Being rather old school, I have only ever seen a few providers have problems with this. The ones that did washed out. The older providers successfully cope and they are of exceptional character. Maybe too many people who have no business even starting in emergency services is the problem?
Perhaps. I think we probably would agree that too many people enter EMS due to a low educational barrier to entry.
I think sometimes though we also just select out people who are different, we sometimes fail to support each other, and many systems lack good mechanisms to help their employees deal with stressful events.
I also saw older employees underrepresented in EMS. I remember conversations with people who had 20 years in, who were having trouble coping with a call from 6 months prior. It didn't seem their age, maturity, generational differences or prior experience had spared them from critical stress.
Again, this is something that is part of the demands. If you can't lift, then you can't do the work. We don't expect people who can't pass a pt test to be soldiers. Why would we expect anything less from the "heros" who are supposed to be above the average who we pay to come and help?
Agreed. There's a responsibility to keep yourself physically fit, that many EMS providers neglect to their own detriment. There's also a certain risk to each lift you do. Sometimes you're unlucky. If there are no lateral positions to move someone with an injured back into, you lose them, and all their experience and training, to another field. I think that this is a problem for EMS.
You have the responsibility to protect your health and safety. If your company doesn't support that, the reasonable choice is to move on, even if it is to another field of work. I give you my loyal assurance nobody at your company is going to pay for your current standard of living if you get hurt.
Agreed. But wouldn't it be better if there were more positions within EMS for people who can't lift?
I keep hearing about the marriage ending infidelity being rampant, but I don't see it anymore than in any other population. Perhaps you just hear about it more in the EMS population?
You may be right. This may be some random idea I've picked up, and reinforced with confirmation bias. It seemed to me that this was the case, but I have absolutely no data/evidence to support that.
A good service is not synonomous with a union.
Agreed. However, in the region I worked in the unionised services were generally preferable to work in. Obviously there were exceptions to this, and I'm not foolish enough to suggest that this can be generalised to another country, especially one with as fragmented and diverse an EMS "system" as the US.
Social problems and considerations are part of medicine worldwide for centuries. System problems are part of all US medicine. If they can't take the job, they are free to go, don't let the door hit them on the *** on the way out.
Absolutely. You can vote with your feet. And part of surviving in medicine is learning to focus on problems you have the power to change, and not ones that you can't.
But surely we'd agree that there's also room for improvement in how today's EMS systems are run?
Ahhh. The tribulations of reducing the energy of reproduction and maintaining a lifestyle higher than the rest of the world. Sounds like people want it all. Best of luck with that.
Also understood and agreed. At the risk of making a huge tangent, I think this is sometimes a cultural bias. If you've never experienced how people live in other countries, it may seem normal to own a pickup, a minivan, and a 2000 square foot house. Then you may end up trapping yourself with all the associated consumer debt.
Anyone still using SSM is either absolutely stupid, greedy, or both. Best of luck to them too. Don't be a fool, McDonalds has better working conditions and in management similar pay.
SSM / MPDS are good liability management but poor medicine, in my opinion. I don't like it much. It was still probably better than McDonalds though
LOL, This is great. I am sorry, but I never hear a patient ask for a clinical researcher. They ask for a doctor. I also hear what physicians who actually touch patients say about those who don't but offer suggestions with studies that seem absolutely laughable.
I never suggested that PhD clinical researchers were even remotely qualified to do clinical care. That's not their role. But there's no denying the value of medical research carried out by PhDs, MDs, and MD/PhDs (both those who work 100% in research and those who primarily do patient care).
Perhaps we're arguing over definitions -- but would you consider someone who studies the effects of TNF-alpha on vascular reactivity in sepsis in a rat model to have some background in medicine? What about someone who looks at IPSCs in myocardial infarction models, or in human clinical trials? Is this not also medicine? What about someone who studies the actions of NMBAs, and lectures pharamcology/physiology to medical students?
I could imagine a specialist physician getting very upset if a clinical researcher tried to direct care. That would just be stupid. But whenever I've seen the two groups interact, I've seen nothing but mutual respect and polite discourse.
Possible or cost effective I agree with. Desirable is another matter entirely.
I guess what I meant by that was that if you put physicians on every ambulance, there'd be a huge issue of skill degradation to manage. I think it might be very frustrating to the individual physicians as well.
Certainly wasn't the respect or the money. But it is good you didn't come away completely empty handed.
I greatly enjoyed it, and expect to enjoy it again. All I was trying to do was highlight what I think some of the reasons people leave EMS are.
Some of these issues have constructive solutions, or at least there exist creative ideas that can be tried. Stress could be alleviated by moving away from SSM models, altering sick leave policies, providing more opportunities for lateral movement, better educational opportunities post-employment, developing a team culture, etc. Some not so much.
All the best.
mentioned in the article bellow and who I credit with a large proportion of my success at uni) about the requirements for coming back and teaching one day. I was told that I'd have to attain a post-graduate certificate in higher education as a minimum, preferably a higher. This was in addition to either a masters in public health with an EMS focus or a masters/PhD in EMS. Believe it or not, there are a relatively large number of applicants and its apparently quite hard to get a job there. I think its people and educational requirements like this that really foster attitudinal change amongst future paramedics. While America still has drill instructor type "educators" presenting dot point presentations to wrote learn during the months of a tech school style qualification, I'm afraid you're going to remain SOL for someone to chat with mate.
