“…he seems to be entertaining his crews and only scaring the children.”  
Tim Noonan, aka Rogue Medic
Blog Post on May 7, 2013.

Apparently me and my “recipe” post are the flavor of the week for Rogue Medic.  He’s posted at length over at his blog in criticism of me and compared my thought process to the cruel humor of a fictional, post-apocalyptic warlord.

In my youth, unprofessional insinuations like this would have bothered me.  Now I just don’t see the point to engaging in it.  For my readers, it’s my sincere hope that each of you can also find enough joy and fulfillment in your careers to keep doing what you love in the face of criticism.  I thought I’d share with readers some photos, both old and new, of me scaring children educating and entertaining children in my time as a paramedic, firefighter, and community volunteer.  Enjoy!

Recipe for PR Event Laughter

Serves: 6 – 8 children and accompanying adults

Ingredients:  Cardiac monitor/defibrillator, defibrillation load tester, small group of children, sense of humor, melodramatic EMS provider

Directions:
1.  Gather together a group of children and display your cardiac monitor while asking, “Has anyone seen a medical show where they used one of these to shock a person in cardiac arrest?”

2.  Wait for responses and colorful explanations while turning on the monitor, unwinding limb leads, and plugging defibrillation cable into defibrillation load tester.

3.  Ask group of children, “Who would like to get shocked?!”  Savor the looks of slack-jaw disbelief on the faces of the children and adults.

4.  As the bravest children begin to volunteer, hand out three ECG limb leads, one for each of the first three volunteers.  Instruct them to put their thumbs on the end of the electrode.  Keep one for yourself.

5.  Explain to the children that each shock is delivered through a single limb lead, while the other three leads act as ground wires and will not receive a shock.  Further explain this is a randomly generated circuit that changes every time the monitor charges.  Claim you have no idea which single person is about to get shocked, but you’re willing to take the chance of being shocked if they are.

6.  With great fear and trepidation, charge the monitor for defibrillation.  Increase the distress of your expression as the monitor reaches full charge.

7.  Prior to pushing shock button give a, “Guess this is goodbye” expression to your partner.  One or more child volunteers may throw the limb lead down in fear.  Allow them to retreat and assign another brave child to the open limb lead(s).

8.  Push the shock button to defibrillate your defibrillation load tester.

9.  Immediately scream in agony, drop your limb lead, and run/jump/cry as you feel is appropriate to convey that you were “shocked.”

10.  After catching your breath, thank them for being brave and invite them to bring their friends back for additional demonstrations on the half-hour for the duration of the event.  With their full attention at your disposal, it is also the ideal time to discuss relevant public safety messages for your organization.

11.  Repeat procedure for the rest of the day, or as long as you can keep a straight face.

Last year I thoroughly enjoyed the Missouri ICE Spring Break conference, and was excited to return for the 2013 event.  This year was even better, and I quickly realized that there was no way I could blog about all the cool things I picked up from this conference in a single post.

So over the next few weeks, I’ll be doing a series of posts on the topics and presenters from this year’s conference.  To kick things off, let’s take a listen to a podcast we made there.  One of the best experiences was putting together this Mini EMSEduCast of all the show alumni who were presenting.  Head on over the the EMSEduCast site and check it out!  

http://www.emseducast.com/archives/1131

If your answer is “yes,” then stop reading now.  Go back to being an astronaut… or a supermodel… or whatever childhood dream you’re now living.

But if you’re not living the dream, then welcome to the party.  Most of us in EMS aren’t enamored with the monotony of our careers.  It’s no big secret.  The drudgery of oxygen, monitor, IV, transport to the N^th degree will wear on anyone.  Does that equal unhappiness?  No, it just means many will accept monotony as an excuse to be average, i.e. unawesomeness.

This week I witnessed… no, that’s not the right word.  I endured the handling of a healthcare team that had succumbed to mediocrity.  Long story short;  I had an outpatient surgery, and it was unpleasant.  Had my wonderful wife not been there to support me, the day would have been unbearable.  The whole experience got me thinking of a passage from Steve Whitehead’s e-book, “The Non-Conformist’s Guide to EMS Success.”

Yes, our work matters. The work of the EMT is vital and worth doing. 

If it doesn’t matter and we choose to do it anyway, we are fools. Since it does matter, it’s worth committing ourselves fully. 

When we do, we are free to support our workplace as a place for meaningful work. Sure, that all sounds good right? It is. But it comes with a bitter pill. A pill that not too many of us are willing to swallow. 

To recreate our workplace as a place of meaningful work, we need to take accountability for creating it. Not the future, the now. We need to accept that we have created our working environment, and we continue to create it each day. 

So don’t mistake this post as a pity party.  No, I want to tell you about the positive aspects of my care.  Let’s talk about the two things performed by healthcare workers that made me smile; warm blankets and a joke.

During the pre-operative procedures and interviews, I quickly became cold in my paper-thin patient gown and grabbed the standard white blanket provided on my bed.  Not much better.  My wife began piling our winter coats on me, and when my nurse saw this she went to grab several blankets from the blanket warmer.  Not from the cabinet in my room where more cold blankets were stored… the blanket warmer.  That doesn’t sound like much of a feat, but if you’ve spent much time in hospitals, then you know the logistics of blanket warming technology.  Though we’ve put astronauts on the moon, we can’t seem to install more than one blanket warmer per floor of a hospital.  Hospital-based healthcare workers will also agree that the patients requesting warm blankets are always placed in the rooms furthest from the sole blanket warmer.  Go figure.  My nurse could have easily grabbed some cold blankets from the nearby cabinet, but she didn’t.  So for the trip to and from the far-flung blanket warmer, I thank you, Nurse Cammie.  You made me smile.

After several other interactions with employees who appeared to be on autopilot, my warm blankets and I were wheeled to the operating room.  A young surgery tech helped clear the hallway of wandering family members and unattended beds.  She smiled at us and joked about racing me to the operating room as she jogged ahead to clear obstacles.  At O’dark-thirty in the morning, no one would have blamed her for being just as uninspired as her co-workers.  But she wasn’t.  She chose to be awesome.  Thank you, happy surgery tech chick, you made me smile.

My experience as a patient reminded me how easily healthcare workers can fall into ruts and stop caring about the little things.  Perhaps they feel like the little things don’t matter because they aren’t part of that bigger than life childhood dream.  But the little things do matter, and they weren’t given to me by the surgeon, the anesthesiologist, or the hospital administrator whose shiny car we passed in the parking lot.  They were given by people whose healthcare roles are very similar to ours in EMS; brief parts in the grand scheme of a patient’s care that can be easily forgotten or greatly appreciated.

If you haven’t read the original post, go check out ”For EMS’ers, Is PA School Just the Next Thing to Do?”  Leave a comment or “Recommend” the post, then hurry on back here.  I’ll leave the light on for you.

Already back?  Good!

First, I agree that PA is a great goal for EMS providers, but it might be a pipe dream for the average paramedic with 5 years of street experience at McAmbulance. Here’s where I see obstacles for most:

1. Many will get tripped-up with the PA school entrance requirement of having a 4-year degree. It’s a damn costly endeavor. I’m still paying off mine, and will be for a while. Few McAmbulance operations are giving tuition reimbursement for employees to pursue a degree beyond the Associate’s degree they probably already earned with their paramedic courses.

2. Even if your employer pays for your 4-year degree, it will be a benefit to full-time employment only.  Ever try keeping your full-time job, family, and personal health together for several years while maintaining an “A” or “B” in Organic Chemistry and a handful of other prerequisite courses?  It’s something I’ve seen done, but only by a few high performers.  And I mean truly gifted people.

All that being said…
Going from paramedic to PA is entirely possible.
I’ve watched others do it.
They are very happy now.
You can do it, but it will be very challenging.
Here are a few tips. 

Second, there’s a bigger issue that needs to be addressed here.  That issue is our collective lack of career development.  As Skip Kirkwood so often points out in his writing, our law enforcement and fire/rescue peers have a dozen different career paths to take within their departments.  Since 2008, he’s been preaching that we need to develop career breadth for medics whose aspirations may not involve supervision.

Too many talented people leave EMS because we give them a job (something to do for a while) but fail to offer them a profession (something to pursue for decades).  As Bob Sullivan suggests, maybe they leave to become PA’s. Perhaps they depart to become RN’s or MD’s.  Regardless, they’re leaving and we need to address that.

 Sias’ story is uncommon with respect to his career development.  It’s normal for some new EMT’s to follow a non-EMS trajectory and eventually become career law enforcement, firefighters, nurses, PA’s, or doctors.  Less common are the EMT’s who become coroners or morticians.  Out of my hundreds of emergency service friends, I know of only two who pursued that path.

Going into the book, I had the preconceived notion of it being a collection of morbid stories that would depress even seasoned EMS providers. Despite the darkness of the cover and title, this isn’t the case.  Sias weaves together several dozen short memoirs with a light and humorous writing style that engages readers to follow him through his pursuit of providing for a patient or family’s needs.

 I enjoyed reading this book and even had the opportunity to talk with Sias on Medical Author Chat with Greg Friese.  Be sure to check out that interview and pick up the book!

A while back I told readers about my opportunity to meet EMS celebrities at this year’s EMS Expo in New Orleans.  One of those celebrities was Greg Friese.  I’ve been a stalker big fan of his for a while now, and I had a ton of questions for him.  Among the questions were…

My EMS Book Review for November is another great offering from The Social Medic in You Called 9-1-1 For What? by Dave Konig. 

 True to Social Medic form, he’s published this gem solely in e-book format.  Not only does this give the reader universal accessibility when using the free Kindle Cloud Reader, but it also offers the dynamic content of hyperlinks to some of these hilarious 9-1-1 calls.

 Many of the calls are related to law enforcement, with a few medical issues thrown in for good measure.  Reading about these asinine requests made of law enforcement made me thankful for my career choice of EMS.  Selfishly, I wanted to read mostly about Fire & EMS “emergency” calls, but that may be something he’s saving for Part 2.

 This humorous compilation is the perfect companion for your next posting assignment on the corner of Boring St. and My Back’s Killing Me Ave.  The icing on this sweet offering is that it’s only a buck on Amazon.  OMG, BBQ!

Skip Kirkwood is the Chief of Wake County EMS in North Carolina, and the current president of the National EMS Management Association.  His EMS resume spans about 40 years, with accomplishments too numerous to list here.  He taught the preconference session “Developing and Managing the Emergency Medical Services Field Training and Evaluation Program.”  I took the two-day course and it was amazing, but I’ll save that for another post.  We had dinner at a great little restaurant called Cochon, which I highly recommend if you’re in New Orleans’ Warehouse District.

I’ve been learning from Skip’s articles and podcasts for several years now.  Saying that he has a wealth of knowledge about EMS management is an understatement.  If you ever have a chance to sit down with him, take notes.  Take lots of notes!

A few of my favorites from Skip…

• Graduate Degrees: Are They Worth It for EMS?
• Violence Against EMS Providers: What Can We Do About It?
• Being the Best We Can Be
• EMS Continuing Education Lacks Creativity
• Finding the Future EMS Leaders
• Field Training Evaluation Program: EMS Educast Episode 138
• Back to School: EMS Educast Episode 63

Greg Friese is the Director of Education for CentreLearn Solutions LLC, the author of EveryDayEMSTips.com, a contributor to EMSEducast.com, and a recipient of the Innovators in EMS 2010 Award.

Greg inspired me to start blogging, and introduced me to Dave Konig when I was ready to launch my site.  His podcast with Rob Theriault and Bill Toon also gave me weekly inspiration when I first started in EMS education.

My favorite’s from Greg…

• CentreLearn (if you’re a training manager, you need this!)
• EMS Educast (subscribe today, be a better educator tomorrow!)
• Everyday EMS Tips (pretty much the entire site!)

Skip & Greg, you guys are awesome!  Thank you for your advice and inspiration, and thank you for your contributions to EMS.