EMS' Dirty Secret
People who make EMS happen are big-time givers who too often don't take what they need out of life.
- Related Links:
- Podcast with author Thom Dick
- Forum Thread: Vol. or paid (yes, here we go again)
- Forum Thread: EMS' Dirty Secret
- Oct. 2007 Editorial: EMS' Dirty Secret
People who make EMS happen are big-time givers who too often don't take what they need out of life. They tend to care for others at the expense of those who love them most.
We got that message again and again from EMS providers who either contacted us in response to Nancy Perry's From the Editor column in the October 2007 issue or answered our calls since that article appeared.
Nancy's column was entitled EMS' Dirty Secret: Are You Paying the Price for Being In EMS? The editorial congratulated EMS Magazine's 2007 award winners, but noted that many of the nominees seemed to be volunteering in addition to working two or three jobs. It speculated about how difficult that must be for families and significant others. And it asked whether we should continue to congratulate ourselves for what appears to be an unhealthy lack of balance. The question was good, and the observation sound enough. Unfortunately, the answers are anything but simple.
HEARTACHE IN THE HEARTLAND
Let's say you're a shift supervisor for a small emergency service in a large geographic area, and tomorrow morning one of your people calls in sick for a shift. You have no way to anticipate the call-in until it occurs--an hour before shift change. You and the offgoing crews are exhausted, and nobody wants to come in on short notice. But we're not talking about building somebody a deck, here--that could wait a day or two. Ambulances need to be staffed, period. What can you do?
No matter how well run they are, small services simply don't have the flexibility of their larger counterparts--especially when it's reduced to the finite whole numbers that make up every schedule. With a little luck, somebody will fill in for at least part of the shift. But when that doesn't happen, supervisors routinely subordinate the rest of their lives and run calls.
That would be bad enough, but there's much more. How do you stay balanced when, despite your limited (or nonexistent) clerical support, you are expected to cope with the endless meetings, public expectations, organizational priorities, inspections, recert deadlines, license renewals, safety issues, customer concerns and personnel matters that are all part of providing EMS? In a small agency, you have two options. You can blow off some of those obligations. Or, you can borrow even more time from the people who share your personal life and free up more time for work. (Of course, if you choose the latter option, you may still fail to meet some obligations.)
Now, imagine a complaint comes in. Or maybe one of your crews has a vehicle failure, collision or injury. Those are all surprise events that demand an immediate response and consume 100% of your attention until they're resolved. If you're blessed with great people, you don't get many surprises. But even the best people make some mistakes.
If you don't have great people, and you can't find or attract them, here's some really bad news: Protecting your own balance may mean relocating your family--or getting out of EMS altogether. The June 2006 Institute of Medicine Crossroads report on EMS acknowledged officially what American EMS practitioners and their leaders have been saying for years: This problem is much bigger than we are.1 The role of EMS in the United States is underfunded, under-supported and underappreciated--at least until an incident occurs. According to that report, EMS has received precious little of the billions of WMD dollars allocated for our emergency responders since 9/11.2 It's like we don't even exist. And there does not seem to be a great likelihood of increasing attention to EMS if we do not force the issue.
