When Johnny Met Rosie--Women in EMS Part 1: Can You Do the Job?

"Please know that I am aware of the hazards. I want to do it because I want to do it. Women must try to do things as men have tried. When they fail, their failure must be a challenge to others." -- Amelia Earhart

I have always been a believer in "girl power." I've never wanted to hear I'm being restricted as a result of my gender. My comic books of choice were Wonder Woman and anything featuring the ladies of the hero world: Huntress, Batgirl, Supergirl, Storm--I wasn't picky. I can tell you that the first Wonder Woman played on TV was not the bodacious Lynda Carter but rather the more athletic Kathy Lee Crosby. I would read Nancy Drew over the Hardy Boys, and any jewelry I wore had to look like an ankh so I could turn into Isis at a moment's notice. I am also grinning as I write this, knowing how many of you out there are nodding in agreement. So perhaps it's not a terrible surprise that I forged ahead into a traditionally male-dominated field.

Recently I informally polled a number of people about whether they'd rather work with a man or a woman. Their responses caught me off guard. Almost to a person, they said the same thing: "If they can do the job and don't make me crazy, then I don't care." When I entered this arena 25 years ago, it was not a gender-neutral environment. There were some women actively working paid BLS, some on ALS, and, depending on the agency, there were plenty to be found behind mics.

When I first came to Newark, there just were not that many women working there, ALS or BLS. Though it kills me to sound like a brachiosaurus howling from its tar pit, the rules were different then, or just evolving. Nobody wanted to hear about hostile work environments, harassment or equal opportunity. You put up with the crap and did the job, or you went somewhere else. Some of it was absolute crap, too: graffiti, name-calling, groping--heck, anyone working in a field like ours knows that most days (even now) we are a human-resources nightmare. Whatever you may think, those rough edges came with the territory. Operating in a realm where our psyches are assaulted by extremes on a daily basis, I am not saying anything new when I say people in emergency services just are not "wired right." It does not make this kind of behavior OK, but it does say something about how you have to learn to deal with it.

It was not just the atmosphere, either; there was the actual work environment. Cities are dangerous places to begin with, and a couple of decades ago there were factors that made them even more so. There was less communication, less technology, more high-rises, fewer police, more chances for things to go horribly awry. You could call for help, but that didn't mean it was coming, so you had to make your own solutions and deal with it.

A lift assist bought you an eye roll and at least a week's worth of ribbing. Showing fear got you a knowing nod, then shoved behind one of your male coworkers. With one violent patient, I got kicked out of my own ambulance, because I was the only girl there. Make the wrong clinical call, and you were made to feel like you'd just proven the stereotypes right: "She's just not up for it, I guess." Didn't matter, even when you didn't want to do it again--every shift you put your combat boots on and went right back out there.

While trying to deal with it, we discovered our secret superhero abilities. Lo and behold, it had everything to do with our gender. If you knew how to play your ovaries right, you had a downright advantage in many situations. A burly 6'2 man saying, "Hey, watch your language!" holds very little water. Let a woman say it, and watch the results. In many circumstances, if you do not exacerbate the situation, people are reluctant to get extremely confrontational with women. In a culture where you don't disrespect your mother, there's a lot women can get away with.

People are often less likely to see women as imposing authority figures. This gives them less fear and can make them more responsive to requests and more forthcoming in interviews, both of which facilitate good patient care. Plus, let's face it boys: For the most part, we've got the kid thing down. Even if we don't have children ourselves, pediatric patients are usually easier to soothe and work with for women providers. After all, who doesn't want their mommy when they're sick?

Then it was time to perfect our craft in an arena where we had to work harder just to be seen on the playing field. We had to confront it and learn to turn it into doing the job.

The Job

The responses in my poll generally had the caveat "if they can do the job." That gave me pause. What is "the job"? What does that mean, ladies? Are you thinking, I can find a vein in a rock and intubate infants without blinking and spot someone with rales across a room--of course I can do the job!?

Sorry, my pretty little pigeons, I'm going to set us back a few decades: It has nothing to do with your brains and everything to do with your bods. Knowing a person is sick is only half the battle. Getting them out is the other. To the people I spoke with, "Can you do the job?" means "Can you lift?". Can you take the other side of that stretcher, the head of that Reeves, the foot of that stair-chair? Can you get that patient to your truck without crippling yourself or your partner? Can you get out of a scene safely with partner and patient intact?

If the answer to those questions is an easy yes, you're in good shape. The rest then goes to your wit and intelligence, and it still has little to do with your medical knowledge or patient care skills.

"Can you do the job?" means "Can you drive?". Even if you're 5-foot-nothing, can you get behind the wheel of an ambulance and navigate it safely in all types of weather and on all manner of roads and in all kinds of traffic conditions? Can you monitor the radios, work the siren and still keep half an eye on the back in case your partner needs help? And even though most women are born without the genetic ability to parallel park (we gave it up to keep our hair), can you back that ambulance into a spot on the first try?

"Can you do the job?" means "Can you hold it together?". Can you ignore wolf whistles and comments from the crowd about how tight your pants are? Can you stand your ground and insist on doing something on behalf of your patient? Can you push forward even when you're failing miserably at a task that should be simple? Can you continue to function when the blood is pouring over your hands and everyone around you is yelling? Can you take that dead baby from your partner and take over CPR? Or will you freeze like a deer in the headlights and let the tears flow? Sounds horribly melodramatic, I know, but it's the same burden every person (not just women) in this field fights against.

"Can you do the job?" means "Can you accept that things may get bad?". Do you enter a scene with a good grasp on basic safety issues? Do you communicate well with your partner? Do you recognize potential threats and work with them in mind? Can you read a scene and know when it's time to back off? If things get ugly (violent), do you have at least an idea of what you need to do?

"Can you do the job?" means "Are you willing to be dirty?". This job is at times putrid and disgusting. You may have to go to ground on a terrain glistening with primordial ooze to the sound of skittering insects, just to secure a person's airway before they die. Can you pick up the odd body part without retching, and can you help a person covered with poo recover some of their basic dignity by pretending it doesn't smell or bother you? The saying goes, "He who hesitates is lost." In our line of work, we aren't usually the ones who lose out if we hesitate.

"Can you do the job?" means "Can you think on your feet?". If you don't take charge of your scene, someone else will. Can you step up and make decisions, then follow through? Can you look over an environment and interpret all those details into a comprehensive picture? Or do you rely on your partners or medical control to make decisions for you?

And before any of my lady friends take umbrage at any of this, take a minute and think--if none of this applies to you, do you know someone to whom it does?

Conclusion

We did learn to deal with it, and then overcome it, and then excel at it. In the early days of my career, that small core group of women (we were referred to as the "inner circle") hung in there. We screwed up, we got hurt, but we learned. We learned how to lift, how to drive, how to get ourselves out of situations without help. We studied, we went to school, and not once did we ever let ourselves feel second. Of that small group of women I worked with when I started, almost all of them went on to be phenomenal EMTs, paramedics, flight medics, nurses and physicians.

Skills can be learned and mastered with practice, but they represent a small portion of what the actual "job" of EMS is. Men, please do not feel left out--all these same traits and abilities apply to you as well. You simply have a less-staggering stereotype against which to climb.

So the next time you sigh heavily and pull on those combat boots, look at yourself in that unforgiving uniform and smile--because every day you go to work, you are doing something many people (both men and women) never will. You are going to do "the job."

This piece (and those to follow) is dedicated to those women I had the distinct pleasure to work with and learn from. I have spent some of the best times of my life and my career with them and it is my profound honor to know them as friends and professionals. Some of them include Maria (Cartagena) Molner RN, Sara (Williams) Crellin MICP, Meg Welton RN, Sioban (Rooney) Opperman EMT, Christine (Karan) King MICP, Deborah Ehling MICN, Nancy (Souza) Orlowski RN FP, Myrna (Ramirez) Bonin MICP, Tammi Schaeffer MD, Det. Joanna Rak, Jen Erickson MICP and Charlene Barber MICP. I will be cliche when I say, "We've come a long way baby!" Thanks for being there.

Tracey A. Loscar, MICP, is the training supervisor in charge of QA at University Hospital EMS in Newark, NJ. Contact her at taloscar@gmail.com. To hear more from Tracey on the issue of women in EMS, listen to the September edition of the EMS Squadcast, a podcast series dedicated to discussions relevant to the world of EMS today.

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