Why we never run...

[EeyoreEMT]

you know, the one comming up in Culumbus, oh is going to have the dark haired co-star. I dont remember which on he is, my brain is fried right now

 

[EeyoreEMT]

I do agree, I have seen many times, many new people run in, almost with empty hands, then, one has to run back out for supplies. How dumb. The ones I was refering to were possibly non-breathing infants and/or children. If it was trauma related, one of us stayed back to gather necessary c-spine equp. and followed in, not running.

 

[Sasha]

This guy is so out of it that he cant even crawl into the bar ditches to help out. Then when the patients do see him they get this disgusted look on their face and request somebody else to take care of them.

That's really sad that your patients are so closed minded they don't want a fat person taking care of them.

 

[medic417]

That's really sad that your patients are so closed minded they don't want a fat person taking care of them.

If the over weight person looks professional it is not usually a problem. But when they look and smell bad how can you blame someone for asking someone else to take care of them. Plus if a persons weight keeps them from doing their job which includes getting into the ditch that the person you qouted said they could not they should not be in 911 EMS even, so then the patients would not even be in position to ask for a change.

 

[EMTinNEPA]

That's really sad that your patients are so closed minded they don't want a fat person taking care of them.

I agree. Some of the best medics and techs I know are big fellas, including Paramedic of the Year recipients.

 

[medic417]

I agree. Some of the best medics and techs I know are big fellas, including Paramedic of the Year recipients.

I bet the patients were not just complaining about the weight. I bet they complained because they looked unprofessional. I know some very big very good medics. But they keep themselves clean and they buy proper sized uniforms. So they look big and professional, they do not look like big slobs.

 

[Griff]

I bet the patients were not just complaining about the weight. I bet they complained because they looked unprofessional. I know some very big very good medics. But they keep themselves clean and they buy proper sized uniforms. So they look big and professional, they do not look like big slobs.

Sasha has an excellent point, IMO, but I think I get where you are coming from as well. I have been in law enforcement for five years now and some of our people are absolutely filthy (literally). I do not think it has anything to do with weight (at least in these cases); the smell and overall grimy appearance significantly detracts from our collective image and hinders our effectiveness to a degree (i.e. witnesses/victims tend to cut FIs short if they are repulsed by the interviewing officer). Again, I don't necessarily think it's about the weight (most of our best officers are big individuals); It's about hygiene. Just my two cents ^_^

 

[Wyoming Medic]

That's really sad that your patients are so closed minded they don't want a fat person taking care of them.

CorrectaMundo Sasha. It is sad if the patient was requesting a replacement just because the EMT was overweight.

Everybody that has replied has been correct. This particular person smells like a foot. On a 48 hour shift he will not shower. He also smokes like a freight train and smells accordingly. It is a mix of BO and smoke.

That being said though, Let me delve into the overweight thing a little more. While I myself am not overweight, I am the son and nephew of extremely overweight people. My mother, Her identical twin sister and another aunt of mine all had gastric bypass ON THE SAME DAY several years ago. They were all VERY obese prior to the surgery.

It was interesting to watch the public's perception and treatment of them prior to the surgery then gradually as they lost weight. People truly do treat obese people as stupid. I have caught myself guilty of it. In the back of my mind I say "why can't they just be skinny, it isn't rocket science". However seeing so many of my relatives battle weight, I forced myself to step back and re-examine. Watching people talk down and slowly to my mother (who is extremely well educated) when she was overweight to now talking to her like a person and even making eye contact.

I cannot speak for others but I feel that this may be the perception of the general public. "why should I let somebody that obviously cannot control their own life try to take care of me in an ambulance".

I am not trying to condone somebody requesting a "skinny" EMT but the perception is a tough one to crack. When an obese medic responds to a medical call with the local FD, it is very tough to get respect. Here are professional people that are medics too BUT they are also in decent physical shape. Around here the FD gets paid considerably less than the hospital based medics. So a rift develops. FD sees themselves as underpaid staff required to stay in shape and pick up the slack of the incapable ambulance crew.

To back up a bit, I think that cleanliness and professionalism go a LONG WAY in the public's perception. If you are obese and filthy (and in my coworkers case, a crappy EMT) its gonna be a hard sell. Obese but tidy, much easier.

I know that I deviated from topic but it is still important. My hope is that people will not underestimate an overweight EMT but also that the overweight EMT will realize that public perception is very cruel and that they should try very hard to break that stigma.

Happy hunting, Hope I did not offend anybody too much

Wy Medic

 

[Sasha]

I bet the patients were not just complaining about the weight. I bet they complained because they looked unprofessional. I know some very big very good medics. But they keep themselves clean and they buy proper sized uniforms. So they look big and professional, they do not look like big slobs.

Your post is an example of the closed mindedness I was talking about. Nothing in here indicates he's dirty. He has trouble finding a proper fitting shirt, but that doesn't equate to dirty.

We have one guy that is so soggy around the mid section that he cannot purchase a uniform shirt big enough (and we have tried 3X). He is a paid staff member and cannot function in the slightest. We cover a county of almost 6,000 square miles and our most common call is a "one vehicle rollover". This guy is so out of it that he cant even crawl into the bar ditches to help out. Then when the patients do see him they get this disgusted look on their face and request somebody else to take care of them.

I read and reread it just to make sure, but I don't see anything to indicate he was dirty or smelly in the originally post. But of course you speculated it right away.

It was interesting to watch the public's perception and treatment of them prior to the surgery then gradually as they lost weight.

People don't just view overweight people as stupid, but as lazy, worthless, gluttons. When they try to lose weight, order the diet coke or go to the gym, they get eye rolls.

I cannot speak for others but I feel that this may be the perception of the general public. "why should I let somebody that obviously cannot control their own life try to take care of me in an ambulance".

We also precieve obesity's etiology as just people being lazy or with out the self control to put the ice cream down.

My point it, PLEASE EXERCISE. I am a big, awkward person (6'5" tall and 230LBS) so if I can do it, anybody can.

It's not always that simple as "Just work out!". Maybe there is some reason they can't work out. We're all guilty of judging people by their outward apperance of health when we have no idea what could be going on underneath the surface. Maybe they can't work out due to arthritis, maybe they're on beta blockers, maybe they live in a neighborhood where it's not safe to go walking alone, but they can't afford to go to the gym. Maybe they can't afford healthy foods and live off Top Ramen and Walmart brand fruit juice. And MAYBE... just MAYBE they don't care about society's closed minded constraints and are happy just the way they are and are comfortable in their own skin.

There are a couple studies to support that obesity is more biological than a lack of willpower. Here are a few I had in my favorites.

Here, it talks about the brain itself, while the person does recognize they're fat, the brain doesn't recognize they're overweight due to a decreased response to Leptin.
Full article here:http://www.scienceblog.com/cms/in-obesity-brain-becomes-unaware-of-fat-12729.html

people may be consciously aware that they are overweight, but “that’s different from the homeostatic circuitry being aware.”

The new results also bolster evidence that a suppressor called SOCS-3 may be responsible for the loss of sensitivity to the fat hormone known as leptin.

The animals that did become obese maintained normal levels of the ARH brain receptors that respond to leptin, the researchers showed, while the level of SOCS-3 rose. Leptin hormone in those heavy animals failed to elicit “any element of the leptin signaling cascade.” The researchers demonstrated that those later players in the leptin pathway remained ready for action. Indeed, the downstream factors were actually found to be hypersensitive to stimulation.

“Previous studies have suggested that SOCS-3 is a negative regulator of leptin,” Cowley said. “As animals become bigger and fatter and leptin increases, SOCS-3 may rise to decrease the signal. It seems that in obesity, SOCS-3 might end up overriding the [leptin] signal completely.”

Here it talks about the brain response to sugar foods.
Full article here: http://news.minnesota.publicradio.org/features/2003/06/02_schmitzr_obesitypsych/

Back in a Minneapolis laboratory, Dr. Levine is going over test results with his assistant. Levine has identified one part of the brain stimulated by sugar. He says it's the same part stimulated when drug addicts take their drug of choice. For this reason, Levine says when it comes to obesity, sugar is a leading culprit.

 

[Bosco578]

I love it when we arrive on scene at the same time as FD and they go racing in ahead of us. My respone to them is usually,now you can run just as fast out......CANCELLED!<_<

 

[medic417]

Your post is an example of the closed mindedness I was talking about. Nothing in here indicates he's dirty. He has trouble finding a proper fitting shirt, but that doesn't equate to dirty.

No it was not closed minded. I stated what was probably the real concern. I also stated how people viewed large professional appearing medics. I have seen the same response to unkempt "skinny" medics. People do not have any confidence in someone that looks/smells unprofessional.

So there are two points I make on this matter: 1. Look/smell professional. 2. Be in good enough shape to physically do the job.

 

[Wyoming Medic]

It's not always that simple as "Just work out!". Maybe there is some reason they can't work out. We're all guilty of judging people by their outward apperance of health when we have no idea what could be going on underneath the surface. Maybe they can't work out due to arthritis, maybe they're on beta blockers, maybe they live in a neighborhood where it's not safe to go walking alone, but they can't afford to go to the gym. Maybe they can't afford healthy foods and live off Top Ramen and Walmart brand fruit juice.

Believe me, I am very aware that it is not as simple as "work out" in many cases. But in many many many more IT IS. My mother was one of those cases. She will even tell you that if she had worked out, the gastric bypass may have not been needed. She reached a point where she was unable to work out due to her physical state. By then is was sort of past the point of diminishing returns.

That being said, If a person is in such a state that they cannot work out, they should not be working in ambulance/fire. The number one killer BY FAR of first responders is cardiac in nature. More than heat for firefighters, more than needle sticks of EMTs. Yet we receive no training on physical fitness when we graduate. And EMS is very physical. Sure, driving around in the bus is easy. What about those calls where you have to lift the shut in down 6 flights of stairs or (as is common here) must hike 1/4 mile down a 50% grade to get to the wreck victim THEM pack them down.

Check this out,
http://www.ems1.com/columnists/jennifer-milus/articles/317094-Nutrition-and-Heart-Disease-in-EMS

It is a very good article and should really point some fingers at EMS in general. We are not immune from the same dangers and when a patient suffering from chest pain gets a lecture from an EMT that is in worse shape than they are, it looks poorly on the profession as a whole.

I'm not saying that everybody needs to have the chiseled abs and massive biceps of the "calender firefighters" but we do need to take care of ourselves and do the best we can. I can GUARANTEE that there are physically challenging things that can be done in the home ( I do not have a gym membership). Me personally, I do push ups while I watch TV. Free and effective. Someone can't do pushups, Do situps. Can't do situps, Walk in place. Can't do any of the above. Then they need to fall back and evaluate weather or not they really should pursue this as a line of work.

I'm not trying to be mean, I am trying to play devils advocate (and no, not the pinball game from the Simpsons). I have been doing this for long enough and in enough places to see the problem for what it is. Remember that paramedic (and all EMT levels) is not considered a license in most states, it is a CERTIFICATION. So until we can look at ourselves and do some soul searching as a group, we will never move into that realm.

Wy Medic

 

[Sasha]

I'm not trying to be mean, I am trying to play devils advocate (and no, not the pinball game from the Simpsons). I have been doing this for long enough and in enough places to see the problem for what it is. Remember that paramedic (and all EMT levels) is not considered a license in most states, it is a CERTIFICATION. So until we can look at ourselves and do some soul searching as a group, we will never move into that realm.

Wy Medic

I was not referring to just EMS, but people in general.

So you're saying, in order to be taken seriously as a profession, we all have to be in shape? What about smokers? That's just as unhealthy. Should we ban cigarettes in EMS too? To be taken seriously as a profession? What about obese nurses, and doctors, should they lose their license because you feel being overweight and in health care is unprofessional?

We are not immune from the same dangers and when a patient suffering from chest pain gets a lecture from an EMT that is in worse shape than they are, it looks poorly on the profession as a whole.

The out of shape EMT lecturing to a chest pain patient has more problems then being overweight. Medics/EMTs should NEVER lecture their patients.

For the record, I AM a skinny EMT.

 

[medic417]

I What about smokers? That's just as unhealthy. Should we ban cigarettes in EMS too? To be taken seriously as a profession?

Yes we should.

 

[Wyoming Medic]

I was not referring to just EMS, but people in general.
So you're saying, in order to be taken seriously as a profession, we all have to be in shape?

YUP, You nailed it (kind of). Like I said (you seem to be good at reading and using what you want) we all have to make an attempt. Every EMS person should be required to adhere to some form of physical standards. Heck, Even truck drivers have more of a physical standard that EMS people do.

CDL drivers have to get a DOT physical to be able to get their drivers license. What about EMS staff who have to be able to act physically for hours at a time while peoples lives and trust hang in the balance? Nope, no doctors physical NO NOTHING.

Same with smoking and sugar and trans fats. IMO anybody that eats that garbage should seriously be concerned for their health and well being. If I were the grand potentate of EMS for the U.S., I would require that all EMTs of every level be able to run 5 miles in under 20mins as well as be able to swim 3 miles with a blindfold on.

You seem to be taking it harshly that I am SIMPLY STATING THROUGH MY SEVERAL YEARS OF ON THE JOB OBSERVATION, that we as a profession in EMS are in crap shape and it shows. Heck, Steve Berry even makes fun of it. I'm not asking or even demanding standards that I have outline above but I am telling people that the public views EMS poorly (sometimes) due to our physical conditioning.

I don't get why encouraging people to work out is so bad. And for that matter, where do we draw the line? Wheelchair ramps for EMTs? Are you saying that we should allow EMTs to drive their little rascal scooters into the ambulance and not be held to any standard? What about people that are so large (like my coworker) that it is a risk to me? Why should I have to strain and sprain MY BACK due to his laziness and inability to lift? Why should my dept. take the risk when this guy that is so big cannot sit the federally mandated 10 inches away from airbags?

Please RE READ all of my posts about this topic. I will paraphrase here again. People should do all that they can to be in the BEST SHAPE POSSIBLE (Im not saying skinny or super model, I'm saying they best shape that that person can be in) and if they do not have the ability to maintain some SAFE level of fitness and health then they should not be in the EMS field. I as a co worker should not have to bear the brunt of injury due to having to pic up slack, the patient should not have to bear the brunt of an EMT that is incapable of providing adequate care, and my employer should not have to bear the brunt of higher associated health cost.

If somebody can HONESTLY say that they meet the above criteria, then my message does not apply do them.

Wy Medic


Ps. yes we should be lecturing our patients. Our job is to provide the best care possible and if that means making the patients not like us by calling them on the carpet, then YES we should. By calling them on the carpet I mean about, cardiac problems, lack of compliance with meds, abusive relationships, drugs, ETC.

 

[medic417]

Ps. yes we should be lecturing our patients. Our job is to provide the best care possible and if that means making the patients not like us by calling them on the carpet, then YES we should. By calling them on the carpet I mean about, cardiac problems, lack of compliance with meds, abusive relationships, drugs, ETC.

Actually liked your entire response. But on the qoute above maybe using educate the patient would be better sounding than lecture. And yes some education is uncomfortable to the one getting it.

 

[Wyoming Medic]

Actually liked your entire response. But on the qoute above maybe using educate the patient would be better sounding than lecture. And yes some education is uncomfortable to the one getting it.

Agreed, EDUCATE does sound better.

 

[Sasha]

Stereotypes! You are associating lack of the ability to lift, or do their job, or lazyness with being overweight!

That's NOT the case 99% of the time. Those who are overweight an unable to do their job, chances are, wont be able to do their jobs if they were "in shape". Just because you're skinny doesn't mean you can lift, just because you're fat doesn't mean you can't lift.

And no, it is not YOUR business to lecture your patients. You are being called to them in a moment of vulnerability and what is viewed in their mind as an emergency. Let the lecture/education be left to doctors and nurses who actually know what they're talking about 90% of the time. Not to the 110 hour trained EMT.

 

[medic417]

Stereotypes! You are associating lack of the ability to lift, or do their job, or lazyness with being overweight!

That's NOT the case 99% of the time. Those who are overweight an unable to do their job, chances are, wont be able to do their jobs if they were "in shape". Just because you're skinny doesn't mean you can lift, just because you're fat doesn't mean you can't lift.

And no, it is not YOUR business to lecture your patients. You are being called to them in a moment of vulnerability and what is viewed in their mind as an emergency. Let the lecture/education be left to doctors and nurses who actually know what they're talking about 90% of the time. Not to the 110 hour trained EMT.

EMS is part of the education of patients if you do not educate or want to educate your patients you need to leave EMS. Read mine and WY posts we both said that very thing. You are doing what he said picking on one word and ignoring the context of the entire statements.

 

[Sasha]

You are doing what he said picking on one word and ignoring the context of the entire statements.

I'm not ignoring the context of posts, I'm picking out statements and replying to them that wont get me banned for my reply.