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EMS Providers Carrying Guns – A terrible idea

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Have you ever tried to kill a noxious, invasive weed in your yard? Think of something like bamboo or creeping charlie… something that isn’t serving any purpose and is hurting the growth of the good grass that you want to be in your lawn, something that just keeps popping up no matter what you seem to do.

That, my friends, is how I feel about the recent eruption of posts on Facebook and the blogs lately about how EMS providers should be allowed to carry guns. It’s an annoyance and hurts any constructive growth for our profession.

I’m going to come out right now and say that it is a terrible, awful, no good, very bad idea that needs to be put down the sewer like the turd of an idea it is. EMS providers should not carry guns. Not now, not ever. Never ever never never never. It is a terrible idea fraught with so many perils and pitfalls that it is more than just a slippery slope; it is a death trap that stands to hurt everyone should it come to fruition anywhere.

I didn’t form this opinion lightly. In fact, I strongly support our right as Americans to keep and bear arms. I generally support concealed carry. I don’t take disagreeing with the likes of the venerable Kelly Grayson as anything other than something very serious. I respectfully, yet strenuously, disagree with his opinion and while I know he has reasons for what he believes; I just can’t support his position on this issue.

EMS providers should not carry guns. They should not be issued guns to carry by their agencies; they should not be allowed to carry on-duty even if they have a permit to carry off-duty; they should not be allowed to carry even if they are sworn law enforcement officers working EMS part-time or as a volunteer. I do not say this because I am a bleeding-heart liberal because I am not. I say this, because it is a terrible idea.

Here are some of the reasons why:

1. Using a weapon for defense or as a tool for any other kind of task takes training, experience, and practice. Not only that, it takes lots of training, lots of experience, and lots of practice. Police officers, military heroes, and other professionals who are armed for their occupations receive lots of training, experience, and (hopefully) practice. Without it, any weapon becomes less of a tool and more of a liability. Remember folks, EMS is a profession where members furiously struggle against adding even tiny amounts of time to their initial training classes and can barely be forced to sit through, let alone actively participate in required continuing education classes. Can we ever hope to get them to train, practice, and gain experience in the safe handling and use of a weapon? It’s not possible and won’t happen.

2. Has gun violence against EMS providers spiked recently? Is it really bad out there? I personally know police officers who have been fired upon and hear regularly about police officers who have been shot. It’s terrible for them and I respect the courage they display by simply doing their jobs. While I hear about and have personally experienced physical attacks on EMS providers, the vast majority of them are closed hand attacks perpetrated by mentally impaired, intoxicated, or otherwise disturbed individuals, I rarely if ever have heard of an EMS provider being shot with a gun or stabbed. While I could believe that EMS providers have a higher risk of being shot or stabbed while performing their duties than does the general public, I have never seen data to prove that. I’ll concede though, that it passes the smell test and could be true. However… do you want to know why EMS providers aren’t being shot, stabbed, or assaulted to the extent that police officers are? It’s because we’re not cops. It should never be taken lightly that we are, if not considered neutral in street culture as we are targeted on occasion, largely considered to be non-combatants. We’re not cops. We’re out there to make everyone feel better and are largely being left alone. It’s a finite balance that will be upset the first time that Clint EMStwood pulls out his shootin’ iron and points it at a gang-banger. Once that happens, we lose our neutrality and will be targeted much more often than the comparatively rare times we are now. People will die because of it.

3. More lives have been saved by EMS’s policy of withdrawal from violent situations than could ever be saved by EMS carrying guns. It isn’t cowardly for us to withdraw, it is lifesaving. We do not enter dangerous situations and we do whatever we can to run from them when we find them. Bravado doesn’t figure in to this. We don’t do it because we are cowardly; we do it because it is not our role to face violence. Eventually, people who skirt this rule and do not withdraw run into situations where they must act in a hostile nature to defend themselves or someone else. Eventually, people who do not withdraw injure or kill someone; perhaps they are injured or killed themselves. EMS providers do not have the legal protection, authority, or ability to act in hostile situations. It isn’t our job and it isn’t our job for a reason. That’s what cops do and EMS providers aren’t cops. If you personally want to be a cop, go be a cop. If you wanted to be a cop but found out that it was easier to get a job as an EMT and now hope to bridge the jobs to realize your dreams, then please leave EMS. You’re not helping as much as you think you are. If you just want to strap a gun on your uniform because you think it looks cool, you’re probably not the type of person who reads EMS blogs because of all of the fancy words we tend to use. You may say that we can still withdraw at the same rates that we do now, but I’ll quote my father, who told me that “When you have a gun, every fight is a gun fight.”

You may disagree with me and that’s fine. Please leave your reasoned, courteous debate in the comments section. However I will state that all of the debates on this topic tend to degenerate into shouting matches where the supporters of EMS providers carrying guns prove to me that the state of this country’s educational system could stand to be improved. Do not do that here.

Stay safe out there. If you'd like to read another opinion I agree with, our friend Greg Friese posted this on the same topic.

Posted by on September 20, 2012 • Filed under: Administration & Leadership, ckemtp rants, Command & Leadership, Emergency Medical Services, EMS, EMS Health & Safety, EMS Management, EMS Topics, Fire Rescue Topics, News, safety, Uncategorized

Splashed Sadness – A look at negative emotions in EMS

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WARNING TO NON-EMS PEOPLE: This post is pretty emotional. If you’re not emotionally equipped to handle really sad descriptions of EMS calls, don’t read it.

Here’s a revelation: EMS People are better suited to handling sadness than are laypeople. Of course we are. Not because we are necessarily any emotionally stronger than anyone else but because we have experience in dealing with it. As anyone could see, a good number of the situations we respond to and either assist with or observe are really sad. In my decade or so of riding the ambulances I have come across more situations than I could possibly remember that I wouldn’t want to casually discuss outside of the industry for fear of really making laypeople very uncomfortable. A story that might turn into a running joke among your colleagues might just depress a layperson for weeks.

Like all medics, I have my coping mechanisms and some of them are healthier than the others, they include sarcasm, dark humor, clean humor, Tanqueray martinis dirty and dry up with three olives, blogging, fishing, picking on my soon-to-be wife (9 days till the nuptials as of today!), playing with my boy, fishing, MGD, cigars, and sarcasm. There are a few other things in there too, I’m a rich tapestry.

This blog gets read by mostly EMS people, but there are public people out there that read me too. For both of your benefit, I’m going to relate some stories here of calls that I’ve personally attended to over the years:

  • A 16yo male takes his 24yo soon-to-be brother in law out into the city for the 24yo’s bachelor party. On the way home, they’re both just obliterated after drinking all night. The 16yo boy is driving home and is going way too fast to notice the semi hauling gravel that pulls into the right hand lane of the 4-lane road they’re driving on. The kid notices it at the last second, swerving just in time to impact the passenger side of the car against the back of the semi trailer. The impact shears off the left side of the 24yo’s skull, popping out the left side of his brain and leaving it, mostly intact, in between the front seats of the car (I almost put my knee into it). The 24yo dies a not-so-immediate death (I don’t want to get into it. Hopefully it was mostly painless). I pronounced the 24yo dead and took care of this very intoxicated 16yo. He was barely able to comprehend the terror of the situation and was covered in blood and brains that formerly belonged to the man his sister was going to marry. He was unhurt but I ran him into the hospital anyway. How could I leave him there immersed in the terror of that scene, in the terror of what he was more or less responsible for?

     

  • A 19yo male comes home from the military and his friends throw him a house party. During the party the 19yo takes his 18yo male friend down to the basement of the house to show the friend a new pistol that the 19yo brought home with him. The friend takes the gun to look at it and playfully twirls it around his finger ‘Old West’ style in an attempt to be cool. When he does, the gun fires, shooting the friend from the chin through the top of the skull. When I got to him, he was still breathing and had a strong pulse however it was mostly his brain stem that was controlling the reflex. Most of his brain was splattered on the basement floor. We worked him, transported him to the trauma center, and I believe that they were able to harvest his organs.

     

  • A man and his wife of upwards of twenty years are just bumming around the house on a nondescript weekday. It’s about lunch time and they’re going to eat at home before they go to the wife’s doctor appointment. The wife gets up to make sandwiches, gets to the counter, and slumps to the floor. She never woke up. We worked her very hard, but her heart had just decided that it had reached its allotted number of lifetime beats.

The above short summaries of calls that I’ve been to are sad. There’s no joke that can make them not sad. If you read this, there are two reactions I expect from you here:

  • For non-medical people: You’ve related these stories to yourself. You may be crying. You’ll think about them and your heart will go out to the unfortunate people involved. You’re sad.

     

  • For EMS People: Don’t these sound like good calls? They were. Yep, they were sad and I felt very bad for the people that were involved. Good calls though. What’s for lunch?

I think I remember what I did after the above three calls. I think that it was profound although my memory is pretty foggy after all these years. After the first one, I cleaned up the truck and actually got to sleep the rest of the night. After the second I cleared and went to a few more calls and then had lunch. After the third I um, had lunch because it was lunch time.

EMS people can probably know what I’m talking about here. I call it “The Howl”. It’s the sound that a family member makes after you’ve transported their close loved one to the hospital where the patient is pronounced dead by the ER Doc before the family gets there. So there you are, cleaning your equipment while the ER staff makes the sad announcement to the family. Here comes The Howl of anguish that the family member makes when they hear the news. I’ve heard it time after time in hospital after hospital. It’s loud. It’s haunting. It haunts my dreams some nights. I say that The Howl is an example of direct sadness. Direct Sadness is the pain/sorrow/anguish/horror that a person feels when they are a primary person in the situation. In my position of hearing The Howl after working the patient and unsuccessfully trying to save their life I experience Indirect Sadness. For the coworkers that I tell the story to and the readers of this blog, “Splashed Sadness” is the term I use. I think that “Splashes Sadness” is what a person experiences when hearing a terribly sad story like that.

In this business, Splashed Sadness is everywhere. It is one of the hallmarks of professional EMS. Think about it like this, I will always remember a conversation that happened between a group of coworkers and me one nondescript morning some time ago. They told the story of a college age male that overdosed on illegal drugs, stopped breathing, and was resuscitated from asystole (flat-line) by the paramedic that was telling the story. He mentioned that the fiancé of the patient was in the ER with the most-probably brain-dead patient and was holding the patient’s hand and telling anyone that happened by that they were supposed to get married that weekend. He said that she just kept repeating “We’re getting married this weekend” over and over again.

The sadness contained in that story splashed on to me and I’ve remembered it to this day. It will probably be there tomorrow too…

I responded by asking if they recommended that she cancel the caterer. Then there were fart jokes and wrestling (It was an all male crew that day). That’s how I dealt with the splashed sadness. I try not to get any of it on me and I try to psychologically squeegee any of it that I do get on me off as quickly as possible by interjecting humor and sarcasm into the situation. Extreme humor to deal with extreme sadness.

EMS people gain experience in dealing with negative emotions and sadness through all of these routes, direct, indirect, and splashed. While I have dealt with Direct sadness in cases of the deaths of close loved ones including my father, I don’t want to deal with any more. I get indirect sadness a lot of the days that I show up for work, and splashed sadness happens every dang time I talk to a coworker or discuss a bad call with a peer. I’m splashing sadness on you all right now as you read the above stories. If you’re an EMS person, you can deal with the splashing. If you’re a layperson, I’m very sorry for doing that to you but I did warn you before you started reading. My theory is that the more experience you
get with sadness, the better equipped you are to deal with it.

Or you go nuts.

Or you go nuts and start blogging and drinking martinis like I did.

Maybe I’ll get credit in a psychology journal for coining “Splashed Sadness” in EMS.

 

Posted by on February 16, 2010 • Filed under: Ambulance, bad calls, CISD, Emergency Medical Services, emotions, EMS, EMS ethics, EMS Health & Safety, EMS pep talk, EMS Topics, EMT, Fire department, Fire Rescue Topics, Firefighter, Firefighter Safety & Health, In the Line of Duty, inside the mind of a paramedic, Paramedic, paramedic education, psychology, sadness, safety

The Drunk Responder

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Greg Friese, over at Everday EMS Tips, has written a post in observance of Drug Free Work Week – Oct 19-25th, 2009 entitled “When a Coworker is Intoxicated” In it, he asks what we would do as EMS professionals and Firefighters in cases where we suspect that a coworker is under the influence. This originally started as a comment to his post, but it went long enough that I thought I could get a post out of it. Here it is:

Ewww, I hate these situations. I’ve worked full-time EMS for a long time, but I’ve volunteered for longer than that. One would think that this is a problem that I’ve encountered more often in the volunteer services, however I’d have to say that the few times I’ve actually noticed it are about equally distributed.

Thankfully, these situations have been few and far between. However, EMS and Fire people like to drink sometimes (ahem) and the potential exists for this to happen more often than you’d think.

In a volunteer service, the classic example is someone showing up for an emergency call after consuming alcohol. Often, these people sincerely did not want to “show up drunk” but thought that the need was great enough for them to show up after having “Just one or two”.

For the paid services, aside from the absolute taboo of consuming alcohol while on duty, the classic example would be spending a late night out at the bar and then showing up for work in too short of a time for the alcohol to be removed from the person’s system. If you’ve ever had a coworker show up complaining of a hangover, this may indeed be the case.

Both are unacceptable. Personally, I know that my career depends on never doing this. I also know that my patients deserve a caregiver who is on top of his (or her) game. I subscribe to the FAA’s rule governing pilots, or the “8 hour from Bottle to Throttle” rule. I take myself out of the response roster for at least 8 hours if I have had one sip of ETOH and I stop drinking a minimum of 8 hours before having to go on duty.

There’s no excuse for a provider having any amount of alcohol on board while performing any aspect of EMS. If the patient smells even a whiff of ETOH on their provider, that provider is drunk until proven otherwise. Even if the provider is under the legal limit the patient loses confidence. Our patients deserve better. If you had EMS come for a family member and smelled alcohol on the responding ambulance crew, you’d think the same thing and would probably become very angry or fearful for the actions of the responding crew.

Remember, each “drink” defined as one ounce of alcohol, raises your BAC (Blood Alcohol Content) by roughly 0.02%. That amount of alcohol takes approximately one hour to be removed from your system by your liver. Each person is different, and other factors come into play… however if you’ve been drinking you need to leave hours between your personal fun and your professional care.

The problem here, of course, is the percieved effect on the person who reports a coworker for possibly being under the influence. In some agencies there may be fear on the part of the coworker who notices the smell of ETOH or other intoxicant that they will be ostracized by the group for blowing the whistle and turning the offender in. In reality, it is your duty to your future patients and the reputation of your agency to turn someone in no matter the percieved ill effects. However, to make this easier I have some tips:

  1. Act immediately – If this person gets activated for a call or otherwise interacts with a patient, they could cause that patient harm. This is unacceptable.
  2. Enlist the aid of a coworker if you’re uncomfortable immediately going to a supervisor – Get someone else to nonchalantly speak to the person or linger in their vicinity to see if they notice what you do. Go together to report the suspicions even if the other person doesn’t notice what you do. It’s that important.
  3. Remember that someone’s life may very well depend on your actions – Friendship among coworkers is one thing, but a drunk firefighter or EMS provider may very well kill someone. You or another coworker may be injured or killed by their actions on the fireground or emergency scene. Your patients may suffer at their hands because their decision making ability and reaction times are impaired. Can you stand that on your hands for not reporting it?
  4. You may be helping the person through a real problem – Is the coworker an alcoholic? Could they be? Being at work drunk, especially in such an important job as EMS and firefighting is indicative of a real problem with alcohol. Turning them in may be the first, and biggest influence in getting that person help or in allowing them to help themselves.

This is a tough situation, but is an easy call. Keep alcohol and other drugs out of the emergency services. Keep yourself sober and sharp while on-duty or responding. It’s just not worth losing everything over a couple of beers. Have your fun and enjoy yourself while off duty but remember, alcohol can be a wonderful servant but is a terrible master. Do yourself, your career, and your patients a favor and leave ETOH in your personal life, far away from your station.

Posted by on October 22, 2009 • Filed under: Administration & Leadership, Command & Leadership, edemse, Emergency Medical Services, EMS, EMS ethics, EMS Health & Safety, EMS safety, EMS Topics, Ethics, everyday ems ethics, Fire Rescue Topics, Firefighter Safety & Health, medical ethics, professionalism, safety

Holy Crap! UK medics…

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Y’all need a taser.

http://www.telegraph.co.uk/news/uknews/5364780/Knifeman-copied-scene-from-The-Shining-as-he-attacked-paramedics.html

Glad that this kind of stuff doesn’t happen where I am much. Medics get attacked all the time, and I am no different… but I’ve never gone through this. I think that here in the states there wouldn’t have been a court case for the perpetrator on this one. I don’t think that the local cops would have used pepper spray here. Probably they would have pulled out their trusty 9mm or the like.

Wow.

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Posted by on May 25, 2009 • Filed under: attack, EMS, EMS safety, EMT, Paramedic, safety, UK medic attacked, united kingdom
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