One year ago I caved in to peer pressure and joined Facebook. A few weeks after learning new definitions for friend and friend of friend, I got my first instant message--ever. (Yes, I'm a technological Neanderthal who still equates IM to an invasive procedure that once prevented polio.) The perpetrator was Danny, one of my partners. He typed something innocuous like, "Good morning, Mike," which is much better than "Where are the keys, Mike?" I was returning Danny's greeting when he sent another message. I had to delete my original reply and type something more appropriate. That happened several times. The whole process was a lot more labor-intensive than an old-fashioned conversation.
I mention that early Facebook encounter because, like you, I've read reports of EMS personnel disciplined or dismissed for allegedly revealing inappropriate material about patients and employers. Bad-mouthing bosses might not be a big deal--it happens in every firm with more than two employees--but posting patient data crosses the line ethically, if not legally. I think the issue is the limits, not the capabilities, of technology. Do we really believe we can substitute software for civility? For sensibility?
In the days before e-mail--way back in the '80s--it was hard for employees to promiscuously publicize business matters. Confidentiality wasn't guaranteed, but workplace chatter was a comparatively benign, small-group phenomenon, marginalized by the practical limits of verbal exchanges. Now we have Send buttons, which give us the means to broadcast, at the speed of light, spontaneous remarks that are, at best, entertaining, and occasionally career-threatening.
Products like Facebook and Twitter turn brief, casual comments into intergalactic gossip. Those two megafranchises are supplemented by thousands of smaller websites--dozens of them EMS-oriented--that facilitate stream-of-consciousness diatribes against public figures, patients, employers, coworkers, acquaintances, friends and family members. Here's a sample from an online fire/EMS bulletin board serving a county close to an anonymous northeastern city (one with subways, very tall buildings, famous bridges and excellent cheesecake):
"Who do we hate the most, we hate you [agency name deleted] Firefighter! We hate you because you spew spineless drivil [sic] here on this site...because your Chief's [sic] are quitters, and your Commissioners are jerk offs, Because you embarrass firefighters all over...by airing your dirty laundry... [agency name deleted] is an embarrassment, so stop with the tick tock BS, and the I love pizza and woe is me [agency name deleted] was a great department crap. You suck plain and simple, your quitter Chiefs suck and your Commissioners suck. That is one department that needs to be shutdown [sic] by the State and consolidated into the neighboring departments, then sell off the 'Taj Mahal' catering hall."
Would you hire the author of that tirade? I'm asking because I've actually had people contact me privately, looking for work, after posting four-star nutties like the one above. I get the impression many people don't consider the consequences of propagating such malice.
When I was growing up, we were more careful about saying silly stuff in public. If we felt the need to vent, we usually did so to close friends with no one else around. It's possible to do the same online using e-mail or private messages, but today's electronic media make it too easy to rant and offend. Sites offering screen names are the most provocative; participants have a free pass to cross boundaries that govern conventional communication.
Our industry takes a step backward every time careless, coarse language tarnishes patients' perceptions of who we are and what we do. If you think the public has little or no access to our outbursts, use the search engine of your choice to look up Do paramedics make good money? When I do that, I get:
"The base pay for medics is crap... most of the time. If your [sic] work a dangerous area you'll get paid better, but you'll still be working long hours (I'm an EMT-B, I work 24 hour shifts.) for little pay... If you want to be a medic you have to understand that it's a great job but it's long hours, low pay, ungrateful patients and a high burn out rate..."
Not exactly the sort of prose that makes "ungrateful patients" feel warm and fuzzy.
My experience with Facebook hasn't been all bad. I've become immersed in a culture once as foreign to me as Mesopotamia. Making friends no longer requires a rapport--just a computer and a pulse. And if our friends disappoint us--not surprising since we've never met most of them--we can unfriend them with a couple of mouse clicks.
Impressive, but what we really need is an Unsend key.
Mike Rubin, BS, NREMT-P, is a paramedic in Nashville, TN, and a member of EMS World Magazine's editorial advisory board. Contact him at firstname.lastname@example.org.