the little things make the biggest difference. It really is the Basic Life Support care that makes everything else work and our calls run the smoothest. Patients do not necessarily perceive the skillful application of Advanced Techniques or medications given to them, but they certainly appreciate the attention given to treatment of their ABCs, their comfort on the cot, pain relief and stabilization through proper splinting techniques, the compassion of the care providers, and the cleanliness of our ambulances and equipment. It has been said that “Perception is Reality”, meaning that the way someone perceives you or your organization affects their own reality. In EMS, good perception actually has been shown to provide for better patient outcomes. Really, if you have more confidence in the skill or effectiveness of your medical provider or a technique, you’re statistically more likely to have a better outcome.

It is so important for us as healthcare providers to focus on providing the best care possible for our current patients, but also to keep an eye out for future patients. Start now by making sure that the ambulance is thoroughly cleaned at the start of every day and after every call. Make sure that your equipment is ready to go and that you’re an expert in its use. Read something educational every day to keep yourself in the right mindset and to keep your skills sharp. Pull things out and practice with them. Come up with questions to ask the more experienced providers and don’t be afraid to ask them. It is every EMTs duty to become an expert in prehospital care and you are the only one who can expand your knowledge enough to become one. Study every day.

Here are some resources I use every day, they teach me something every time I use them:

-          Http://www.happymedic.com – A San Francisco Firefighter/Paramedic and his adventures in EMS.

-          Http://www.999medic.com – A British paramedic working EMS with our neighbors across the pond.

-          Http://www.theEMTspot.com – Educational tidbits, tips, and tricks from a Colorado Paramedic.

-          Http://www.EveryDayEmsTips.com – A Social Media, training, and EMS guru with daily tips to improve your care.

-          Http://paramedicine101.blogspot.com – In-Depth Educational Articles for EMS providers.

-          Http://www.LifeUnderTheLights.com – Your’s Truly’s random musings on the EMS.

Of course, getting your hands on a copy of JEMS or EMS Magazine is great too. Learn something every day, take pride in yourself, your service, and the care you provide. Your next patient could be your loved one, make sure they’d get care that you’d be proud to give them.

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Posted by Ckemtp on November 3, 2009 • Filed under: Ambulance cleaning, EMS, EMS Motivation, EMS Topics, EMS pep talk, EMS training, EMT, Emergency Medical Services, Patient Management, Public relations, Training & Development, Your Happy Medic, courtesy, ems education, medicblog999, profession, professionalism, technology-communications-ems-topics, volunteer fire department, volunteer firefighter

Sunday Randomness – Some EMS Pet Peeves

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< Rant>

Call me old and cantankerous. Call me obsessive too, probably. After being in EMS for a while now, like over a decade or so, I’ve become somewhat set in my ways.

No, not to the point where I’m not keeping up with cutting edge medic stuff or to the point where I won’t try out new fast food joints… and heck, just today I even tried out a new way to clean the station bathroom using the hose and the truck brush.

You know that the “Wash and Wax” stuff we use to shine up the trucks works AWESOME on the porcelain goddess! I can see my reflection!

But I have definitely developed some Old Guy in EMS Pet-Peeves (or as you UK folks call them, “Frumpydumples” or something weird like that) and I just remembered that I have a blog that people come to read. Because of that, I think that I’m perfectly entitled to rant a bit on what my EMS pet-peeves are. It’s a beautiful thing, for me.

So, without further ado, in no particular order, here are some of Ckemtp’s all time EMS pet peeves.

#14245 Swearing in front of a (member of the public)

Look, there are days where I can spew forth a string of sassy talk that would make Popeye blush. I get it from my mother (She’s a saint). I also grew up in the country around farmers and got my start in a rural firehouse. I know how to swear with the best of em’ (“#$Q#$” See? There ya go). However….

IF YOU ARE AN ON-DUTY PUBLIC SAFETY PERSON DO FREAKING NOT SWEAR IN FRONT OF A PATIENT, THEIR FAMILY, OR ANYONE ELSE FOR THAT MATTER!!!

It’s not cool. It’s not “Just how I talk” and I don’t have to get used to it. People don’t have to adjust to you. You’re a professional, you have to adjust to them. When you do this, it not only makes you look like an ignorant ass (ahem) but it also makes ME look like one by shaping public perception of our profession.

Call me what you want to. I don’t really care. It doesn’t matter matter if we’re with a patient, at a facility in front of staff, or out in public having lunch. You are representing everyone, every EMS and public safety person. Act like it.

Do this in front of me and expect correction, immediately, in front of the patient. (Yes, it’s that important). Swear in front of children and I might just have to hit you.

#3523 Encouraging the Refusal of Medical Assistance (RMA) before assessing and treating the patient

Hey, guess what… I understand that you’re tired. I understand that you’ve got better things to do today. I completely understand that you’re tired of running what you consider to be “BS” calls all day.

But you’re an EMS professional, right? You’re SUPPOSED to be sent to people who call 911. Yea, there… I said it. It’s your FREAKING JOB to assess everyone who calls you to the BEST OF YOUR ABILITY before you give them a professional recommendation about what they should do. If you ask a person “So do you want to go to the hospital or what!?” angrily before you even, like, feel for a radial pulse or get a pertinent history and physical exam you’re NOT DOING YOUR JOB. Most patients WANT you to give them a recommendation on what you think they should do. You’re an EMS professional, do just that.

If we told more people “Well, Ma’am/Sir I believe that what’s going on doesn’t really warrant an ambulance trip to the emergency room. I’ll be happy to take you if that’s what you want me to do, but perhaps you could get better care by taking a trip over to the (Insert Local Urgent Care Clinic Here) or by calling your personal physician and telling the receptionist that a paramedic/EMT told you that you should be seen today, or (Insert locally specific alternative treatment path here)” we could defer a lot of what you consider to be “BS” calls. Not everything is an emergency, but every patient deserves our professionalism, if not our respect. It’s our job and our duty to everyone. Yes, it really is. No, your argument doesn’t hold water with me. You don’t deserve to be so cynical.

Appropriately assess, treat, and make your decisions on behalf of every patient. Don’t put your personal feelings in there. It’s not ethical. No, it’s not. You want to be an EMS professional? Act like one and Earn It.

#7628 Not being EXTREMELY CAREFUL when handling the cot

Ok, this is a patient safety gripe. Have you ever dropped a patient while they’re on your cot? I have. I don’t consider it to be my fault other than the fact that I was responsible by being one of the two people holding the cot at the time. I’ve never forgotten the look of horror on each and every one of their 4 faces. I. Felt. Terrible. It haunted me for weeks. It still does. We’re supposed to protect our patients. To ‘First Do No Harm’ is somewhere in our extended code of ethics. If you’re dropping people on your cot, you’re doing harm.

If I see you absentmindedly wheeling the cot, I will stop the cot, watch you continue walking until you wrench your arm out of it’s socket, and then laugh under my breath. I will compel you to pay friggin’ attention to the cot and the patient before I move again. If you resume being absentminded, I will repeat.

If you don’t know basic physics, which will tell you that the center of gravity for flipping a cot is much smaller when the cot is travelling on from side to side rather than from front to back, then you shouldn’t handle a cot. Yes, the cot wheels rotate 360degrees but that does not mean that you can move the cot sideways. Move it in a straight line. When you need to turn you stop, rotate the cot on its axis, then move in a straight line again.  

Yes, I ended that paragraph with a period. There wasn’t any more to say about that. Know what else there isn’t much to say about? The fact that you WILL have BOTH hands on the cot when moving on anything less stable than a level hospital hallway. That’s the only time you can use that little handle on the front of the cot. If you’re on ANY other surface, it’s both hands on the cot.

Yes, that was another period. Trust me. I’m saving you years of torment and some lawsuits.

Alright. Today’s rant has gone on long enough. Thanks for reading! < /rant>

And yes, there will be more coming. I rant a lot. It’s one of the reasons I started blogging. Thank you for reading it.

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Posted by Ckemtp on October 25, 2009 • Filed under: Ambulance, EMS, EMS Health & Safety, EMS Topics, EMS rant, EMS safety, Emergency Medical Services, Public relations, Vehicle Operation & Ambulances, ckemtp, ckemtp rants, pride, profession, professionalism, rant

“In Their Eyes” – From Guest Author – Randy Lovelace EMT-B

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Ladies and Gentlemen, Boys and Girls, EMS people and Firefighters,

I bumped this post up, because Randy’s such a darn good guy.

This post is placed with the permission of the author, Randy Lovelace EMT-B. He’s a friend of mine and a firefighter/EMT-B at a department where I work. He wrote this article after a training that our department completed and it was just published in our department’s monthly newsletter. I believe that the post needs more exposure, because it is just great. It exemplifies the camaraderie and community spirit that is embodied in our small-town department (that runs about 3k calls a year). We’re an anomaly, our small-but-proud department. We’ve got a fanatically devoted, passionate group of highly trained volunteer firefighters and EMTs that provide the best possible service to our citizens.

I’ve taken out the references to our department because I try to maintain my anonymity to provide another level of protection of patient confidentiality. It doesn’t detract from the piece.

Thanks Randy, great article.

————————————

In Their Eyes

Last Saturday, May 30th, the Mid-Size Midwestern Fire Department held training for all members at the Greenlee Farm site. Everyone that came was kept busy with all the work of training evolutions, scenario management, fire control, safety, and finally, the actual burning of the house on the property.

Throughout the morning, people started coming out to the site to see what was going on and find out why there was so much activity. Many of those people, however, were family members of the firefighters. There were wives, children and significant others all interested in seeing what we do and how we do it.

For the firefighters, the activities were fairly fast-paced. Most of the training was geared towards fire suppression, which required teams to advance hose lines into the burning structure, identify the source of the fire and its fuel, and correlate the conditions inside with a method of fire attack that would result in the maximum possibility of success while subjecting the firefighters to minimum risk. Some new operators were manning the pump controls on the engines, others were shuttling water from the nearest water source to our site, and dumping it into porta-tanks for use by the firefighting teams.

Instructors, safety personnel, training officers and operations officers all worked throughout the morning, checking everything, verifying that all risks had been mitigated as much as possible, and that all planned training was taking place on time to previously determined standards.
For many of the firefighters running evolutions against the scenarios, this was their first time in a burning structure beyond our training tower. This was their first time fighting fire in scenarios where the fire could get away from them, and their first time in conditions where the heat was a physical entity – attacking you as soon as you entered the house.

Our probies proved that morning that they knew how to properly check their nozzle and hose line before entering a structure. They remembered that you turn the nozzle head to the right (for a stream pattern) to fight the fire, and verify you have water, not air, coming out that hose. They didn’t know that our primary interior training officer was intentionally setting the nozzle for a fog pattern every time a previous team got done, just to test what they did remember. Even our newest firefighters remembered that you position yourself outside the hose line as it turns around a corner, and they all got to experience what it truly meant to back up the nozzle man – that they were his eyes, his guardian angel. They learned how much they could ease the work of aiming the nozzle for the nozzle man, or make it extremely difficult to even hit the fire if they positioned themselves improperly. They demonstrated that although the fire was exciting, it was a known force, and they were to look for the unknown dangers lurking in this burning environment in order to protect themselves and their partner.

Our new firefighters all came to understand the reason for properly wearing all their gear even outside the burning building. They got to feel the immense heat of the fire from 10 yards away, and they felt how much their gear does shield their skin from that heat. They learned that a fog spray from a nozzle can create a magic barrier, insulating them from the heat and allowing them to complete tasks near the fire.

At the end of the day, we had probies and rookies saying they’d never been this hot, they didn’t remember a time when they were this tired. Firefighters of all levels of experience were drenched in sweat, looking for any place at all to sit down, rest and cool off. This day, everyone worked their tails off, everyone was tired, and most had aches of one sort or another.
It’s days like this when we could have been mowing our lawns or napping in a hammock that each of us asks, “Why do I do this? Why do I give up my free time to train so hard?”
The answer to those questions could go in many directions. We could say there’s nothing better to do, it’s for the adrenaline rush, it’s for the camaraderie, it’s to get far away from the Wife’s Honey-Do list. But, reflecting honestly, I think we work and train like this for a different reason. I believe a small piece of each of us wants to be a hero. I’m not talking about saving the world all by ourselves, and I’m not talking about the rush to disaster when all others rush the other direction. I’m simply talking about doing something that needs to be done, when it needs to be done, and doing it well enough that we end up making things better, not worse, for all involved parties. I’m talking about doing the right thing, serving our community doing things that others will not or cannot do.

The belief I’ve just stated, however, was modified on Sunday, the day after our training burn and all that hard work. I got a phone call from my daughter, relating something that happened between my son-in-law (a firefighter) and his son, Austin.

Austin was at the fire on Saturday, and he watched everything he could. His eyes were flashing in every direction, seeing what was going on, where the fire was, what the firefighters did to contain it, watching pump operators, watching hose line tasks, listening to the commander give instructions over the radio. He looked for his father, wanting to see what Dad was doing. When his father sat down, Austin joined him, assuming the same posture. And Austin had the biggest smile I’ve ever seen on a child’s face during that entire time.

When he got home, Austin wrote his father a letter, and drew a picture for him. The letter, transcribed exactly, read:

To Daddy,

Dear daddy I loved waching the fire. It was one of the most coolest things I ever sean. I sean a fan fall that was fun. When I get older I hope I am going to be a firefiter. Just like you.

From Austin

(transcribed with permission from Austin and his Dad)

After my son-in-law read this letter, he was quoted as saying “Aw Buddy, that’s great. Thank you. I love you, too!”

When this story was related to me, tears began to form in my eyes, and I started to understand that I just might be wrong about this entire process. These people I trained with on Saturday, they’re not probies and rookies and veterans and officers, these people are family. I don’t train with them, and go to calls with them. I work with them. I work to protect them. I work to accomplish things together that we could never finish alone. And they all do the very same for me. We nurture each other, we care for each other, we make each other better people that any of us thought we could be.

This firefighting family isn’t a replacement for my own kin. But they’re a perfect model of our families at home. We do the same things at the department as we do at home. We protect and nur
ture, we prepare, we train, we work at home just as we do with the fire department.
I realized that we say we have many reasons for being volunteer firefighters, but in the end, we do it for our families. We do this because we have a need to teach our own how important it is to do good things. We teach them that rewards aren’t always monetary, quite often, they’re heartfelt. We teach them that hard work can be its own reward. In this process, we get benefits as well. We raise children that aspire to be like us, children that are excited for what we do, even when they see how hard we work and sweat to accomplish our tasks. We’re teaching future members of society to love the work we love, and we are preparing them to replace us when we’re too old to continue the exhausting pace that firefighting demands. We’re teaching our children that success exacts a toll – exhaustion, aches, sweat, time. Success demands that we first be ready for a challenge before we can tackle that challenge. And we teach them the sweet taste of victory when we’ve done all that work. We provide them with functional families, homes with love and caring, places to be safe from the rest of the world.

As you prepare for Father’s Day on the 21st, take time to reflect on what you’ve just read, as well as the following concepts. Please note, the phrase “father figure” implies gender, but there’s no gender requirement to be a father figure.

1. If you mentor, you’re a father figure to the one benefiting from your tutelage.
2. If you lead, you’re a father figure to those you command.
3. If you’re the Fire Chief, you’re a father figure to the entire department.
4. If you have children, you’ve already met at least 2 of the previous tests.

For each of us, there’s one more benefit. Austin said it in his letter and all of our children have said the same at one time or another. We’ve already done what we’re still hoping to accomplish. In their eyes, we’re already heroes.

———————————-

Comments on this post will be read by the author. He deserves kudos.

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Posted by Ckemtp on June 18, 2009 • Filed under: Ambulance, EMS, EMS Blog Carnival, EMS Health & Safety, EMS Humor, EMS Topics, EMT, Fire Rescue Topics, Fire department, Firefighter, Public relations, appreciation, camaraderie, fire, fire truck, funny, humor, pride, volunteer fire department, volunteer firefighter

EMS Week 2009 – Letter to the Editor

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*** Note!! – I’m getting a lot of traffic sent by Google looking for EMS Week thank you letters. There are more than one on this site. This is just the one that was indexed first and pops up first. Look at the home page to see more.

Here is a letter to the editor that I sent to a local paper in honor of EMS week. You may change the name of the service and the geographic location and use it for your service if you wish. EMS Week is May 17th through the 23rd 2009.

———————————————————-

You may never give it a second thought but we’re here for you. When the unthinkable happens Emergency Medical Professionals are standing ready to swoop in and help you and your loved ones. Whether it’s a serious medical condition or accident, EMTs and Paramedics are quietly and heroically performing lifesaving tasks in our communities every day.

EMS Week 2009 will be celebrated this year the week of May 17th to the 23rd. It is a national awareness week highlighting the vital services provided every day by the Emergency Medical Services professionals throughout every community in the United States. Here in (GEOGRAPHIC AREA) we are lucky to be served by dedicated EMTs and Paramedics who give of themselves in many capacities to ensure that our lives are protected.

The (is the 911 ambulance provider for the (GEOGRAPHIC AREA). In addition, we provide (SOME OTHER SERVICES IN SOME AREAS). We would like to thank the citizens in our service area for all of the support that they have given us in the past and would like to take this opportunity to express our continued passion for health in our community. We pledge to continue providing the highest quality Emergency Medical Services and Medical Transportation and to continuously find new and innovative ways to improve our quality and service to our community.

In order to do this we are calling on our citizens to support us by taking a few steps of their own. First, everyone should learn CPR. It is a simple and easy way to make a big impact in the lives of your neighbors and loved ones. With the odds of surviving sudden cardiac arrest decreasing roughly 10% per minute without adequate CPR and Defibrillation, good early CPR saves lives. If everyone knew this lifesaving skill just think of what we could do and who we could save. Please contact our office or your local hospital to find out about upcoming classes.

Second, everyone should learn the warning signs for heart attack and stroke. Studies have shown that 60% of people call a friend or family member when they realize that they may be having a serious medical problem. You should know that approximately 1% of cardiac tissue dies per minute in an untreated heart attack. Paramedic ambulances provide lifesaving medications that can stop or slow down this damage and can be at your side within minutes of a call to 911. This treatment is not only lifesaving, it also can greatly improve your quality of life after the attack.

Again, thank you to our citizens for their support. We encourage the public to say hello to our EMTs and Paramedics as they see them around town and also to contact our office for more information on any of the above topics. Please also see our website at Http://proems.blogspot.com

Sincerely,

Ckemtp NREMT-Paramedic

Anytown Ambulance Service and Malt Shop, Inc

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Posted by Ckemtp on May 11, 2009 • Filed under: 2009, EMS, EMS Week 2009, EMS practice, EMT, Fire department, Letter, Paramedic, Public relations, Week, information, letter to the editor, newspaper

Oh no you didn’t…

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Really? Did you just?? Oh come on now… you don’t really think??

Seriously…

Did you really just call me an “Ambulance Driver”?

An Ambulance Driver? Oh come on… Four years of college level classes, hundreds upon hundreds of hours of continuing educations, a veritable alphabet soup of certification acronyms behind my name, and this nifty Star of Life disco ball patch on my arm and you STILL just called me an Ambulance Driver? Really? Oh come now, do you know that calling me an ambulance driver is like calling a High School Teacher a “Nanny”, or calling a Police Officer a “Police Car Driver” or calling a Nurse a “Bedpan Jockey”, or calling a Firefighter a “Fire Truck Driver”, or calling a scientist a “Microscope Looker-Inner” or calling a Congressman a “Pork spewing bloviator” (I could go on, but I won’t… although that last one might be right)

EMS is an acronym for “Emergency Medical Services”. EMT stands for “Emergency Medical Technician”. Nationally, there are three levels of EMS professionals. Each level signifies to the public that the person holding the Title and the requisite license or certification has met stringent educational and training standards that allow them to take care of people. These levels are EMT-Basic, EMT-Intermediate, and EMT-Paramedic. Some of the states have expanded on this by offering additional levels of certifications between the levels, such as the EMT-IV Tech in Wisconsin (an EMT-Basic that can start IVs and give some limited IV meds), or the EMT-Paramedic Specialist in Iowa that is above the NREMT-P a bit but still below their Critical Care paramedic.

A paramedic these days has a college level education, takes over 1000 hours of didactic (classroom) time and can spend anywhere from 6 months to a year in clinical rotations. We can poke, prod, cut, inject, bandage, stabilize, evacuate, and care for you sixteen ways from Sunday. In my ambulance I carry 48 different emergency medications that I have to know how to use REALLY well or I can kill you. (I do know how to use them really well, trust me, so do my peers). I can intubate your trachea so you can breathe, reinflate your collapsed lung with a needle, surgically open your airway if I need to in order to save your life, and do a whole host of other things that you wish that you never ever need. My ambulance is a critical care unit on wheels that can be at your curbside in under 8minutes flat twenty four hours a day seven days a week. Today’s ambulances bring the emergency room right to you and begin advanced medical care right away. This care saves lives and improves your medical outcome greatly for a whole host of medical complaints.

And you, Joe public, still call me an “Ambulance Driver”. Which, if you hadn’t noticed, somehow irks me a bit.

Unfortunately for me, and for the members of my profession, it’s not your fault that you call me that, dear Joe Public. It’s my fault. It’s the fault of each and every EMS professional out there that you know so little about our profession and our industry that you resort to calling us that detestable term. It is our responsibility to get the word out. It is our responsibility to educate you about our life saving services, and our responsibility to let you know just how and when to use us properly. If we don’t do it, and therefore let the responsibility fall to others, we EMS people aren’t going to be happy with the job they do. We’re not going to be happy with the popular representations of paramedics in the popular media. We’re not going to be happy with the results of our public health education campaigns.

The American Heart Association has recently released a campaign entitled “Mission: Lifeline”. It’s a marketing campaign aimed at increasing public awareness of heart attack symptoms so that Joe Public calls us first when they start having the big one. If you’ve been reading this, you know that my all time biggest pet-peeve is when the people having conditions where they need us and need us now but aren’t dramatic like a car accident or cardiac arrest don’t call us. I can’t make a direct quote, but I read a study once where like 60% of people call a friend or family member first when they think they’re having symptoms of a heart attack. Calling EMS for these 60% or so of potential patients whose lives may very well depend on the early interventions we can provide them seems to be an afterthought. I can’t tell you how many people I’ve transported from small hospitals to big hospitals that were having the big one and DROVE THEMSELVES INTO THE ER without calling us.

Please, Joe Public, know that the VERY FIRST CALL you should make when you have pains in your chest is 911. Do NOT hesitate. Do NOT worry about the cost. JUST CALL US!! Do you know that approximately 1% of cardiac muscle tissue DIES AND CANNOT BE SAVED per MINUTE in a bad heart attack (myocardial infarction)? The difference is simple. You call 911 and usually (depending on where you are located) an ambulance arrives within 10minutes and starts lifesaving interventions and gives you medications to help slow or stop the damage in progress and salvage heart tissue that is being damaged. Please remember that “Time is Muscle” and that the extra expense of an ambulance is more than covered by the quality of life that we’re keeping for you. Really. Please call. Don’t wait. You can call your family AFTER you call 911. Please, I’m begging.

I’m also telling you EMS people out there to get the word out. Go market yourselves! If you want people to know what we do, it is YOUR PERSONAL RESPONSIBILITY to tell them. Go, do it now. If you want my help to write something, e-mail me and I’ll help. For free even. It’s that important.

Ambulance driver….. Seriously.

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Posted by Ckemtp on March 31, 2009 • Filed under: AHA, Ambulance, Ambulance Driver, American Heart Association, Command & Leadership, EKG, EMS, EMS Humor, EMS Management, EMS Topics, EMS ethics, EMS rant, EMT, Emergency Medical Services, Ethics, Mission Lifeline, Paramedic, Public relations, STEMI, ckemtp rants, edemse, ems 2.0, everyday ems ethics, funny, grumblemedics, inside the mind of a paramedic, new perspective, rant, technology-communications-ems-topics

Grumblemedics

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Grumblemedics, you know them. You’ve seen them. Heck, you may even be one. Whether they’re a Grumble Pee or a Grumble Bee, there’s an apparent glut of them in the profession and I’d like to know why. See, to me, EMS is the greatest job in the world. Sure, there’s the great pay and benefits, but there’s also the great hours, plentiful time off, and comfortable ergonomic working environment. I can’t tell you how many times I’ve been just left with a warm-fuzzy feeling after a shift…

Ok, so that could have been an exaggeration, I know that there are things in this profession that just plain ol’ stink. But I gotta tell you, EMS really is my favorite job. I really can’t imagine doing anything else. While there are times in my career that I’ve wondered if it was an abusive, co-dependent type of relationship, I realize that I would not want to be anything other than a paramedic.

So why does it seem like there are so many Grumblemedics? Could it be the long hours with little chance of getting a day off? Could it be the fact that we must get up at all hours of the night to take care of someone in better shape than we are? Tangent: The other day another crew transported a person with a chief complaint of “Dry Feet”. When they asked him if he really wanted transported, he said “Yeah! I got dry feet!” Or, the one last night where a woman had an NSAID pain patch fall off at 4am and called us because she thought that she was going into withdrawal. End Tangent.

OK, heck with the ending the tangents. There are a whole heck of a lot of calls that can be filed under “They called us for THAT!?” Why do people do this? Why? I mean, I’ve been called for things that I wouldn’t even take an aspirin for more times in my career that I can count (And I know that’s more than ten because I have ten fingers and if you think that I’m going to take off my boots after working in them for all of these 24 hour shifts you’re nuts). Why do people call us when they have a muscle cramp? Why did the guy call me when he got a fish hook in his finger? Why do people who happen to be type 1 diabetics drink themselves into a stupor and then call me first thing in the morning to wake them up? Seriously, I once spent a few months going to some guy’s house every shift bright and early in the morning to squirt him with a little D50 and he’d sign the refusal that would send him on his way. It ended when we began putting him on the cot and starting to drive to the ER before we sugared him up. He’d wake up in the rig just as we were backing into the bay doors and be mad at US for transporting him. Sorry guy, but you obviously need more help than we can give you.

So, there may be times in my career that I’ve been a Grumble Pee, but that might be expected. Heck, if I worked in a factory I’d probably be complaining about the lack of adequate ventilation and the fact that I couldn’t sit in the crew lounge and watch TV for a few hours of my shift. We all complain about things we can’t change or our own perceptions of injustice. I would guess that any profession has those things that the people in the profession just hate. Heck, would any of us want to work retail during the holidays? They don’t even get to jab strangers with sharp objects or have their own keys to the leather restraints.. Now THAT would suck.

You know what my absolute, all-time, worst pet-peeve is in EMS? No? I’ll bet you don’t care either but this is my rant and you can’t seem to stop me. My biggest, all-time, worst pet-peeve in EMS is: People who don’t call us when they need us. Yep, I would gladly take a hundred 3am “lost condom” calls rather than have one potential patient have that occult MI and lose any percentage more of heart muscle than they have to because they didn’t want to call EMS and bother us. You see, I work in rural EMS these days where people are nice, and they don’t want to bother their local EMS service with getting up out of their chairs, and they don’t want to bother their neighbors with having to look out their windows at the pretty flashing lights, and they really don’t think that the fact that the left side of their body is numb is any reason to be alarmed. These non-calls that should have been calls bother me more than any of them, and we all grumblemedics are somewhat on the hook here.

If you’ve read any of what I’ve written, you’ve probably seen my statement that “PR Saves Lives”. It means that the more positive Public Relations an ambulance agency has, the more people trust them, and the more people are apt to call them when they truly need them. I haven’t seen studies on what an effective PR program does in reducing so-called “nuisance calls”, but I have seen recent studies that say like 60% of patients having heart attacks make their first call to a friend or family member upon the onset of their crushing chest pain. I’m here to tell ya, I’m jealous. I want to get that call.

So maybe grumblemedics like I probably will be about an hour from now when someone calls me at 3am for something that I would take pepto-bismol for need to remember that we are blessed to do this job, and that EMS professionals need to approach this business with the heart of a servant. Because that’s what we are. We aren’t here for our health, we’re here for everyone’s health. Sometimes people get scared and call us because they’re scared and it is our job to make them feel better by telling them they don’t have to be scared anymore. Sometimes we need to haul them in so someone with a whole-heckovalotta medical education can tell them that same thing. I decided a long time ago that if I ever got to a point in my life where I had to call the ambulance just so I could get some human contact because my real chief complaint was loneliness that I didn’t need some punk kid with a pulse and a medic card judging me.

Us grumblemedics need to realize that the nuisance calls are never going to go away. We’ve got to realize that there are, however, ways to combat them:

  • Check your Ego at the Door: You serve the public. Not the other way around. You are blessed and dang lucky to be the person that this person asked to take care of them in their or their loved one’s hour of perceived need and you best not forget it, because your mental health is at stake, and their life could be too. The best EMS people approach this job with a servant’s heart.
  • Evangelize EMS: You want the general public to know how to properly use EMS, right? Then what have you personally done to help teach them. Get out there and get the word out. Don’t hide in your station, or in the parking lot you’re posting in. Get the message out about what you’re there for, what you’re capable of, and how friendly you are while you are doing it.

  • Everything is PR: Every single, solitary thing an EMS person does affects the publics’ perception of them, their service, and the profession in general. Really. When you meet up with another crew for breakfast in the morning and talk about how wasted you got last night at the bar don’t think that the people around you aren’t listening. When you swear in public don’t think that the kids who are looking up to you in your shiny uniforms with your neat big truck aren’t filing that away. Take your public image seriously. Exude professionalism at all times because it saves lives. The more comfortable everyone is with your professionalism affects how apt they are to call you first, call you fast, or call you at all in a life or death situation. That can make all the difference for a lot of potential patients.

There’s a lot more that every one of us can do, but I’m tired here and I still have the last 8 of my 24 to do be
fore I have to get up in the morning and do 8 hours with my other full-time job and then do a 4 hour training with my volunteer department. Hey! I have an idea!! Maybe if there weren’t so many grumblemedics and the public took a more positive view of our value to society we could maybe squeeze some more pennies out of them at budget time and get paid better so we wouldn’t have to have so many freakin jobs and work so many hours to feed our families! Yea, wouldn’t that be great!!

As always folks, comments and flames are welcome. Public commentary is most appreciated, but I may always be reached privately at: proems1@yahoo.com

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Posted by Ckemtp on February 10, 2009 • Filed under: Ambulance, EMS, EMS Health & Safety, EMS Topics, EMS ethics, EMS rant, EMT, Fire department, Firefighter, PR, Paramedic, Public relations, first responder, friendly, grumblemedics

Professing EMS

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Some time ago I was working a shift in a clinic on a particularly busy day when I had a few moments to sit down, have a cup of coffee, and talk with my coworkers. It was the usual stuff, talk about the day, tidbits about personal lives, and since most of the people I was working with were women, talk about things that I didn’t really need to hear about. After a few minutes we all had to get back up and head back onto the floor to keep up with the constant tide of flu-season sniffles.

It was all pretty mundane for me until the doc that we were working with who hadn’t been there much before, made a statement. As we were walking out, he said “Man, I really hate this! This isn’t my love, it’s not my passion!” I was taken aback. I asked him what he meant. He went on to say that he really wanted to be a concert pianist and that he only did medicine now because he didn’t know how to do anything else.

Now, I’m not you… but even though this guy was a pretty good Doctor, I immediately felt sorry for all of the patients that day. I mean, would you want this guy to be your doctor? Who in their right mind would want someone who hated taking care of you taking care of you?

It did, however, get me to thinking… Is that where we are in EMS today? I mean our profession. The profession of EMS, our careers and our industry. Are we made up of people like this doctor? Now during the day that I worked with him, he never made any egregious errors in patient care, nor did I see him do anything illegal, immoral, or fattening. However, if providers aren’t *in* to providing to care, would you want to have them providing care to you or your family? What about your service? Sure, we all know providers who love EMS, love their patients, and can’t wait to take care of any patient that calls for their help, but while I would hope that they are the majority… are they?

EMS is a profession in its infancy, we’ve only been around since sideburns were popular, but in that time we’ve gone from dedicated but untrained people rocketing around in hearses to professional providers practicing curbside critical care. It’s a great profession to be in and I’m proud to be a part of it. As a group we’re a pretty dynamic fast paced lot. I would like to ask our group though, do we have the love of providing care to the breadth of society who call us when they think that the life or health of their themselves or their loved ones are in danger? Or have we fallen short of the lofty goals set forth by Johnny and Roy?

Yep, I’m asking a lot of questions here. I just would like to open up a dialogue among the EMS professionals out there. Ask yourselves if the EMS providers in your area are advancing the profession of EMS to the place where you think it should be heading. Ask yourselves if you work with people who have the love of the profession enough so that if they were strangers and you were a patient would you want them making decisions about your life? I think that it’s high time that EMS is taken over by EMS professionals who care about advancing our profession into the future, not by people who don’t care enough to understand the vast array of issues that face our industry today. I would like EMS people to take ownership and drive our industry where we believe it should go. It’s our profession, and our responsibility to strengthen our service to meet the challenges that are facing our communities. And that responsibility starts with you, the individual EMS provider.

You, as a caring EMS professional actually have the tools to do this. First off, realize that EMS is a profession all its own, truly a dynamic industry that has earned a place in the very fabric of country. Think about it, our generation and the generations to come have grown up with the notion of 911. They know that when the unthinkable happens, all they have to do is call the magic three numbers and someone will come and help them. It’s a powerful piece of the American psyche that people rarely give second thought to… but they all know what they’re going to do the next time they find Grandpa unresponsive. I think that if EMS ceased to exist (and contrary to what it may look like from the dashboard of your ambulance some days, it’s not all that likely) our society would look a lot different than it does now. People need to have the notion of EMS. And make no mistake, we’re darn privileged to have the role in society that we do. It is, however, up to us to awaken the public to what it is that we do, to educate ourselves to our own potential, and to show the medical establishment what we’re capable of. Ask yourself, really ask, if you want some other group to decide where we’re going for us, oh… say like the nurses’ lobby, or the IAFF, or the DOT, or the (insert non-EMS acronym here). You are sitting right now in an industry on the cusp of a watershed change, and it’s up to you to take ownership and steer EMS where you want it to go.

Here’s what I’m doing, and what I would like to suggest to you all. First, recognize that EMS is indeed a profession; and a good one at that. Second, evangelize EMS to all you meet. You can’t complain about the system abusers (or worse, the people who truly need us and yet don’t call us) if you aren’t out there educating them about what we’re here for. Third, realize that “PR Saves lives” and make sure that the information out there about EMS in your community is projecting the message that you think it should, and if it isn’t, write something up and get the word out to change that. Talk with everyone you can and let them know just what it is that we do, who we are, and what we’re capable of. Take ownership of EMS, because if we don’t, someone else out there will.

As always, post publicly if you want public discussion, or contact me at: ProEMS1@yahoo.com

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Posted by Ckemtp on February 10, 2009 • Filed under: Ambulance, EMS, EMS Topics, EMT, Ethics, Firefighter, Paramedic, Public relations, ems 2.0, everyday ems ethics, fire