Monday, May 26

Off Duty EMT and been drinking? Guess what?

You're not an EMT.

This may seem like it's coming from left field, and it kind of is.  One of the perks of having a website is that I get to see all the terms people type into search engines to find the site.  Until the Hangover movie I was the #1 google result for "strippers and cocaine."  True Story.

However a google search today troubled me a touch.  Especially since they hit me 6 times with it:

"if im an off duty emt and ive been drinking" (sp)

Well, Tiger, I think you might be a few into your day already so if you were the one doing this search put the drink down and let's have a chat.

Your search cut off a bit early didn't it?  Was there something else there like "should I help people?" or "will I get fired?" or "do I have to use apostrophes?"

Here's the short answer to all your possible questions:

No.  Except the apostrophes part.

As soon as you take a drink, smoke, snort, shoot, heck even if you pop an ambien or a flexoril you're not an EMT, you're just you.  While I have been known to break that rule, it was because one of my close friends had been badly cut in a fight.  I didn't go running into a situation inebriated simply because I just got signed off on splinting.

Take off the star off duty and have a responsible time doing what it is you do, but remember that anything you do while using that title or wearing that star reflects not only on you but the tens of thousands of us who know the difference between Professionalism and irresponsibility.

"if im an off duty emt and ive been drinking" yields far more relevant discussions on this topic and I hope you read them.

A Comment on Typical Idiot EMS Managers by Burned Out Medic.

Burned Out Medic had a post up recently I thought I commented on, but apparently you have to hit 'submit.'  Who knew?

The post is in reference to a Call the Cops story about an ambulance crew being reprimanded for going 90 MPH even though the vehicles govern out at 70.

Have a read and come back for my comments.

Well let me start by saying I agree 100% and that I'm going to have to disagree 100%.  Typical EMS Manager, right?

 

The trouble with the situation mentioned in the Call the Cops story is that there are no facts.  There does not appear to be any investigation policy or framework, nor is there any documentation confirming the speed of the vehicle, the exact location, time of day, etc.

Most field crews believe EMS Managers are sitting in the office hoping beyond hope that someone calls in a complaint so we can puff up our chests and assert the hair's width of authority we have.

Let me confirm that that is not the case at all.  In between phone calls from hospitals, regulators, our own managers, chart reading, report filing and other mundane tasks involved with making sure you can still practice, citizen complaints are taken very seriously.

I used to get weekly calls from a fellow who swore up one side and down the other that a crew raped him*.  Same crew, every week. Seriously.  For over a year we were on casual conversation terms each time he called.  Heck one week he didn't call and I was actually worried.  But the first time he called it was taken very, very seriously.

The conversation was recorded, run data was pulled, AVL signals gathered and only after confirming details from the caller was I able to conclude his complaint to be without merit.

The crew accused wasn't even working that night but had transported this individual a number of times.  That same crew had recently been accused of other things by other members of the public and medical system.  Each time he called I'd pull the AVL map as we spoke to confirm the crew in question was in the clear.

You see my friends, complaints do not happen in a vacuum.  They are most often the result of someone getting a bill for service or just plain not liking EMS in general.

The example given by Call the Cops that Burned-Out references is hilarious because it can be easily disputed:

  • Obtain complaint in writing or verbally recorded.



  • Pull the unit history for the ambulance in question.



  • Pull AVL data for location.



  • Access maintenance data to ensure governing device installed and properly working.

  • Access previous violations for pattern behavior.


That'll take maybe an hour.  The thing most field crews don't realize is that good people can still do bad things.  If you're a 5 star crew and get a complaint I handle it the same as a complaint about the crew that was in my office yesterday for what ever other frivolous thing the rumor mill says they were in for.

The tough call comes when the AVL data shows the unit traveling on the roadway in question, at the time in question, at the speed limit, but 3 hours earlier data show the vehicle traveling above the speed of the governor.

Now what do you do?  The crew has been proven to not be guilty of the accused offense, yet we now have data that show their defense is faulty.

It's easy to sit in the rig and gossip about how the managers are out to get you after what happened to so-and-so but just remember it's a lot of work to get you in trouble, and you know how we pencil pushing EMS Managers hate work.

If your managers are so bad at what they do, promote.  Nothing in EMS is easy, even sitting in a little room with a tie on reading charts and going to meetings.  The ultimate answer to bad leadership is to become a leader yourself.  Show me you can do it better than they can and your service will be the better for it and, as a result, your patients will have a better experience, which is all that matters in the end.

 

EDIT - *Forgot to mention, not the real reason he called, but just as unusual and hard to believe.

Wednesday, May 21

Deposition time and a friendly face appears

As a middle manager I get pushed forward as the "expert" at certain ways my agency handles things.  For example, since I am the only one that reads through all the charts I am the default "expert" on how to read through charts.  You get the idea.

This is important when a court case comes along that a chart was written for.  This happens often since many assaults, vehicle collisions and the like end up going to the lawyers.  I won't say going to court since it appears the system is rigged to favor them handling this all before we get to a judge.

I've been brought in to explain how ePCRs are created, stored and retrieved more times than I care to recall since each and every time the questions are exactly the same as are my answers.  I get a City Attorney to sit next to me and make sure I only answer the questions I'm supposed to and they often greet me in the hallway with a "The usual today" as if ordering an egg salad on whole wheat.

Every time it was exactly the same, until I suddenly sat down across the table from a familiar face.

This lawyer did his homework.

As I sat down, poured my water and readied my notebook I saw a 3 inch tall pile of clearly well handled papers, some stapled, some not, but in just enough disarray to show they had been reviewed, not simply all printed at once.  Right on top I saw a familiar face: Happy.

This lawyer had printed out at least 100 of my blog posts, news stories about the Chronicles of EMS, had photo copies of articles I wrote for magazines, photos of vendor events at conferences...you name it, it was there.

I suddenly felt a wave of panic flow over me and my wool dress coat was heavy.  He had achieved his initial purpose of setting me off my game and I did my best to recover as he launched into personal questions about my experience as a Paramedic and blogger.  The City Attorney was surprised to see all this material and at that point I wish I had mentioned the blog in our preparation.

Luckily, when we got to the vendor photos I was able to mention they are the same vendor as the medical charting system we use and my familiarity with the product is a result of those interactions.  The City Attorney made a very complex legal statement that I believe translates to, "Move along."

The rest of the interview went as always, I describe the manner in which crews enter data, that the final report can not be edited, that anyone viewing the chart afterwards is in the log, blah, blah, blah.  The clinical interviews are far more interesting but are very far between.

After the interview the City Attorney pulled me aside and mentioned that I should have told him about the blog and I apologized.  He laughed it off and said, "At least this time you had something new to say!"

Wednesday, May 14

Fresh perspective

Can you really ever see something from a fresh perspective?

If you are in the middle of a storm, how can you step back and see anything BUT a storm?  Much like looking at a cloud, as soon as it looks like one thing, you'll constantly see it as that until it's gone from site or morphed into something new.

 

Listen to an old song and sing the wrong words?  Even though you know for a fact there's a bad moon on the rise, not a bathroom on the right?  How can we clear out the mental cobwebs that keep us seeing what we see and hearing what we hear?

Do we seek out new clouds and new music or are we simply exchanging one set of perspectives for another?  How can one truly CHANGE perspective?

It begins with challenging your comfort zone, your home base.

Why do you feel the way you do?

What motivates you to feel that way?

What influences are in place to maintain those feelings?

Do the people around you support your perspective or do they challenge it?

Do your activities allow you to challenge your perspective or do you find comfort in the status quo?

All these questions are important when evaluating change of any kind but are essential when evaluating change that impacts more than simply your own little world.  Imagine that seeing that cloud as a dinosaur instead of a tea pot meant lost jobs, revenue, market share or something else important to your agency?  What if the old lyrics meant a low paying, poor working conditions job but the proper lyrics meant a better opportunity for you and your family?

Would you still stick with the dinosaur or would you ask others what they see and possibly be tainted by their perspectives?

Would you sing the old lyrics and shuffle along or will you challenge your perspective, your ideas, your beliefs?

Changing course on major decisions isn't easy and should not be undertaken without serious consideration of the impacts of your perspective.

After all, what if you're wrong but won't challenge your pre-conceptions enough to find out before it's too late?