I was thinking about the name of this blog today, and it made me chuckle. When I started the blog, it was 2006, and I was most certainly burned out. I enjoyed being there for people who needed us, and I took a lot of pride in how responsible and competent I tried – tried – to be. But I was tired. Tired of going on 12 runs every night. Tired of stupid partners. Tired of dickhead patients. Tired of interagency squabbles. It’s funny how easily everything irritates you when you’re irritated to begin with.
Five years later, I still enjoy being there for people who need us, and I still take a lot of pride in how responsible and competent I’m trying to be. I’ve learned to politely explain my very simple expectations to (especially new) partners with whom I haven’t worked at the beginning of the shift, and for the most part they humor me and don’t disappoint. I spend a lot of time trying to teach patients and their families the important but overlooked things so they don’t keep calling for simple problems anyone should be able to handle at home.
I am still tired, but it seems to be different things now that I’m tired of. I’m really tired of the overuse of oxygen and spinal immobilization. I’m tired of how my paperwork has to be because of lawyers and judges who don’t tell stupid plaintiffs to fuck off. I’m tired of stupid policies because of the fear of these potential litigants and the legal professionals who don’t have the intestinal fortitude to tell them they’re abusing tort law. I’m tired of the lack of disposition options – either receiving hospital or not, nothing else – afforded us on many of these calls. I’m tired of the paradigm of customer service that prefers that we don’t tell patients they’re being stupid. I’m tired of seeing precordial leads placed incorrectly, no matter how plainly you explain that there really is only one way to do it, at least in male patients. I’m tired of cocky new EMTs and medics whose only reason for being in this profession is to get into the fire service and are thus dismissive of EMS work and the people who do it.* Cognitive dissonance – I know.
My attitude toward work has changed, I think, partly also because of a partner I once had. I think that in trying to worry less about the usual stressors, my focus has also become more directed toward clinical issues, particularly how to influence newer folks on how to apply critical decision-making skills in the less-than-ideal field settings and appear less like idiots at the hospitals. EMS has always had a fairly high turnover in personnel, and the dilution of skills and experience levels is a constant problem, certainly not helped by the people who use EMS to transition to the fire service. Over the past few years, EMS 2.0 has shown a lot of promise in using the internet to accomplish a lot of things, including – most importantly, to me – continuing education.
Time does fly, doesn’t it?