Throughout my years in EMS I have participated in a lot of EMS Week events.  I have been to banquets, had breakfasts, lunches, even dinners provided to me by employers and organizations to say “thank you” for another hard year’s work.  This year, I am with a different organization and my experience this year was a bit different and enlightening.

Sure, we had a cookout, which was great.  Nothing like burgers and ‘dogs on a warm pre-summer day, but this past Monday, I got to dress up in my Class-A’s and have my mother pin my badge on me during an appointment and graduation ceremony put on every year for the new paramedics to join the organization.  It was a great experience, complete with bagpipes, drums, a color guard, and plenty of speakers, and I took a great deal of pride to have the honor to stand up there, but there was another group there that I think this event meant more to.

The real winners Monday night were our families.  While the organization was saying, “thank you for being one of our paramedics” to us, the more important message was the “thank you” they were extending to our families for the time we sacrifice away from them.  They are the ones who have to put up with the time we spend working during holidays, and birthdays, and anniversaries.  I feel sometimes that our loved ones deserve the biggest pat on the back, so let this be my “THANK YOU” to all of you.

It got me thinking about what other missed opportunities we, as an industry, have during each and every annual EMS Week and I can’t help but feel like taking the opportunity to educate the public is probably the biggest one.  For example, there is such a push for compression only CPR by the general public that maybe we should seize an opportunity to further our cause and make our jobs a little bit easier.

This year, American Medical Response did just that.  They led the way for the AMR World CPR Challenge.  This past Wednesday, all over the country CPR instructors from all over the country put on free clinics to teach the public how to do compressions only CPR.  I have heard word that nationally, almost 60,000 people were trained, and from what I have been told that is a conservative estimate.

I have also heard that around 3,000 of those who were trained were as a result of the efforts of my old division in Springfield, MA.  Once again, they prove their worth to the community.  Here is the video from a story done (ironically enough) by WGGB News 40 in Springfield featuring Springfield’s CES coordinator Jim Welcome.

While today might be the last day of EMS Week, don’t lose sight of all of the great things that go on out there.  Sure, one can argue that it is our job, but damn it it’s a heroic one.  Great things happen every day.  Don’t sit back and wait for someone to pat your colleagues on the back for their accomplishments, when you see something great, take the time to recognize it yourself, and let them know that what they did made a difference for someone.  Who knows, maybe if enough people do that, the attitude and the concept will become contagious.

Curious, question for EMS folks on FB: It appears, based on comments to various news stories in the past, that the greatest solution to all that ills EMS is greater pay. Respect is restored, working conditions and staffing improve and the general idea of professionalism is better. Fire-based, hospital-based, third service, doesn’t matter, just pay us more and the service will get better.
Really?

No, not really.

The same issues I had when I got the paid gig for $4.35/hr are here at my current gig where medics average $65,000 to start (according to indeed.com).

EMS in general is paid what the market allows and what we are worth.  Keep in mind that EMS does not require a degree and Paramedics can get licensed in as little as 1 year in some places.  If some kid walked into my office and told me he went to school for something for a year my first question would be “When are you going back to finish?”

Pay is a result of our goals, not our goal.

Increasing our education standards and proving our worth to the industry is step number one.  But of course the stumbling block to education is how to pay for it.

If you think the reason you are not treated like a Professional is the size of your paycheck I think I know where your priorities are.  If your first concern is that you don’t have access to enough education I’ll ask where you live and why you’re still there.

There are high paying EMS jobs out there, folks, I’ve had one for 10 years, but you have to be willing to put the effort into it.  No one is going to wander into the station or yard one day and say “You guys are great, here’s a raise.”  Your employer has no incentive to increase your compensation unless they desire a particular set of skills that bring that kind of salary.

EMTs are entry level and their compensation reflects it.

Paramedics have more responsibility and therefore more compensation.

A flight medic has even more responsibility, so more compensation.

A Firefighter/Paramedic has a different skills set, different compensation.

You get the salary you’re getting because that’s what you’re worth to your employer.  If you started off at $10 an hour, got your degree, teach on the side, and are still making $10 you need to talk to your employer about the increased value you can bring to the organization.  Maybe you’re in line for a promotion or reassignment with your increased education and experience.

It all comes back to education.  If you learn more, not only can you increase the care you can give to your patients, but you become a more responsible care giver and show your manager that you’re not just in the seat for a thrill, but to make a difference.  Folks like that make less errors, collect less complaints and are more likely to collect extensive billing and demographic information.

That makes you a keeper and worth more to them.  You increased your value.  That is the only way you will increase your compensation.

Let’s imagine that I’m wrong and simply snapping our fingers and giving you more money is the solution.

Now you make twice what you did yesterday.  Now what?  Now will you go back to school?  Teach?  Where is the added value we’re paying for?

The patients are the same, your rig is the same, your protocols haven’t changed and you haven’t changed.  There isn’t much we as EMTs and Paramedics can directly control but our own attitude and education are the easiest to improve in a short amount of time.

Just raising your pay won’t improve your attitude or the attitude of your co-workers.  It won’t help your manager see the worker bees from the cling ons and it surely won’t help your patients.

If you think you’re worth more to your organization than you’re being compensated, tell them, and get ready to pack.  The high paying jobs are out there, but you’ll likely be in a busier system and competing against higher education and higher motivated applicants for the extra money.

Case in point: me.

When I left my last job I was a Firefighter/Paramedic serving a suburban area working on both the Engine and Ambulance.  I was making just under $10 an hour on a 24 hour schedule.

When I got my degree in EMS and began teaching I knew I could reach out an look around for something better and have a good chance of landing it.

When I got hired in San Francisco as a Firefighter/Paramedic assigned to a 24 hour Ambulance I had tripled my salary.  Tripled.  But the cost of living was double and my old shifts of sleeping most nights turned into 32 run paramedic pinball sessions that I loved, but took their toll.

I moved 800 miles to get that gig and I have the broken down UHaul story to prove it.

You can get a high paying EMS job.  They exist, but you have to work for it.

What are you willing to do to prove your worth to EMS?

In a meeting Thursday night held by the City of Springfield’s EMS Commission, the five commissioners voted unanimously to recommend American Medical Response to handle the 9-1-1 contract in their city for the next five years.  Last night I posted on my personal Facebook page that this decision was a “. . . much deserved and expected victory” for the staff at AMR Springfield, and now that I look back on it, and look back on the decision, I do not feel that statement fully

A Springfield truck with the skyline in the background.

describes the impact of the EMS Commission’s recommendation to the city.

The real winners in this situation are the citizens on Springfield because they are getting the best care that they possibly could by having the paramedics and EMTs of AMR Springfield to respond to their emergencies.  AMR has had the opportunity to be in the lime light a few times in the past couple of years with the tornado of 2011 and the gas explosion of 2012 to name just a few, and while those calls were very high profile and visible, they barely make up a chapter in the story of AMR Springfield.

The things that are really important are the things that happen every day.  It is not the multitude of trucks that I had sitting in our staging area on Worthington St that night, it was the other ambulances that were out still answering the “routine” emergencies that made the difference.  It was not just our crews going to door to door with State PD and Springfield Fire in the Island Pond Road area of the city after the tornado hit that deserve more recognition, it was also the other crews parked up on the other side of the debris field ready to pick up any emergencies on the north end of our City.

Heroic things happen every day in every city across the country and Springfield is no exception to this.  It is the medics who recognize that STEMI on a 12-Lead and call an early heart alert because that is what their training has taught them to do that matter.  It is the EMTs that are able not only to recognize what calls need a paramedic to respond with them but also their ability to recognize the calls that they can handle, especially when things are getting busy to make sure that there is a crew out there to grab the next call that comes in.

If I could give one piece of advice to those who are still up in Springfield, it would be this: Always believe in yourself and remember what your mission really is.  Always remember that what matters is the care that goes on in the streets.  Always strive to learn something new every time you step on the truck, and always make sure that you do the best that you can for every patient you come across, not matter how serious or how minor their emergency might be.

Take a bow, AMR.  You deserve your moment in the spotlight.  Let’s make this a great 5 years!

It is a great feeling to be accepted to present back in the state that I so recently left where I spent the first twelve years of my paramedic career.  The title of my presentation is “The Solution is Pollution: Using Capnography to Guide Your Treatment.”  Exciting, huh?

Are you in or around Massachusetts?  Come out and take some great classes given by a number of great speakers.  Want to contribute in your own way?  Take a look at the advertising and exhibitor packages that are being offered.  The committee that puts this conference together each year is doing a great job conference is growing exponentially every year.  If you ask me, I would say that the Massachusetts EMS Conference is well on its way to becoming the premier EMS Conference in New England.  It is great to be part of it as a presenter this year.

Interested in attending?  Click here!  Be sure to check out the Exclusive Facebook Pre-Sale

Do you want to be an exhibitor or sponsor?  Click here!

We are seated by the hostess and she makes sure we have our menus and place settings.  Well, at least she’s supposed to.

Then an either overly friendly or clearly distracted waiter will come over and offer us an appetizer and to get us started with drinks.  OK, sure, I’ll have a water.  And have you ever introduced yourself back when they tell you their name?  It’s like they’re confused.

Then the server gets deflated thinking I’m only drinking water when in reality I’m ordering it now because if I ask for a water AND a beer, they’ll forget the water all together.

We finally order and are awaiting the food.  No surprise there.  If the food comes out too fast you have to wonder, right?

Then the oddest thing happens.

Someone, not our waitress, brings out the food.

Not only do they have no idea who ordered what, but it’s never how we ordered it.  Why? Because if the waitress had picked it up she would have noticed the salad never made it out, that the wrong kind of meat is in the tacos and that the sauce with the chicken only rhymes with what I asked for, specifically.

“But your food gets out quicker this way.”

No, I never got MY food, I got what they brought, but it was wrong.

Then as soon as it hits the table the waitress magically appears asking if we got everything OK.

No, no we didn’t, where were you?

Why does any Tom, Dick or Harry wandering past the pass think it’s OK to grab my order and bring it out?  If there’s a mistake that is where you want to find it, not when Johnny the under waiter brings me the tray and has to ask about each and every dish.  Sally is serving Table 5, let Sally check on the food.

Each and every argument for the speed or so called efficiency of this system is countered by the fact that your speed is costing quality.

And it’s not just where I ate tonight, but most establishments today.  Waiting for food that is as ordered is OK, rushing me something close and thinking I won’t notice is no way to run a service based industry.  If the servers need help, let the under waiters handle all the drinks and refilling the waters and all the crap that seems to be “bothering” the waitress and distracting her from making sure the orders come out as…well…ordered.

And another thing, while I’m at it, waitresses, please look at the table you’re about to talk to and gauge if it’s the right time to ask if everything is OK.  I once ate at a restaurant where the waiter seemed to be just out of visual range…ALL THE TIME.  As soon as the water was low, he happened to be nearby with the pitcher.  Never once asked how we were or how the food was.  He just knew that since we were there and he was there that if we had something to say we’d say it.

I never waited tables and I’m not ragging on the waitresses, I’m asking this to the managers.  The ones who sometimes bring out said food or are idle in the corner in their tie staring out into the dining room.  The ones who awkwardly go from table to table every hour asking the same lame question: “Everything good here?”

For the third time and while I’m wrangling a kid with my mouth full of food, “mmmphmmdp”

And he’s gone.

</rant>

Well BGM, I haven’t the foggiest.  I only know that where I’m working it has been like that since, oh, the late 1840s.

Tradition is an easy answer, but most of the nomenclature stems from when the Companies were Volunteer.  The wagon, engine etc actually belonged to the Company, as did the response area.  When asking about who was at a fire, you could say, “Oh that was at 4th and Brannan” or “It was in district 5, Battalion 3, Division 1″ similar to Companies in the military.

However, everyone knew where the engine companies were.  Before they were rolled into the municipal fire service and numbered in the order they joined they had names like Liberty Hose, Knickerbocker and Valiant.  It’s was Valiant’s fire, it was Knickerbocker’s fire.

When Knickerbocker joined the municipal and took on the number 5, it became Knickerbocker 5′s fire.  Then 5′s fire.  And here we are.

SFFD Gorter Tower

Ladders and Trucks came later when they were also rolled into the municipal service, joining in different order than the engines they would be housed with.  That’s why in some places Engine 4 is housed with Truck 1 etc.  In the early and mid 70′s when computers were added some Departments (including mine) changed the truck numbers to match the engine number to avoid confusion.

But when I was growing up in a suburban Department that was roughly the same age as me I heard my father and his buddies refer to other stations by their numbers as well.

“Are we drilling with 19′s this afternoon?”  It referred to the crew being a part of the company, part of the house.  The men and women assigned there belonged to it, not the other way around.

Does that answer your question?

Oh and BTW a tanker has wings. 

HM looking at phone news feed – “Oh look, 48′s had a 2 alarm fire this morning.”

MrsHM – “48′s?  Which Companies are due on a second to the Island?”

HM, startled, -”What did you just say?”

MrsHM – “Didn’t I say that right?”

HM, proud, -”Yes, you did…”

A select few humans have discovered this fact and escaped, creating an underground resistance to fight the machines in the future and free human kind.

Spoiler Alert: I kind of doesn’t work.

Every time I hear someone in EMS complain about kidnapping, or having their chart blown up in court for all to see or some other urban legend of our Profession, I have to wonder what they would do if Morpheus arrived to show them the truth:

I picture Kelly Grayson sitting in a leather chair in some sweet shades and a fancy coat, holding out 2 pills to new EMTs.

You can take the blue pill, go along pretending this is all there is.  Backboards for everyone and NRBs at 15 liters per minute,  partners who torture with 14g catheters and refuse to tuck in their shirts, merit badge refreshers that rehash what we think we know and another conference class on how things used to be.

OR

You can take the red pill, and see the truth.

We are keeping you poorly educated and poorly paid because we need a steady stream of adrenaline junkies to replace you when you get burned out in 6 months.  You’re living in a dream world, new EMT, a dream world where the bare minimum is acceptable, even encouraged, and we make sure you’re just happy enough to accept it.

You go to work, collect billing information, treat from the cookbook, follow your patient’s every demand no matter how outrageous and it bothers you.

But what to do about it?

You’re here because you know something is wrong, but you can’t seem to put your finger on it.  No matter how many conferences you attend, magazines you read or managers you talk to, the answer seems to be the same:

“The future is now!”

But you don’t see it.  How can the future be here if it looks just like the last 30 years of guessing at science and pretending that taking them all and letting the MDs sort it out has ever worked?  When will you realize that “that’s the way we’ve always done it” is the last excuse of the desperate?

Take the blue pill and you’ll wake up tomorrow thinking your desire to improve was misguided, a waste, a dream.  You’ll strap up your boots and go to work, still wondering what is bothering you about what you do.

Take the red pill, stay with me, and see just how far we have to go.  Learn more about why, expand your horizons and seek out solutions.  I can show you the truth behind the lies, but you have to forget everything you know and trust me.

I offer only the truth.  Nothing more.

Morpheus: I imagine that right now you’re feeling a bit like Alice. Tumbling down the rabbit hole?
Neo: You could say that.
Morpheus: I can see it in your eyes. You have the look of a man who accepts what he sees because he’s expecting to wake up. Ironically, this is not far from the truth. Do you believe in fate, Neo?
Neo: No.
Morpheus: Why not?
Neo: ‘Cause I don’t like the idea that I’m not in control of my life.
Morpheus: I know exactly what you mean. Let me tell you why you’re here. You’re here because you know something. What you know, you can’t explain. But you feel it. You felt it your entire life. That there’s something wrong with the world. You don’t know what it is, but it’s there. Like a splinter in your mind — driving you mad. It is this feeling that has brought you to me. Do you know what I’m talking about?
Neo: The Matrix?
Morpheus: Do you want to know what it is?
(Neo nods his head.)
Morpheus: The Matrix is everywhere, it is all around us. Even now, in this very room. You can see it when you look out your window, or when you turn on your television. You can feel it when you go to work, or when go to church or when you pay your taxes. It is the world that has been pulled over your eyes to blind you from the truth.
Neo: What truth?
Morpheus: That you are a slave, Neo. Like everyone else, you were born into bondage, born inside a prison that you cannot smell, taste, or touch. A prison for your mind. (long pause, sighs) Unfortunately, no one can be told what the Matrix is. You have to see it for yourself. This is your last chance. After this, there is no turning back.
(In his left hand, Morpheus shows a blue pill.)
Morpheus: You take the blue pill and the story ends. You wake in your bed and believe whatever you want to believe. (a red pill is shown in his other hand) You take the red pill and you stay in Wonderland and I show you how deep the rabbit-hole goes.

It should be noted that many Matrix fans believe that the “real world” and Zion are also parts of the Matrix used to control the radical element and that the machines have anticipated their desire to rebel.

EMS doesn’t need a Neo to come and save us, or even a Morpheus to show us the way to the Oracle to hear what we need to hear.  But what we do need to do is wake up, look around and stop taking half truths and scare tactics as solutions for our patients.

Which will it be?  The red?  Or the blue?