It's Brewster again! You pull into your station's parking lot and there's his ratty brown Jeep. Your regular partner, Jenny, is on vacation, and you've been working with partners du jour for the past three weeks. But this guy's such a load. He works full time for an air service and nearly full time for your agency as a second job. He's always tired—too tired to clean the rig, too tired to run 12-leads, too tired to do physical exams, too tired to do this and too tired to do that. And he always looks like crap, from his disheveled hair to his scruffy boots to his wrinkled uniform. Worst of all, sometimes he smells as bad as he looks.
You've talked to your captain, and so have your colleagues, but your agency can't seem to control its turnover. They'd rather bring in what's left of Brewster than pay overtime for a real, live paramedic. To them, Brewster is just a plug in a leaky schedule.
Sure enough, your first call is for a cardiac arrest, and you and the first responders practically have to drag him through the run. Grrr! You're an EMT. You don't get paid to shoulder this guy's responsibilities. You've had enough.
Q. Brewster is a slug, that's all; he has no respect for himself or his profession. One of these days his laziness is going to cost somebody's life, and our leadership doesn't seem to care. What can I do?
A. This is a really common dilemma, especially today. I am wondering, was this guy ever a good paramedic? If not, maybe he really needs somebody to free up his future. But if he was a good medic, he's worth some trouble. These are terrible times for a lot of EMSers who were barely making it even before the economy tanked. It seems important to know why Brewster feels compelled to work so much.
Q. Nobody seems to know much about Brewster's personal life; he never really talks about it. He was a really good paramedic for 10 years. But that all changed about two years ago, and ever since then he's been worthless.
A. So this is somebody who was a good paramedic at one time. (Good paramedics don't grow on trees, and, in the span of 10 years, he must have helped a lot of people.) Then there was an identifiable turning point, and nobody thought, hey, maybe something bad happened to this guy? Now he's working way too much and acting like a burnout. It sounds like he's in trouble. Has anybody asked him what's going on? I mean, one on one? Maybe after all those years of service he deserves better than a few shrugs and a bad rep.
Q. How can you help somebody who doesn't care about what he's doing? Brewster knows better. But he just shows up, puts in his time and collects his pay. Nobody respects him.
A. We spend our lives taking care of people we don't know. We risk our safety for them, our sanity and our families' security. We sometimes go to great lengths to figure out why they call us for no apparent reason. (Some calls seem really stupid, right? But people always do what they do for a reason.) Yet, when one of our own manifests signs of crisis that we would consider significant in a patient, we go deaf, dumb and blind. Scheduling is an important job, and it's not just about putting names in the spaces on a calendar. People are valuable, and people who write schedules know important things about them. Like the rest of us, they need to be observers, analysts and advocates.
Q. That's all true, but I'm a neophyte in my system. I have a fraction of Brewster's experience. I'm not the only one who sees him as a slug; everybody does. What's a bottom-rung EMT going to do about his situation?
A. Accurate assessment isn't based on a popular vote, nor is it always about who has got the most experience. Like the kid in the fairy tale about the emperor with no clothes, you respond to what you observe, not what everybody else expects you to observe. The longest journey begins with the first step. Take that step, and talk to this guy. Ask him if he's OK, and tell him you're worried. Then, take another step. Tell somebody with a little more authority than you have.
Sadly, it may be the first reminder they've had in a very long time.
Thom Dick has been involved in EMS for 39 years, 23 of them as a full-time EMT and paramedic in San Diego County. He is the quality care coordinator for Platte Valley Ambulance Service, a community-owned, hospital-based 9-1-1 provider in Brighton, CO. Thom is also a member of EMS Magazine's editorial advisory board. Reach him at email@example.com.
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