Are most EMS personnel THIS unprofessional?

[zaboomafoozarg]

I recently completed my ride-along time for my EMT-B class. My knowledge is not that expansive, I will readily admit, (even though I am at the top of my class ) but I was still absolutely shocked to see how the "real" medics behave.

Just to clarify, this is not a rant in any way, because I still had a good time: I just want to know if this is what I get to look forward to for the rest of my career.

For starters, these folks' vocabulary appeared to consist only of the necessary medical terms, a few verbs, and primarily the F word.

Every other word, pretty much. Then, of course, there are the conversations. Horrible. Laughing, joking, and even just talking about absolutely inappropriate matters. You know what I mean.

Then there's the attitude. I got a sampling of more whiny drama, gossip, and downright nastiness in 6 hours in that EMS station than one should normally expect in... oh, I don't know, a month! This includes your typical backbiting sessions, and one woman becoming extremely angry and yelling because the kitchen was dirty and then basically stomping around from that point on. (Yes, I was hoping and praying for a call to come in so I could get out of there )

The standard professional behavior one would expect from trained medical personnel was nonexistent. This includes insulting the 96 year old verbally-responsive patient right beside her in the ambulance... "She BLEEPing reeks!" and ranting about how much of a %&*( @!)% )$(! ^&%* idiot her primary caregiver is because she was reluctant to send the DNR with them in the fear that it might get lost. Then relating the entire thing to the hospital staff as he wheeled her in on the cot, all the while ignoring the actual patient. Another squad exhibited the same type of behavior when we pulled up to a trailer park. The scorn was just seething from them.

Not only this, but the EMT/Patient communication one is taught in class to use was not displayed at all. Not once throughout the day did any of the medics I saw introduce themselves properly, ask consent to treat, or even really talk to the patient as a human being. If any actual addressing was done, it was in the form of, "Hun," "Old girl," or simply implied, "you." Then the patients just had to sit on the cot in the ambulance while the medics worked on them in virtual silence (save for the two standard questions, "how old are you? are you allergic to anything") all the way to the hospital. No reassuring, no explanation of procedures and treatment as administered.


And then, to top it off, the level of care seemed downright unprofessional even to my own inexperienced eyes. Not once did any of the shortness of breath or difficulty breathing calls receiving anything more than 3-4 liters of O2 via Nasal Cannula. What happened to the non-rebreathers that are supposed to be used? One woman who could hardly breathe and speak only 1 word per sentence was forced to walk to and climb into the ambulance by herself. A patient who fell and had severe left shoulder pain was mercilessly jostled by the medics manning the stretcher. Trust me, they could have been far more gentle.

These are just some of the things that took place, and let me tell you, it was not what I expected!

I don't believe I saw even one good example during the entire time period.

So that's why I make this post here. Is this really the way things are? I understand the job can be stressful but come on, the people with whom I was acquainted there wouldn't have been able to hold a job as a gas station attendant acting like they did, let alone medical professionals. And I wouldn't be so concerned, except I saw the same thing in every case If this is the norm, then I guess I'm in for a fun ride.


Your thoughts and input be much appreciated.

[Kaisu]

Absolutely, totally and completely is NOT the norm. I would not tolerate anything less than a professional attitude on the ambulance and take exception to those that demonstrate lack of compassion, or are judgmental.

As far as conversations and behavior in the station - yes, there are the profanities and the "inappropriate" conversation occasionally. However, if anyone behaves like the woman you describe over the kitchen - well it just wouldn't happen. Kitchen cleanup is one of assigned PM duties and the crews enforce the completion of same amongst themselves. If a crew is on a transfer and unable to perform PM duties, others pitch in and get it done.

It sounds to me like you are with an agency/shift very far on the continuum of what is "typical" behavior. EMS varies company to company, area to area.

Just look at the variety of posts on this forum. They range from the illiterate and ill informed to amazing demonstrations of competence, maturity and commitment.

Do not allow these people to color your entire view of the industry, and if you can, find someplace else to get your ride time.

[Linuss]

Couple of things I'll comment on real fast:

the "innappropiate" humor is a part of EMS, and medicine in general, for better or worse. Google "Gallows humor" and you'll understand why.


As for the sob getting an NC instead of a NRB, as you hopefully continue on in your career and get higher education, and more tools to use, you'll realize very few people get the EMT-student blanket treatment of "15lpm NRB", sob or not.

[exodus]

Speak to some of the superiors at your school and let them know what happened on the ride-along and they should know how to follow up with it. And you can probably request another ride-along with someone else too..

[Foxbat]

Originally Posted by zaboomafoozarg

Is this really the way things are?

Some of them are.
Dark and/or politically incorrect humor, profanities and gossip are very common in EMS. As far of the use of NC instead of NRB, it depends on the situation.
The way they talked to pts. sounds very inappropriate and not typical. Making pt. who had difficulty breathing to walk and climb into ambulance definitely does not sound right.
I would find a different place to do ride-alongs...

[mycrofft]

Gresham's Law as applies to EMS: crummy attitudes drive off good ones.

[Luno]

Your thoughts and input be much appreciated.[/QUOTE]

Wow, sounds like you got your eyes opened to the good, the bad, and the absurd of the profession. So we'll just handle this piece by piece...

For starters, these folks' vocabulary appeared to consist only of the necessary medical terms, a few verbs, and primarily the F word.

Every other word, pretty much. Then, of course, there are the conversations. Horrible. Laughing, joking, and even just talking about absolutely inappropriate matters. You know what I mean.

This should of been curtailed especially with a rider, however, if there were ever a microphone in my rig while it's just me and my partner the conversation would probably be similar. Understand that you are an outsider looking in. In our station, there's the young kid, the gay guy (not actually homosexual), the old guy (me) and another guy named after a cartoon character. The topics range from jokes about kids vs cars and SIDS (coping mechanisms through humor) to evaluating cardiac arrythmias and or symptoms from previous calls that our crew or the other crew can't figure out. The key is that it is a closed society with it's given rules accepted by all members of the society. You were an outsider, and they probably should of censored themselves accordingly. The topics of discussion aren't really yours to critique as you have no bearing or reference to the appropriateness in a closed society, so take that advice for what you paid for it. And yes, absolutely inappropriate things are discussed, and often laughed at. I'd also be cautious, as I've seen crews exaggerate things and do things to make someone feel uncomfortable... i.e. you...

Then there's the attitude. I got a sampling of more whiny drama, gossip, and downright nastiness in 6 hours in that EMS station than one should normally expect in... oh, I don't know, a month! This includes your typical backbiting sessions, and one woman becoming extremely angry and yelling because the kitchen was dirty and then basically stomping around from that point on. (Yes, I was hoping and praying for a call to come in so I could get out of there )

This will happen with any crew that you live with, it happens in the military, it happens in the private sector, it even happens in the public sector, gossip and interpersonal conflicts will happen, and need to be dealt with. Yes, occasionally people explode. The upside is these circumstances rarely last, as you can only live with conflict for so long...

The standard professional behavior one would expect from trained medical personnel was nonexistent. This includes insulting the 96 year old verbally-responsive patient right beside her in the ambulance... "She BLEEPing reeks!" and ranting about how much of a %&*( @!)% )$(! ^&%* idiot her primary caregiver is because she was reluctant to send the DNR with them in the fear that it might get lost. Then relating the entire thing to the hospital staff as he wheeled her in on the cot, all the while ignoring the actual patient. Another squad exhibited the same type of behavior when we pulled up to a trailer park. The scorn was just seething from them.

Not only this, but the EMT/Patient communication one is taught in class to use was not displayed at all. Not once throughout the day did any of the medics I saw introduce themselves properly, ask consent to treat, or even really talk to the patient as a human being. If any actual addressing was done, it was in the form of, "Hun," "Old girl," or simply implied, "you." Then the patients just had to sit on the cot in the ambulance while the medics worked on them in virtual silence (save for the two standard questions, "how old are you? are you allergic to anything") all the way to the hospital. No reassuring, no explanation of procedures and treatment as administered.

The standard of care including the treatment of a patient is absolutely unacceptable, and is not standard. This kind of behavior needs to be corrected. EMT/Patient communication as taught is subjective at best. I've use "hun," "sweetie," "bud," "boss," "chief," and probably several others that are used to calm, reassure, and decrease the emotional distance between the patient and caregiver. However, it is just a tool in the box to calm and reassure the patient, and sometimes might be inappropriate.

And then, to top it off, the level of care seemed downright unprofessional even to my own inexperienced eyes. Not once did any of the shortness of breath or difficulty breathing calls receiving anything more than 3-4 liters of O2 via Nasal Cannula. What happened to the non-rebreathers that are supposed to be used? One woman who could hardly breathe and speak only 1 word per sentence was forced to walk to and climb into the ambulance by herself. A patient who fell and had severe left shoulder pain was mercilessly jostled by the medics manning the stretcher. Trust me, they could have been far more gentle.

I'm going to go out on a limb here, and state that your class hasn't prepared you to critique a practicing medic's calls. You will learn that you don't treat the book, you treat the patient, and not every SOB needs an NRB. The patient that had to walk, there may have been mitigating circumstances. The shoulder pain, there's potentially issues there that could go either way. I'd guess what I'm saying is that there might be more to the situations then meet your class trained eyes. When I joined the field, I felt the same way coming out of class, so do I empathize with you.

So that's why I make this post here. Is this really the way things are? I understand the job can be stressful but come on, the people with whom I was acquainted there wouldn't have been able to hold a job as a gas station attendant acting like they did, let alone medical professionals. And I wouldn't be so concerned, except I saw the same thing in every case If this is the norm, then I guess I'm in for a fun ride.
These are just some of the things that took place, and let me tell you, it was not what I expected!

I don't believe I saw even one good example during the entire time period.

I guess the only thing I can say about this, is really what do you expect from a profession that requires less education than someone who cuts your hair? A profession is not built on a 120hr certificate... That also being said, these aren't the only shocks that you will experience if you decide to enter this field.

These are just my opinions from 6 years in prehospital medicine...

[Canoeman]

I still might encourage you to talk to their bosses. Something tells me this is not the first time that this behavior was presented. Just bad carma all the way around. And no this is not typical. Press on.

[JonTullos]

Blue humor is just a part of how things are done sometimes. While it isn't "nice" it's just there. Plus some people cope with the stress of EMS and blow off steam by talking about sex or using profanity. While I choose not to participate, I'd rather they do that than bring an uzi in with them.

As far as how patients were talked to and about, that's totally wrong. At my services these medics would have lost their jobs post haste. I'm sorry you had to see that. Like it or not, though, there are some bad ones out there. Eventually they'll be caught and have to answer for it.

[zaboomafoozarg]

Well this much feedback is certainly nice. Thanks for the interest, everyone. And the advice. Fortunately I only had to do one ride along. And it was mandatory that it be this company. In November some insurance laws are changing and I will attempt to get permission to ride along at a much closer, local, and largely rural service (3 plus's right there) where a couple relatives work (also a plus.) So I'm not overly concerned about one bad experience. I just wanted to know if anyone else had noticed it as a trend in their experience, and I'm glad to see the general consensus is negative.


Most of what I said is subjective, I realize. Meaning, it wouldn't matter in the slightest to some people. But it's still a patient oriented field... where I would think propriety should be paramount.


I will clarify one thing: the nasal cannula was put on by the EMT. Medic didn't even say anything. But that might be their protocols, I don't know.



I'm not sure that the education level (I assume you're referring to EMT and not Paramedic too, by the way) has that much to do with it, because... much of what I heard and saw would not be even close to tolerated in a minimum wage entry level position! Let alone a job of this importance. Furthermore, who would you rather have be a compassionate, helpful and, if at all possible, remotely pleasant person of character: your barber or the person responsible for saving your life? But, apparently being an untrained outsider, I do not have the keen eye or educational requirements for spotting blatant indecency.