Drive your ambulances into the future!

CCC lit a firestorm across the EMS blogging world in this post, and since I’m a humble firetender, it’s my pleasure to keep it burning; maybe even transmute it a little!  Rogue was kind enough to jump in and also list some of the Bloggers that have been commenting on the loaded issue of feeling comfortable being referred to as “Ambulance Drivers.”

Naturally, I chimed in and in the process saw a few things that I wanted to comment on, for one purpose only; to keep the conversation going. This is all valuable stuff everyone’s been talking about and the term “Ambulance Driver” was just the spur these topics needed. The question that arises for me is even though the descriptor “Ambulance Driver” may work for us now, will it carry us into the future?

It’s Disclaimer Time, folks!!!

“Us” is you. I haven’t lifted a gurney since 1985. Back in 1975 I was sure I was stepping on to the ground floor of what was soon to become a valuable and valued profession. I’m here asking you “Why didn’t that ever happen?” Not with an accusatory finger but with a challenge; “Isn’t it about time to make this a profession?”

We’re I not clear on Kelly Grayson’s intent and certain that he will be one of the people leading EMS into this new era, I’d be reluctant to fixate on the term. (A little, anyway!) But, as Kelly himself says, in the final analysis, it’s one’s professionalism that tells the story and in that he shows no inconsistency. He brings honor to the term. Remember “Ambulance Driver” is just the jumping off place for bigger issues.

Back to our regular programming…

Back then, the term we bristled at was “Hack” so I can see some improvement!

You have models to go on to build this into a profession. Nursing is one. They built expanding scopes of practice commensurate with the increasingly complex center of technology that the hospital had become. They took on the person-to-person duties that Physician’s once handled. Today, those connections have largely trickled down to Nurse’s Aides! Bottom line is they expanded their own value to medicine by filling in gaps that Doctors were leaving open as they became more entrenched in keeping up with an ever-increasing body of scientific knowledge of disease entities and products designed to overcome them.

What I think is that if you really look at the people you serve — the actual people you serve — and recognize that gaps you’re being called on to fill and get yourself adequately trained to fill them, yes, you can turn this into a profession. You’re fulfilling a much more complex and important niche in the fabric of society than you give yourselves credit.

I see the territory of EMS changing rapidly into 80% social service and referral — sometimes resulting in transport — 15% emergent medical responses and 5% acute emergency availability. EMS has become a societal stopgap measure designed to pick up the pieces left behind as the populace is cured by modern medicine just enough to be chronically ill. The problem is people call EMS because THEY think they’re Acute! So you get pissed off because you think you’re here to treat acute! You’re not; you’re here to treat what ails them, and you know what? You’re not adequately trained to do it! You’re trained to intervene a litlle and then transport.

A response in EMT Medical Student’s Blog  to Rogue places arguments about use of the term in proper perspective:

Imagine if EMS providers took this much interest in discussing the poor state of EMS education.
Imagine if EMS providers took this much interest in discussing the issues facing reimbursement for the services that EMS provides (including removing the transport requirement).
Imagine if EMS providers took this much interest in developing EMS research.
Imagine if EMS providers took this much interest in developing systems to prevent calls.
Imagine if EMS providers took this much interest in tackling any of the vastly more important issues rather than being called an “ambulance driver.”

Imagine if EMS providers put as much interest into making EMS into a profession (instead of the current “profession in name only” situation) that we currently do complaining about the term “ambulance driver.” We might actually get something done.

Medic 51 emphasizes two crucial parts of the formula for our future on his blog.

If we want to establish EMS as a true profession and a part of the healthcare system we have got to start having some pride in ourselves. We have to start standing up for ourselves.

The part that’s not getting grasped is that EMS is part of a much larger healthcare system. It no longer needs to function in its own bubble, and, in fact, does injustice to the populace it serves while insisting it’s all about emergencies. Standing up for ourselves means acknowledging the actual world we function in and develop the skills we need to handle it professionally.

But there’s a leadership aspect to it as well. In a sense, for this phase, everyone in EMS needs to take on more responsibilities in being people worthy of respect as Coma-Toast speaks to here:

There are several levels of leadership that one must go through to earn respect. It’s not automatic and must be earned. In the early stages of your leadership role, people follow you because they have to. You’re the supervisor, manager, or director. But with position comes responsibility. You’re not only responsible to your people, but more importantly to yourself. An indispensable quality of a leader is the ability to evaluate themselves before trying to influence others.

The Social Medic is equally aware of where the future is headed and I think he’d agree; right now, we’re not quite there. There are things we must do:

So maybe the whole issue isn’t about the words, it’s about the attitude. Flash says in Rogue’s blog:

Finally, three decades ago when I was very active trying to work with assembling an advocacy group for EMS in my state, I was told by someone very wise that as far as he was concerned, he could not foresee EMS ever being accepted as a medical profession in its own right…He also pointed out that most EMT/Paramedics, when they are off work, are not interested in continuing education, in self-development by reading journal articles, in improving their knowledge and skills. He said, “When they get off work from that 24 hour shift, they want to get their boats and go to the lake and drink beer and watch football. You’re never going to get them interested in any kind of an organization to improve EMS because they really just don’t care.”

Believe it or not, there are other people out there who care enough to look into where we’re at now — even though they are not and haven’t been involved in EMS — and offer invaluabe perspective:

Ray Bange, on Rogue’s Thread

You can talk as much as you like within the occupation and EMS sector  but you will continue to have difficulty getting appropriate recognition of funding needs, training and clinical practice until you reach the ears of the decision makers and alter the perceptions of kindred health professions and the public…You need to get paramedics into positions of policy development both locally and nationally and you need to develop a stronger sense of inner strength and professional ethos and ‘own’ the profession. (My perception for what it is worth)  That’s what the national professional body in Australia has been doing for some years – and it works!  It takes time but a promoting a coordinated consistent message does have an impact… (emphasis mine)

One of the more effective ways I have used to bring about change is to monitor the media and then engage the program producers, directors, scriptwriters and journalist who help to shape the public opinion.  Politicians will soon respond to that because most of them want to stay in their positions.

In essence, the dog has to wag the tail. EMS practitioners need to SHAPE their own futures.  A valid starting point is changing the image of it in the public’s eye. Isn’t it abundantly clear no one else has done it for them to date?

My last comment will be to make my position in all of this clear as a bell:I opened my first volley with CCC by referring to him with this term. He responded:

I’m flattered to be considered an “esteemed colleague” by the way.

Most everyone I’ve been talking about in the EMS blogging world are still out there, in the field, doing the work. Please forgive any presumption that I am still in your league, I get carried away sometimes.



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