You're getting ready for another shift. You fill your thermos with coffee, iron the uniform you forgot in the dryer, clip your ID to your shirt, slide your glove holder on your belt and head out. Did you realize this would be your last day in EMS?
Preparation is one of the key words in emergency care. Crew rosters are arranged weeks or months in advance. Preventive maintenance is routinely scheduled for rigs and equipment. Before every shift, rig lights, flashers and beacons are checked, defibrillators are charged and tested, glucometer readings are recorded and oxygen levels are checked. After the shift, any equipment that has been used is cleaned and stowed, supplies are recounted and restocked, and the rig is washed, fueled and made ready for another day.
Being unprepared in EMS is bad for patients and bad for business; that's one of the reasons organizations plan and prepare so extensively. From the CEO's office to the medical director's desk, successful companies plan for positive outcomes. Their business goals reflect trends in politics, nationwide healthcare changes and community needs. The plans incorporate changes in working relationships with other first-responder agencies through mutual aid, SWAT and hazmat. Plans are passed down to employees through changes in policies and procedures. Patients are part of the changes when they're affected by response times, protocol changes, transfer guidelines and insurance and Medicare coverage.
As EMS providers, we prepare ourselves by attending classes to get new certifications, tracking CEUs to maintain our proficiency, memorizing protocols and practicing scenarios at training sessions, and reading EMS journals about trends in prehospital care.
However, there's one important event to which many of us haven't given much thought. Although we may be well prepared for every day in EMS, some of us are completely unprepared for our last day in EMS.
Sure, we all know that everyone has a last day in the business. It's just common sense--everyone has to leave EMS sometime. We've seen it happen to other people: They get hurt, develop a serious illness, have a conflict with the boss or make a serious error in patient care, and suddenly that person's name is no longer on the shift schedule. They're out of EMS.
Sometimes leaving EMS happens to more than one person at a time. A fact of EMS life is that sometimes companies go out of business, change owners or reorganize, and all the employees lose their jobs. Many of those employees didn't expect anything to happen and don't have a plan for their future. They didn't realize, when they went to work that day, that it would be their last day in EMS. Although they may have been well prepared for their role in prehospital care, they were not prepared to work in another job when EMS stopped being an option.
Imagine, just for a moment, that you can't work in prehospital care any longer. You have just had your last day in EMS. What would you do? Your options will be determined in large part by the reason you are out of work.
Reasons for Leaving EMS
If you are injured on the job, you will probably be eligible for disability pay, but do you know what portion of your wage you will receive and for how long? Does your disability coverage start as soon as you're injured, or do you have to supplement your hours with personal time or sick days? Will your disability check pay your bills? Does your company have a retraining program or a policy of placing injured employees on light duty or restricted work? If your injury is permanent and you can't go back to working the street, is there another place for you in the company? Have other employees with work-related disabilities been transferred to permanent positions?
What would happen if you were injured outside of work? If you have a serious car accident or fall off your roof, will you have any disability coverage through other insurance? How long would your organization hold your job for you if your return to work was delayed?