Hate Firefighters that complain about EMS? You might be one. I was.

It is no surprise that anyone working in the Fire Department who hates EMS is in for a rough career.


I have met many a "Basic for Life" who groans everytime the bells ring and it is not a fire.  Some even groan at building alarms.


I was talking with a colleague recently and we stumbled into the problem most in EMS struggle with and one I built this platform on:  BS calls.


You might be thinking "Justin, calling them BS calls isn't respectful.  It's that kind of attitude that encourages less than Professional actions by our low information voter EMS types."


But they are BS calls.  The scraped knees, the MVCs without injury some passerby called in, the headaches after slurpees and stomach aches after a seafood dinner, all BS calls.


And if you agree then you still have a lot to learn about modern, and I'll argue future, EMS.


If you argue that you only exist for emergencies and the other calls waste your time, your argument is no different than the firefighter claiming they are there to fight fire, not wipe asses.


So let's rename BS calls as Basic Service Calls.  Not EMT Basic, but Basic care.


You exist to assess.  So many in EMS list their abilities to treat as their claim to fame when we have all known for a long time that treatments are useless without a complete assessment.  That headache, stomach ache, every call you go on deserves a complete assessment to determine possible solutions to you patient's chief complaint.  If your main reason for assessing is simply whether this will be a transport or not, perhaps we should get you an application at Dairy Queen.  I can say that, I used to work there.  If all you d is check your boxes on the ePCR and exclude the patient from your box of tricks are you even addressing their concerns?


Every single call you are sent to is someone who didn't know what else to do.  What an amazing opportunity to help them.  Not with a 12-lead most times, or albuterol even, but listening to their concerns and reacting to them.


If the guy on 3rd street keeps calling every time he runs out of meds, can we possibly help him figure out why instead of getting upset he called again?  In case you haven't noticed, getting mad and yelling at him only makes him call and complain in between calls for 911 to refill his meds.


Getting upset isn't working.  So instead, get involved.  It will take just as long to complete a transport or refusal helping him or ignoring him so why not make the time you have with him useful?


You don't need Advanced Practice, Community Paramedicine or (I can' believe I'm about to type this) Integrated Mobile Healthcare (ewww) to make a positive impact while still acting within your scope of practice.  There is no law that keeps you from being a patient advocate.  Since he called you for medical care you are now able to access his medical record (as much as he gives permission for) to determine what may be the trouble.  Call his Doctor's office and mention to the clerk who answers that you are on a 911 call and need to speak to his Doctor.  Dude will be on the phone in a heartbeat.  If the van service from the managed care service is always late or keeps skipping the house, make a call.  If the home care nurse isn't doing what they are supposed to be doing, ask for their agency's contact information and follow up with your concerns.


All of this can be done in the same time frame as your frustrated conversation with your regular that will end the same way it always does unless you change your perception.


He IS the reason you are here.


Like the Fire Service before us we are doing a great job at preventing major medical issues and because everyone seems so intent on getting to any scene as fast as possible, we see many conditions far earlier than before, meaning they're not as dire as our 20 year veteran colleagues remember.


We are the safety net these people need when their insurance company fails them.  We are the number they call when Medicare can't cover everything.  We can make a difference if we try and we don't even need to try very hard.


These calls will frustrate you.  They frustrated me so much I wrote about them.  As I did I realized I was getting frustrated for no reason at all and that I alone had the power to help these people.  That's where EMS 2.0 became a reality for me.  That's when Chronicles jumped off and my perceptions changed forever.  Had I kept stewing in my frustrations there is no telling where my sanity would be.


If you disagree with me and believe the first word in EMS is more important than the last word in EMS give up ever becoming a Professional.  You'll burn out in a few years and I hope you don't hurt anyone between now and then.


It's time to take the extra step so many think is not their job, not their responsibility or not in their power:  Help people.


 

Comments

Tim said…
Amen Brother. Thanks for the work you're doing.
Sean said…
Well said. I would suggest that this type of care also be adopted by our ER colleagues. Busy as they may be, the RN eye rolls just aren't needed when a BS call (or any call) is wheeled in.
People just might call less if we fix their silly little problem...
Tj said…
EMS 2.0, Community Paramedicine, or I prefer to call it 'preventative paramedicine'. Preventing patients from going to hospital needlessly.

In the UK 'Urgent Care' services are becomming more common, with paramedics being paid as specialists - over and above that of critical care paramedics.

Blue lights and sirens? - nope.

Shed loads of trauma? - nope.

Full paramedic assessment to ensure correct diagnoses made, treatment (including prescribing rights) given and appropriate safety netting in place - you bet.

Thes 'urgent care paramedics' get stuck right into the healthcare system. You've got a problem? Just like you describe they'll fix it.

Prevention is better than cure, lets be part of the solution.

Tj

@meditude
another aussie medic said…
Bang on the money as usual - and I find it both amusing and interesting that no matter where in the world we are - it's all the same!

I've only been in this game for 14 years - but it does make me laugh at the young ones (says me in my mid 30's!) who are so focussed on skills based patient care, while they completely miss a) the basics, b) listening skills and c) thorough assessment ability which considers differential diagnosis.

....even to the point where I've been asked "how do you know so much when you've not done a degree?"
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